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US: Report reveals striking gender device in prescription medication spending

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Women shoulder a significantly greater out-of-pocket cost burden than men when it comes to prescription medication spending, according to a US report.

The data shows that in 2024, women spent $8.8 billion – or 30 per cent – more than men on out-of-pocket prescription costs.

Combined with the common responsibilities of managing a career, family planning, and caregiving, women are left frustrated with the financial pressure required to maintain their health.

 

Though the “pink tax” is often thought about as higher prices on consumer goods, the research suggests that it also manifests itself in the hidden costs of healthcare.

Higher healthcare utilisation, higher rates of chronic conditions, and spending on female-specific conditions like women’s fertility and menopause contribute to this imbalance.

Women are filling more prescriptions than men, but forgoing treatment isn’t more cost effective in the long run, either.

If left untreated, many of the conditions women are proactively managing can be debilitating, interrupting their lives and work, and necessitating more serious and expensive medical interventions down the line.

Tori Marsh, MPH is Director of Research at GoodRx which authored the report.

Marsh said: “Though we typically think of the ‘pink tax’ as an upcharge on goods and services, these latest findings illustrate how the spending gap between men and women transcends grocery store shelves, with women paying a premium just to maintain their health.

“This gender inequality leaves women with a greater financial burden, potentially requiring women to choose between their own health and other recurring expenses.

This can lead to more serious health issues and create extra strain–not just on individuals–but on the healthcare system as a whole.”

The report found that women spent 30 per cent more out-of-pocket than men last year, a trend that has remained consistent over recent years.

Menopause treatments, for example, cost an average of $16.95 per prescription.

Conditions that demand specialised treatments, like endometriosis and morning sickness, require an even more substantial spend ($29.38 and $37.87 per prescription, respectively).

Women ages 18 to 44 spend up to 64 per cent more out-of-pocket on medications than men of the same age group. As they age, the gap gets smaller.

Women ages 45 to 64 spent 35.3 64 per cent more than men in 2024, and women over 65 spent 16.5 64 per cent more.

According to the report, women also spend 113 64 per centmore out-of-pocket on depression medications and 103 64 per cent more on anxiety treatments than men.

These disparities are likely driven by both higher prescription fill rates and systemic factors, such as differences in how mental health conditions are diagnosed and treated between genders.

Menopause

Menopausal hormone therapy may lower dementia risk, study suggests

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Women using menopausal hormone therapy had a lower dementia risk, with oestrogen-only users showing fewer Alzheimer’s-related brain changes in a recent study.

Researchers stressed that the findings do not show that hormone therapy prevents dementia, but found women using oestrogen-only treatment had fewer biological signs linked to Alzheimer’s disease.

The observational study also found that women using this form of hormone therapy were less likely to receive a clinical dementia diagnosis.

The study combined clinical data with biomarkers and evidence from brain tissue collected after death to build a more detailed picture of the relationship between hormone therapy and Alzheimer’s-related changes.

The findings contrast with several previous studies reporting that menopausal hormone therapy increases dementia risk.

Dr Hadi Hosseini, associate professor of psychiatry and behavioural sciences at Stanford University in the US and senior author, said: “Our study is unique in that we looked at all the standards of Alzheimer’s diagnosis, including the gold-standard outcome: Alzheimer’s-associated hallmarks in autopsied brains.”

Hosseini said many conditions can affect memory and that clinical diagnoses are not always accurate. Examining brain tissue allows researchers to look directly for the defining biological features associated with Alzheimer’s disease.

Researchers examined medical records from 21,462 women taking part in two large US studies.

They looked only at women who used oestrogen-only therapy because previous studies indicated that treatment combining oestrogen and progestin may increase dementia risk.

This group was compared with women who reported no use of menopausal hormone therapy.

The records included data from 258 brain autopsies of women who had reported using oestrogen-only menopausal hormone therapy and 2,701 autopsies from women who had not used hormone therapy.

After adjusting for factors including age, women who took hormone therapy had a 35 per cent lower chance of showing biological signs of Alzheimer’s disease than those who did not use hormone therapy.

Hormone therapy use was also associated with a 39 per cent lower risk of receiving a clinical dementia diagnosis and a reduced risk of memory problems or declining functional abilities.

Dr Tom Blackmore, research programmes manager at Alzheimer’s Research UK, said: “Dementia has been the leading cause of death for women in the UK for over a decade, yet we still don’t fully understand why women are more likely to be affected by the condition than men.

“Understanding how hormones, menopause and ageing influence brain health is an important area of dementia research.

“While these findings are interesting, this study can only show an association and cannot tell us whether hormone therapy itself reduced dementia risk.

“Many factors influence a person’s likelihood of developing dementia, and women who received hormone therapy may differ from those who did not in ways that also affect their long-term brain health.”

In current standard practice, oestrogen-only therapy is prescribed to people who have undergone a hysterectomy because of the increased risk of endometrial cancer.

Blackmore also said the study focused exclusively on women taking oestrogen-only hormone therapy, which “differs substantially from how hormone replacement therapy is typically used today.”

Although early studies suggested menopausal hormone therapy might help protect menopausal women from dementia, later research produced inconclusive results.

A large analysis published in 2003 suggested the opposite, finding that oestrogen-plus-progestin formulations appeared to increase dementia risk, particularly when started at an older age.

Hosseini said: “There have been a lot of conflicting findings about MHT’s [menopausal hormone therapy’s] effects on Alzheimer’s disease outcomes.”

He added: “Different studies may have involved different age ranges of initiating MHT.”

Hosseini said studies may also have examined different clinical outcomes and biomarkers, combined different hormone therapy formulations or looked at different routes of administration and treatment durations.

Blackmore added that the findings “are not a reason for women to start or stop hormone replacement therapy with the aim of reducing dementia risk.”

He added: “Instead, the study provides valuable clues about the biology underlying dementia and highlights the need for more research into women’s brain health.

“Larger and more diverse studies will be needed to determine whether hormone-based treatments could play any role in reducing dementia risk.”

According to Alzheimer’s Research UK, an estimated 982,000 people are living with dementia in the UK, with around 65 per cent of those affected being women.

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Menopause

Third of women unaware of perimenopause mental health impact

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A third of women surveyed did not know perimenopause could affect mental health, with many experiencing symptoms for months before recognising them.

The survey of 1,000 women found many had been caught off guard by mental health symptoms linked to perimenopause or menopause.

It was conducted by Dynata on behalf of LifeStance Health in June 2026 and included women born between 1960 and 1990 who had, or suspected they had, perimenopause or menopause.

Respondents described anxiety as somewhat or extremely severe in 66 per cent of cases and depression in 54 per cent, with many initially attributing the symptoms to a separate condition rather than a hormonal transition.

Stephanie Eken, chief medical officer at LifeStance Health, said: “Women’s mental health needs change across their life stages, and perimenopause and menopause are among the biggest transitions of all.

“Specialised, life-stage-specific care should be standard practice, and I believe the organisations that build care around this reality, rather than taking a one-size-fits-all approach, will define the next era of women’s health.”

Around 33 per cent of respondents said they did not know perimenopause could cause mental health symptoms.

Almost half, 49 per cent, were surprised that mental health symptoms linked to perimenopause or menopause could last for several years.

A further 22 per cent were surprised that perimenopause could begin shortly after childbirth.

The survey found 74 per cent experienced symptoms for six months or longer before suspecting perimenopause or menopause, while 27 per cent recognised the transition within six months.

Before recognising the symptoms as potentially linked to perimenopause or menopause, 49 per cent believed they were experiencing anxiety as a standalone condition and 39 per cent thought they had depression.

Around 36 per cent were surprised that symptoms linked to perimenopause or menopause could resemble a standalone mental health condition.

Among respondents who tried therapy for perimenopause or menopause-related symptoms, 83 per cent said it was helpful.

Around 82 per cent of those who tried medications such as antidepressants or oestrogen also found them helpful.

Nearly half, 47 per cent, said mental healthcare should be a standard part of perimenopause care, while 59 per cent said they would be more likely to seek mental healthcare if they knew it could meaningfully improve their symptoms.

Around 35 per cent said perimenopause or menopause had a slight to significant negative impact on their overall mental health, while 42 per cent reported a negative impact on mood.

However, 32 per cent reported no impact on their overall mental health and 22 per cent reported no impact on mood.

The survey points to women experiencing mental health symptoms for an extended period before connecting them to perimenopause or menopause, with many initially attributing anxiety or depression to an unrelated cause.

That delay may help explain why nearly half did not realise how long these symptoms can persist and why more than a third were surprised they could resemble a standalone mental health condition.

Despite the awareness gap, most respondents who sought treatment, whether therapy or medication, said it had been helpful.

Separate research published in 2023 estimated that menopause symptoms cost the US economy around US$1.8bn a year in lost work productivity.

The estimated cost rose to US$26.6bn when associated healthcare costs were included.

That research was based on more than 4,400 employed women aged 45 to 60, with its authors saying further studies in larger and more diverse populations were needed to confirm the findings.

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Motherhood

New psychedelic treatment shows early promise against postpartum depression

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A single day of inhaled psychedelic treatment may relieve postpartum depression symptoms, with effects lasting for a week, early research suggests.

Postpartum depression is a severe mood disorder that affects women after giving birth. Symptoms can include extreme sadness, anxiety, changes in sleep and eating habits and difficulty bonding with a baby.

The condition affects up to one in five mothers globally. If untreated, it can have lasting effects on a mother’s psychological wellbeing and a child’s cognitive development.

Standard antidepressants, including selective serotonin reuptake inhibitors, a common type of antidepressant, often take four to six weeks to start working.

They can also cause side effects including weight gain, nausea and sexual dysfunction.

The only medication specifically approved by the US Food and Drug Administration for postpartum depression is zuranolone. It works faster than standard antidepressants but requires a 14-day daily course and carries warnings about drowsiness.

Researchers are exploring psychoactive compounds as possible alternatives for faster relief.

Mebufotenin, also known as 5-MeO-DMT, is a psychedelic compound that acts on serotonin receptors in the brain. Serotonin is a chemical messenger involved in functions including mood, sleep and digestion.

Previous early-stage trials found that an inhaled synthetic formulation called GH001 produced very rapid antidepressant effects in people with treatment-resistant depression.

Lead authors Martin Johnson of St Pancras Clinical Research and Kristina M. Deligiannidis of the Feinstein Institutes for Medical Research investigated whether the treatment could safely help women with severe postpartum depression.

The trial assessed its safety, side effects and impact on maternal functioning. It was funded by GH Research, the company developing the drug.

Researchers enrolled 10 women aged 18 to 45. All had major depressive disorder that began shortly before or after giving birth and were at least four weeks postpartum.

Participants also had to score at least 28 on a standard depression questionnaire, indicating moderate to severe depression.

Treatment was given on a single day using a specialised vaporisation system, with patients inhaling the medication from a collection balloon.

Doses were adjusted according to each woman’s response.

Participants first received 6mg. Those who tolerated the drug but did not experience a sufficiently intense psychoactive effect could receive 12mg one hour later, followed by 18mg after another hour if needed.

Researchers used a specialised scale to assess the intensity of the psychedelic experience, including feelings of losing control and how profound the experience felt.

Further doses were stopped once participants reached a predefined score.

Patients were monitored for changes in vital signs, psychiatric symptoms and overall comfort.

The psychedelic effects lasted for an average of around 20 to 25 minutes after each dose.

Participants also had to arrange for a trusted adult to care for their baby while they received treatment.

The main measure was the change in depression scores between the start of the study and day eight. Researchers also measured symptoms two hours after the final dose and on day two.

Four participants were lactating, allowing researchers to test their breast milk and assess how quickly the drug was eliminated from their bodies.

All 10 women experienced at least a 50 per cent reduction in depression symptoms two hours after their final dose.

By day eight, average depression scores had fallen by around 96 per cent and every participant met the study criteria for remission, meaning they no longer met the clinical threshold for depression.

Participants also reported improvements in maternal functioning.

Scores on a questionnaire assessing psychological wellbeing, self-care and mother-child interaction improved by around 56 per cent by day eight, with gains seen across almost all areas measured.

No serious adverse events were reported.

The most common side effect was mild to moderate headache, experienced by five of the 10 women.

The treatment did not cause lingering sedation and all participants were able to return home on the day they received it.

Among the four lactating women, levels of the drug and its byproducts in breast milk peaked around one hour after the final dose and fell below detectable levels after about 10 hours.

Researchers said this suggests mothers may only need to pause breastfeeding for a relatively short period on the day of treatment, although further research is needed before firm clinical recommendations can be made.

The trial was open-label, meaning both participants and researchers knew the active drug was being given.

There was no placebo comparison group, making it impossible to rule out the possibility that expectations about the treatment influenced the reported improvements.

The sample was also small and lacked demographic diversity, with nine of the 10 participants identified as white.

Almost none of the women were taking other psychiatric medications during the trial, meaning the findings may not reflect how a broader and more diverse group of mothers with postpartum depression would respond.

Researchers followed the women for only one week after treatment, leaving questions about how long the antidepressant effects may last.

Future studies will need to follow patients for several months to assess whether depression returns or additional doses are needed.

Larger trials will also need to randomly assign participants to receive either the active treatment or a placebo.

These studies will be needed to confirm the treatment’s safety and determine whether the drug itself is responsible for the rapid reduction in symptoms.

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