United States: New Specifics aimed at easing menopause symptoms like hot flashes have lately entered the Despite their implicit benefits, numerous women face significant walls due to insurance companies’ disinclination to cover these medicines or the demand to try volition treatments first.
Insurance Hurdles
Alina Salganicoff, Senior Vice President and Director of Women’s Health Policy at KFF, emphasizes the difficulty women face in penetrating these specifics. She notes,” it’s not like a croaker can write a tradition and you go to the drugstore and pick it up.” The high cost of new medicines frequently leads insurance plans to deny content, leaving women at the mercy of health insurance companies.
Innovative Nonhormonal Treatments
Traditionally, hormone replacement therapy has been recommended during menopause. However, this option is not viable for all women, particularly those with breast cancer. The new medications, such as elinzanetant and fezolinetant, offer nonhormonal alternatives.
Elinzanetant: Developed by Bayer, this drug has shown significant reductions in hot flash frequency and severity in clinical trials by targeting brain receptors NK-3 and NK-1, which control body temperature, mood, and sleep.
Fezolinetant (Veozah): Approved by the FDA last year, this medication specifically targets the NK-3 receptor and has demonstrated effectiveness in reducing hot flashes for over six months.
The Menopause ‘Moment’
Menopause, affecting a significant portion of the population, is gaining more public attention. Celebrities like Halle Berry have openly discussed their experiences, helping to destigmatize the condition. Dr. Rajita Patil from UCLA Health acknowledges the increased awareness but stresses that menopause care advancements should have occurred much earlier.
Insurance Coverage Issues
Insurance providers remain hesitant to cover newer menopause treatments. For example, Kaiser Permanente requires women to try at least two non-FDA-approved medications before authorizing Veozah, which can cost up to $550 per month. These alternatives may include off-label uses of antidepressants or painkillers, which are not specifically approved for managing hot flashes.
Dr. Stephanie Faubion of the Mayo Clinic Center for Women’s Health criticizes this practice, stating, “Before they receive a medication that is FDA-approved to treat hot flashes, women are being asked to try drugs that are not specifically approved for the management of hot flashes.” This situation frustrates both patients and providers, as noted by Dr. JoAnn Pinkerton from the University of Virginia School of Medicine.
Future Prospects
The cost of elinzanetant remains undisclosed until FDA approval. Analysts predict it could be as expensive as or more than Veozah, potentially continuing the cycle of insurance-related access issues for women in need of effective menopause treatments.