Reimbursed Care Access in Saint Martin (French part)

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Esketamine (Spravato and equivalent authorised presentations) is approved and reimbursed in France in narrowly defined indications for treatment‑resistant depression when used as an add‑on to an oral antidepressant, with age and treatment‑history limits specified by the national health technology assessment. The French Haute Autorité de Santé (HAS) issued an opinion maintaining reimbursement for Spravato in adults under 65 with severe, treatment‑resistant major depressive episodes not responsive to at least two oral antidepressants in the current episode, and specifies its use as an add‑on in a controlled setting. # Esketamine is listed in national drug databases and marketed nasal spray presentations are treated as stupéfiants for distribution control, with dispensing and supervised administration requirements described in product information. # Because Saint‑Martin (French part) is administered under French social security rules for overseas collectivities, the same national reimbursement decisions and prescription/dispensing controls apply in practice (local implementation through the CGSS/health authorities for overseas territories). #

Ketamine (chlorhydrate de kétamine) is an authorised and reimbursed medicinal product in France for approved indications (primarily anaesthesia and certain emergency or analgesic contexts); national expert and regulatory evaluations have addressed ketamine formulations and reimbursement for anaesthetic indications. # In psychiatric practice in France there has been increasing off‑label use of intravenous racemic ketamine for treatment‑resistant depression in specialised centres; this use is considered off‑label (hors AMM) and is typically not covered as a standard reimbursed psychiatric treatment by public insurance except where local hospital care pathways and coding allow inpatient/hospital reimbursement. French addiction‑vigilance and specialist societies have published syntheses and cautions regarding off‑label psychiatric ketamine use (safety monitoring, urinary and hepatobiliary risks), and recommend it be delivered in controlled clinical settings with appropriate follow‑up. # Practical reimbursement and access in Saint‑Martin will follow French national rules and local health‑insurance administration (CGSS/CPAM pathways applicable to overseas collectivities), meaning licensed anaesthetic uses are routinely reimbursed where indicated, while outpatient/off‑label psychiatric ketamine infusions are generally not reimbursed as a standard outpatient psychiatry procedure and depend on local hospital organisation or research protocols. #

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.

Currently classified as a strictly controlled substance under national drug scheduling laws, with no authorized medical use outside of approved clinical research.