CurrentCentenePolicy N/A

Clinical Policy: Zuranolone (Zurzuvae)

Defines medical necessity criteria, prescriber requirements, dosing limits, approval duration, and exclusions for Zurzuvae (zuranolone) for treatment of postpartum depression across Centene lines of business (Commercial, HIM, Medicaid).

Policy Summary

PayerCentene

PolicyClinical Policy: Zuranolone (Zurzuvae)

Policy CodePolicy N/A

Change TypeRevised (annual reviews 2Q 2024, 2Q 2025)

Effective DateDec 1, 2023

Next Review DateN/A

Key ActionProvider must submit documentation (office chart notes, lab results or other clinical information) supporting that member has met all approval criteria.

POLICY UPDATE CHANGES

Added obstetrician-gynecologist as an additional prescriber specialty and specialist that can perform a clinical interview to confirm severe depression; added BDI and EPDS scales as additional methods to identify severe depression.

Updated dosing regimens and removed commercially unavailable branded therapeutic alternatives in Appendix B per Clinical Pharmacology; references reviewed and updated.

1FDA-approved indication (PPD)

14Maximum treatment course (days)

50 mgMaximum daily dose

12Postpartum eligibility window (months)