Mind the Gap: Women spend over 50% more than men on mental health prescriptions
Women face steeper out-of-pocket costs for mental health care than men.
New data from GoodRx, a platform for medication savings, shows that women consistently spend over 50% more out of pocket on medications to treat their mental health. This spending gap is driven by higher healthcare utilization and higher rates of chronic stress among women due to a multitude of factors. Women disproportionately shoulder caregiving and household responsibilities, face economic inequalities and higher rates of poverty, and are more often subject to traumatic events like sexual or domestic violence — all of which may elevate stress and psychological strain.
In 2024, women spent a staggering $5.4 billion out of pocket on treatment for mental health conditions, compared to $3.6 billion spent by men. That’s a $1.8 billion gap. The gap is largest for treating certain mental health conditions, such as anxiety and depression, and certain age groups.
Key takeaways:
- When it comes to mental health, women are paying more out of pocket for their prescriptions than men.
- New data from GoodRx Research finds that women spent over 50% more out of pocket on mental health medications than men in 2024, totaling over $1.8 billion in additional spending per year.
- The gender gap in mental health spending widens with age. Among the 45 to 64 age group, women spent 99% more than men on their mental health prescriptions, and in the 65-plus65 plus age group, women spent 117% more.
- Women consistently outspent men on treatment for depression and anxiety across all age groups, while ADHD spending was higher among boys compared to girls under 18.
Higher use, higher cost: Women shoulder a larger out-of-pocket burden to treat mental health
No single cause explains why women pay more out of pocket for mental health care. Women have unique healthcare needs and circumstances that may require continuous management. In addition, women see healthcare professionals more often than men, which leads to more prescriptions and higher overall costs.
Anxiety, depression, and panic disorder have the largest medication spending divide between men and women. These conditions can be chronic for some people and require long-term symptom management. They can also go hand in hand with other chronic illnesses such as diabetes and cancer.
Women spend more out of pocket than men on medications for:
- Depression: 113% more
- Anxiety: 102% more
- Panic disorder: 53% more
- Bipolar disorder: 46% more
- Obsessive-compulsive disorder: 26% more
The gender gap in healthcare spending isn’t necessarily about higher drug prices — it’s about frequency. Women fill more prescriptions to treat mental health conditions, like depression and anxiety, which can be chronic or ongoing. So frequent doctor visits and long-term treatment needs play a part in higher out-of-pocket costs over time.
There are also broader issues at play: Women are more likely to be caregivers, face economic hardship, and experience trauma — all of which increase stress and drive greater healthcare use.
While women consistently pay more out of pocket for many prescription medications, not all mental health conditions follow this trend. In fact, schizophrenia is the only mental health condition where men spent more on medications than women (49% more). This may be driven by differences in prevalence, symptoms, and treatment responses between men and women with schizophrenia.
Looking at total spending on ADHD medications, women and men spend roughly the same amount out of pocket. However, as discussed in more detail below, this pattern differs by age group.
The age divide in mental health prescription spending
When it comes to mental health prescriptions, the gender gap shifts significantly with age. Among individuals under 18, boys actually outspend girls on mental health medications. This is driven largely by higher rates of ADHD diagnoses and treatment in young males. Boys also outspend girls on medications treating bipolar disorder, obsessive-compulsive disorder, and panic disorder. Similar to other age groups, girls under 18 outspend boys on medications treating anxiety and depression.
But that trend reverses sharply in adulthood. Starting around age 45, women begin to shoulder a much larger share of out-of-pocket spending on mental health medications. In fact, spending on conditions like anxiety and depression climbs steadily with age, particularly for women.
While mental health prescription fill rates are the highest among adults ages 18 to 44, the gender gap in spend is relatively narrow during these years. This may reflect better insurance coverage or more consistent employer-sponsored plans that help offset costs. But, as women age, the gender divide grows.
At the same time, spending on ADHD declines as both men and women age. The share of spending on ADHD for boys is highest for those under 18 and decreases with age. Out of all common mental health conditions, 82% of the total out-of-pocket spend for boys under 18 was on ADHD medications. For girls, only 68% of the total out-of-pocket spend in the under-18 group was on ADHD medications.
For the 65-plus age group, only 9% of women’s total spend on medications for mental health was on ADHD. For men, it was 11%. This is potentially due to underdiagnosis of ADHD in older adults, where symptoms may be overlooked or dismissed unless severe. This may be partly due to a lack of clear treatment guidelines for older adults.
A clear pattern emerges across age groups: Women fill more prescriptions and spend more than men, and the gap widens with age. As women’s mental health needs increase over time, so do the costs they’re expected to carry.
The bottom line
Maintaining mental health comes at a higher cost for women; they face a persistent and widening out-of-pocket burden for mental health care as they age. This financial burden stems from higher healthcare utilization, more prescription fills, the need to manage more chronic conditions, and greater emotional and caregiving burdens that drive long-term treatment needs.
While boys under 18 have higher ADHD-related costs, women consistently outspend men across conditions like anxiety, depression, and panic disorder. While insurance coverage offers some relief, mental health care remains a significant expense for many women — reflecting ongoing challenges in making care more accessible and equitable.
Methodology
Out-of-pocket costs: GoodRx calculated total out-of-pocket costs using a representative sample of U.S. prescription fills from January 1, 2024, through December 31, 2024, andnormalized amounts paid based on the dispensed quantity to a 30-day supply.
Condition-level spending was estimated by analyzing drug-level expenditures and rolling up to condition based on each drug’s most likely indication. The mental health conditions considered in this analysis are ADHD, anxiety, depression, obsessive-compulsive disorder, panic disorder and schizophrenia. Other conditions were filtered out due to a lower fill volume.
Total out-of-pocket spending was estimated by analyzing a representative sample of U.S. prescription fills and extrapolating to national spending levels using data from the IQVIA 2024 Report on the Use of Medicines in the U.S. and IQVIA Longitudinal Access and Adjudication Data through December 31, 2024.
Co-contributors: Sasha Guttentag, Ph.D., Amanda Nguyen, Ph.D.
This story was produced by GoodRx and reviewed and distributed by Stacker.
