Zurzuvae (zuranolone) — Point32Health

Initial criteria

• Documentation of moderate to severe postpartum depression (PPD)
• AND Documentation that patient is postpartum for 12 months or less at the time of request
• AND Onset of depressive episode is between 3rd trimester and 4 weeks following delivery documented by standardized rating scales such as Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS), Quick Inventory of Depressive Symptomatology (QIDS), or Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria
• AND Documentation that patient has not responded adequately to a trial of an oral antidepressant, or clinical rationale that trial of an oral antidepressant is not appropriate due to severity of depression (clinical documentation required)
• OR Patient was recently started on the requested medication in an acute care setting, residential setting, or partial hospital setting
• OR Patient lives in or the prescribing provider's office is located in Maine

Approval duration

14 days