New Menopause Drugs Offer Relief from Hot Flashes, Newly developed drugs aimed at relieving severe menopause symptoms. such as hot flashes, have recently been introduced, offering hope to many women. However, doctors report that insurance companies are often unwilling to cover these costly medications or require women to try less effective alternatives first, leaving many with substantial out-of-pocket expenses.
Challenges in Accessing New Treatments
“It’s not as simple as getting a prescription and picking it up from the pharmacy,” says Alina Salganicoff, senior vice president and director of women’s health policy at KFF. “New drugs are expensive, and insurance plans are often hesitant to cover them.”
Innovative Nonhormonal Options
While hormone replacement therapy (HRT) is commonly used to manage menopause symptoms, it is unsuitable for some women, such as those with breast cancer, due to the risk of exacerbating their condition. The latest treatments, however, are nonhormonal.
Bayer’s new drug, elinzanetant, has shown promise in reducing both the frequency and severity of hot flashes by targeting brain receptors NK-3 and NK-1, which regulate body temperature, mood, and sleep. Clinical trial participants reported improved sleep and enhancements in overall quality of life.
Dr. JoAnn Pinkerton, who led one of the elinzanetant trials, noted its effectiveness in reducing hot flashes and improving sleep. Bayer plans to submit the drug for FDA approval this year. If approved, elinzanetant would join fezolinetant (Veozah) by Astellas, which targets the NK-3 receptor and has been found to reduce hot flashes for nearly six months.
Growing Awareness of Menopause
Menopause is finally gaining public attention, with celebrities like Halle Berry vocalizing their experiences and advocating for better care. Earlier this month, Berry publicly declared, “I’m in menopause!” at a Capitol Hill event supporting a new congressional bill to enhance menopause care.
Despite this increased awareness, insurance companies remain slow to cover newer treatments. For instance, Kaiser Permanente requires women to try two other non-FDA-approved drugs for hot flashes before they can access Veozah, which costs over $550 monthly. These alternatives often include off-label uses of medications like gabapentin or Effexor.
| Topic | Details |
|---|---|
| Growing Awareness of Menopause | |
| Public Awareness | Increased recognition of menopause and its symptoms. |
| Education | More educational resources available for women about menopause. |
| Healthcare Discussions | Encouragement for women to discuss menopause symptoms with healthcare providers. |
| Workplace Policies | Implementation of menopause-friendly policies in some workplaces. |
| New Menopause Drugs | |
| Drug Development | Introduction of new medications specifically targeting menopause symptoms like hot flashes. |
| Clinical Trials | Positive outcomes reported from clinical trials, including better sleep and quality of life improvements. |
| Accessibility | Availability of new drugs to the general public. |
| Relief from Hot Flashes | |
| Symptom Relief | New medications effectively reducing the frequency and severity of hot flashes. |
| Patient Testimonials | Women reporting significant improvements in daily comfort and function. |
| Insurance Barriers Persist | |
| Coverage Issues | Many insurance plans not fully covering the cost of new menopause drugs. |
| Out-of-Pocket Costs | High out-of-pocket expenses for women seeking these treatments. |
| Advocacy for Coverage | Growing calls for insurance companies to include menopause drugs in their coverage. |
| Healthcare Inequity | Disparities in access to new treatments based on insurance status and socioeconomic factors. |
The Frustration of Limited Access
“Women are being asked to try drugs not specifically FDA-approved for hot flashes before getting an FDA-approved treatment,” says Dr. Stephanie Faubion, medical director of the North American Menopause Society. Dr. Pinkerton notes that many healthcare providers feel limited in prescribing the most appropriate medication for their patients because of these insurance barriers.
Bayer has yet to disclose the cost of elinzanetant, but analysts predict it could be as expensive as or more than Veozah.
Impact on Women’s Lives New Menopause Drugs Offer Relief from Hot Flashes
Cindy Laughery, a 60-year-old nurse, began experiencing hot flashes and sleep disturbances six years ago. She represents the many women whose quality of life could greatly improve with these new medications. Provided they can overcome the financial and insurance challenges
FAQs: New Menopause Drugs Offer Relief from Hot Flashes, but Insurance Barriers Persist
What are the new drugs available for treating hot flashes in menopausal women?
The latest drugs for treating hot flashes include medications such as fezolinetant and elinzanetant.
Do these new drugs also help with other menopausal symptoms?
Primarily, these drugs are designed to target hot flashes. Some patients might experience improvements in related symptoms. But they are not specifically indicated for treating other menopausal symptoms like mood swings or vaginal dryness.
Why are there insurance barriers for these new menopause drugs?
Insurance barriers exist because these medications are new and may not be included in all insurance formularies. Additionally, insurance companies might consider them as non-essential or elective treatments, leading to limited coverage.
What can women do if their insurance does not cover these new medications?
Women can appeal to their insurance companies, provide documentation from their healthcare provider about the necessity of the medication. Or explore patient assistance programs offered by pharmaceutical companies.
How much do these new drugs cost without insurance coverage?
The cost of these medications can be high without insurance. Often ranging from several hundred to over a thousand dollars per month. Prices vary depending on the specific drug and dosage.
What should women consider before starting these new menopause drugs?
Women should review their complete medical history, current medications. And symptom severity with their healthcare provider to determine if these new drugs are suitable for them. They should also consider the cost and potential insurance challenges.