It will be important to mind the gap here—the gap between how much women and men may be spending on mental health prescription medications. A GoodRx analysis estimated that in 2024, women spent around 50% more out of pocket than men did on mental health prescriptions. That’s $5.4 billion for women compared to $3.6 billion for a $1.8 billion difference. Now, there are four possible things that could be driving this difference. And, spoiler alert, none of these Rx-related possible things would be good.
GoodRx Based The Analysis On A Sample Of Prescription Fills In 2024
The analysis was based on a sample of over 250 million prescription fills for mental health medications in 2024. As Tori Marsh, MPH, the senior director of research at Good Rx who led this analysis, explained, “These fills come from a national claims dataset licensed by GoodRx, which captures anonymized retail prescription transactions across payers, pharmacies, and geographies.” Marsh then described how they went from the findings from this sample to the national estimates: “We extrapolated the results using IQVIA’s 2024 Report on the Use of Medicines in the U.S. and IQVIA Longitudinal Access and Adjudication Data.”
Note that this was not a peer-reviewed study published in a scientific journal and did have a number of different limitations, some of which will be discussed later. Therefore, take everything you can get from it with a grain—or maybe multiple grains—of salt. Nevertheless, the findings do raise important questions and call for further studies to figure out, “What’s going on,” in the words of that Marvin Gaye song.
Women Filled More And Spent More On Prescriptions For Different Mental Health Conditions
Marsh and the GoodRx team found that women not only spent more on mental health medications but also filled more prescriptions of such meds. The following graph shows how much more for different mental health conditions:
The somewhat darker and thinner blue bar represents how much more prescriptions women filled compared to men percentage-wise for each mental health condition. The somewhat lighter and thicker blue bar represents how much more women spent than men percentage-wise for each. As you can see the spend for women for depression was 113% higher than men, followed by anxiety at 102% more, panic disorder at 53% more, bipolar disorder at 46% more, and obsessive-compulsive disorder at 26% more.
The Mental Health Prescription Gap Between Women And Men Increased With Age
The GoodRx analysis also revealed that these mental health prescription spending and fill gaps between the sexes increased with age. Just look at what happens to both the thinner and darker blue lines and the ticker and lighter blue lines in the following figure as you go from the below 18 years age group all the way up to the over 64 years age group:
The Limitations Of This Analysis
Now, Marsh did say that they couldn’t determine from the analysis alone whether women were paying more than men for each prescription fill or for the same medications. It’s not clear whether the greater spend was due simply to women filling more mental prescriptions.
Furthermore, this analysis was for only one year rather than multiple years. It could not show trends over multiple years. So, there remains the possibility that 2024 was an outlier, an unusual year.
Additionally, prescription fills are not the same as usage. In theory, people could be getting the medications from pharmacies or mail-order outlets and then leaving them in their medicine cabinets, night stands, hedgehog-shaped pill boxes or wherever unused.
Moreover, a sample is a sample and isn’t exactly the same as the entire population, no matter how representative of the whole population the sample may be. Plus, the analysis didn’t take some deeper dives that will be mentioned later.
Why Might Women Be Spending More On Mental Health Medications
Nevertheless, what Marsh and her team found was not an itty-bitty discrepancy between men and women. It was more like a city-biggy difference, which suggests that something real is happening here. The question here is what. Well, here are four possibilities:
- Possibility One—More women are suffering more mental health challenges than men: Studies have suggested that women are more likely than men to be diagnosed with certain mental health conditions such as depression and anxiety disorders. There are also periods of time where women may be more likely to experience depression symptoms such as during and after pregnancy, around the time of their menstrual period during perimenopause.
- Possibility Two—Women are more likely than men to seek care for mental health challenges: Of course, just because women may be more likely to be diagnosed with a mental health condition doesn’t necessarily mean they are suffering such conditions more frequently. Studies have also suggested that men are less likely to seek help and treatment if they do have a mental health condition.
- Possibility Three—Doctors are prescribing medications to women at a greater rate than to men for the same mental health challenges: Of course, just because you are struggling with a mental health challenge doesn’t necessarily mean that you should be taking a prescription medication. There are other approaches such as counseling and therapy. One concern is that some doctors may be too quick to jump to prescribe medications to certain people rather than try other possible treatment approaches first.
- Possibility Four—Women have worse insurance coverage than men: Could the higher out of pocket payments for women be due to their having worse insurance coverage than men do? Data have shown that women are more likely to be uninsured and when they do have insurance, what’s covered tends to be less. This possibility alone may not explain the higher fill rate of prescription medications, though.
More Studies Are Needed
Any number of the aforementioned four possibilities could be at play either separately or in some combinations with each other. It will be important to figure out what’s going on because each of these possibilities is not good.
On the one hand, if women are indeed more likely to experience mental health challenges, the big question is how can this gap be closed? Since men and women kind of are connected with each other and aren’t on separate planets, anything that affects women will end up affecting men and vice-versa. This also applies to the possibility of men quietly struggling with mental health challenges without seeking help or treatment. This could impact their partners, families, co-workers, employees (if the men are business leaders) or entire populations (if the men are political leaders, for example).
On the other hand, if this is an issue of either the overprescription of medications to women or women having worse insurance coverage, then surprise, surprise, the broader healthcare system in the U.S. needs fixing. You may not think about healthcare system problems if you aren’t currently using the healthcare system regularly. But what happens when it is your turn to get care. Will your treatment be actually driven by scientific evidence? Will you be able to pay for your care?
While it does have its limitations, this GoodRx analysis serves as a good opener to more consideration and more studies—not just about mental health medication use but also about broader issues. In other words, the gap that this analysis found shouldn’t just be something that we as an interconnected society should mind, it should be something that we should fully address.
