Mental Health

mental health conditions affect millions

Mental Health Conditions

causes and treatment strategies may be wide-ranging

May 1, 2026

Mental health conditions affect millions, significantly impacting plan sponsors and their members. Mental health journeys are unique but there are keys to helping those with mental health conditions find their individualized path to healing.

PBIRx Intelligence

Learn how PBIRx helps our clients save while ensuring appropriate access and adherence to mental health treatments - below

What is mental health?

What is Infertility?

Mental health encompasses many facets and conditions

What is mental health and what are some common disorders?

- Mental health encompasses an individual’s emotional, psychological, and social well-being. It can have an impact on how people think, feel, and have a strong correlation with behavior. Some factors that can affect mental health include genetics, life experiences, and lifestyle choices such as diet, exercise, and social dynamics.
- Common mental health conditions include anxiety disorders, depression, bipolar disorder, and schizophrenia.

Prevalence of Mental Health Conditions

~23% of the US adult population

National Institute of Health (NIH) estimates that 23% of the US adult population live with a mental illness

- The National Institute of Health (NIH) estimates that 23% of the US adult population live with a mental illness. This number has been steadily increasing. Despite the high prevalence, a recent survey of over 2,000 US adults conducted by the National Alliance on Mental Illness revealed that more than 25% of people were not aware if their employer offers mental healthcare benefits, an employee assistance program, flexible work arrangements or sick days for mental health purposes.
- Over 1 in 5 human resources and benefits leaders surveyed by Lyra Health say addressing serious mental illness is a key focus for their mental health strategies in 2025 and something they believe will significantly impact employee well-being over the next five years.

Treatment of Mental Health Conditions

Combining non-pharmacological approaches with medications when appropriate

How are mental health disorders treated?

- Effective treatment of mental health conditions combines non-pharmacological approaches such as cognitive behavioral therapy, interpersonal therapy, meditation, and addressing lifestyle choices such as adequate sleep, proper nutrition, and appropriate levels of exercise, in conjunction with medications when appropriate.
- Many new drugs have been approved by the FDA in recent years to treat mental health conditions. These join a toolkit of several drugs that have been available for many years and are generically available. This is largely due to advancements in neurobiology and an increased focus on addressing mental health in our society.

Key New Drugs on the Market for Mental Health

Drug Name
Exxua
Zurzuvae
Auvelity
Igalmi

Approval Date
Sep 2023
August 2023
August 2022
April 2022

Indication
Major Depressive Disorder
Postpartum Depression
Major Depressive Disorder
Agitation associated with schizophrenia or bipolar disorder

Approximate Monthly Cost
$1,500
$15,750
$565
$1,008

Dosage Form
Oral Tablet
Oral Capsule
Oral Tablet
Sublingual Film

Key mental health treatment observations

- Exxua has some key advantages as compared to its predecessor, buspirone. It has a longer half life and better affinity for the active receptor site which allows for once daily dosing, rather than multiple doses per day.
- Zurzuvae is the first and only drug approved to treat postpartum depression, which impacts approximately 10-15% of women.
- Auvelity acts on the NMDA receptor, which is unlike any other oral antidepressant.
- IGALMI is the only sublingual film FDA approved for reducing agitation related to bipolar disorder.
- Lybalvi should not be taken within 7 days of short acting opioids and 14 days of long-acting opioids as one of its ingredients can cause opioid withdrawals.

PBIRx Intelligence

PBIRx helps our clients ensure appropriate access and utilization

PBIRx PharmD Mental Health Specialists help our clients ensure appropriate access to, and utilization of, mental health treatments

- PBIRx keeps clients and broker partners apprised of new drugs to market with our monthly newsletter which provides essential information with actionable insights.
- PBIRx helps clients stay compliant with new legislation such as the Mental Health Parity and Addiction Equity Act (MHPAEA), which aims to provide equitable access. One of the key components of the MHPAEA is non-quantitative treatment limitations (NQTLs) for mental health and substance use disorder (MH/SUD) benefits compared to medical and surgical benefits.

PBIRx Intelligence Partnering with you to manage your pharmacy benefit spend

- As mental health treatments become more widely adopted, it is important for stakeholders to stay informed and educated on the evolving market to make the best decisions for their organizations and their members.
- PBIRx will continue to be at the forefront in providing informed guidance to our valued client partners as they navigate the evolving landscape. Our team of PharmDs and pharmacy experts work at the granular level to identify cost-saving opportunities without compromising patient care. With our support, patients can access the medications they need to manage their mental health conditions, while payers can achieve cost savings. Contact us today to learn more about how we can help you manage your medication costs.

Author:

Nabil Khan, PharmD, RPh

PBIRx STRATEGIC ACCOUNT CONSULTANT

Mental Health Organization and Resources

- Substance Abuse and Mental Health Services Administration: samhsa.gov
- Suicide & Crisis Lifeline: call or text 988; chat at 988lifeline.org
- Veterans mental health resources: mentalhealth.va.gov
- Maternal mental health: call or text 1-833-TLC-MAMA (833-852-6262)