Biogen Shifts Zurzuvae Strategy as OB/GYNs Become Key Players in Postpartum Depression Care.

As Biogen approaches the two-year mark since the approval of its postpartum depression (PPD) treatment Zurzuvae, the company is adjusting its strategy based on real-world insights into how the drug is being prescribed. Initially, psychiatrists were assumed to be the primary audience for the medication. However, Biogen quickly realized that obstetricians and gynecologists (OB/GYNs) are actually leading the charge in identifying and treating PPD.

Lawrence Wai, head of Biogen’s U.S. neuropsychiatry franchise, explained in an interview with BioSpace that while postpartum depression is often associated with mental health specialists, the nature of the disorder means that any doctor who first encounters symptoms has a responsibility to intervene. Since most new mothers remain under the care of OB/GYNs during and immediately after pregnancy, these specialists are often the first to notice signs of PPD.

Wai highlighted a popular analogy used by psychiatry educators—a meme showing three versions of Spiderman pointing at each other—to emphasize that OB/GYNs, women’s health providers, and primary care physicians all share responsibility for managing PPD rather than deferring it to another specialist. “That really captures the critical urgency of this market,” Wai said.

A Challenging Launch and Market Response:

Zurzuvae was approved in August 2023 specifically for postpartum depression, rather than for the broader major depressive disorder population that Biogen and partner Sage Therapeutics had initially hoped to target. Despite these limitations, Biogen reported $28 million in sales during the first quarter of 2025, with 10,000 women treated since the launch.

Biogen CEO Chris Viehbacher shared during the company’s earnings call in May that about 80% of Zurzuvae prescriptions came from OB/GYNs during the first quarter. The number of physicians prescribing the drug also rose by 20% in that period. This data underscored a key lesson: OB/GYNs are vital in the diagnosis and treatment of PPD, perhaps even more so than psychiatrists.

Viehbacher described a “virtuous cycle” in which positive patient responses to Zurzuvae encourage more doctors to actively screen for and treat postpartum depression. “It’s encouraging to see repeat prescriptions and physicians gaining confidence in proactively diagnosing PPD,” he noted. Because Zurzuvae is typically a one-time 14-day treatment, Biogen’s efforts focus on educating doctors to continuously identify new patients who could benefit.

Focus on the ‘Fourth Trimester’:

Data gathered by Biogen reveal that most PPD diagnoses happen within the so-called “fourth trimester” — the postpartum period when women return for checkups with their OB/GYN. Outside of this window, the likelihood of diagnosis and treatment drops sharply, Wai explained. This decline is partly due to fragmented care once mothers leave the OB/GYN’s practice and the difficulties in securing timely psychiatric appointments.

“Once the patient walks out of the OB/GYN office, who knows what’s going to happen,” Wai said. With this insight, Biogen is focusing its efforts on OB/GYNs as the primary line of defense against postpartum depression, though family care physicians also have a role when mothers present symptoms in their practices.

Real-World Impact and Overcoming Stigma:

Biogen has invested in educating OB/GYN practices, which are often busy and high volume, to raise awareness about Zurzuvae and how it differs from traditional selective serotonin reuptake inhibitors (SSRIs). Wai recalled an instance where an OB/GYN initially dismissed Zurzuvae as just another SSRI. Upon learning that Zurzuvae is a distinct medication with a rapid onset of action—often providing symptom relief within three days—the physician became interested enough to request a full educational session for the entire practice.

The feedback from prescribers has been largely positive, with real-world experiences aligning closely with the clinical trial data that supported Zurzuvae’s approval. This consistency is notable, as new drugs sometimes fall short of expectations after launch.

However, the challenges of diagnosing and treating PPD remain steep, especially due to persistent stigma. Wai shared a poignant story of a physician who lost a patient to postpartum depression following a difficult pregnancy complicated by hypertension and gestational diabetes. The patient took her own life a week after delivery, despite the doctor’s best efforts in managing her physical health. This tragic case deeply affected the physician, motivating her to pursue mental health certification to better support future patients.

OB/GYNs must often read between the lines to identify PPD, as many patients suffer quietly or mask their symptoms. “Many women say they feel overwhelmed, which doctors might dismiss as normal after childbirth,” Wai said. But in truth, “overwhelmed” can be a subtle cry for help, and recognizing these clues is critical to breaking through stigma and ensuring timely treatment.

Looking Ahead:

Biogen’s experience with Zurzuvae underscores the complexity of addressing postpartum depression. It requires a collaborative approach across multiple medical specialties, with OB/GYNs playing a pivotal role in early detection and intervention. Through continued education and targeted outreach, Biogen aims to sustain the momentum it has gained in this “all of the above” market—helping more women access effective treatment and reducing the stigma that so often silences them.