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Home/Research/Esketamine/Health Economics & Reimbursement

Esketamine for Health Economics & Reimbursement

5 papers and 2 clinical trials exploring esketamine as a treatment for health economics & reimbursement.

Compounddissociative

Esketamine

Esketamine (Spravato) is the S-enantiomer of ketamine, approved as an intranasal treatment for treatment-resistant depression and MDD with acute suicidal ideation. It is administered under clinical supervision with post-dose monitoring and has reached over $1.6 billion in annual sales.

Full Esketamine profile
IndicationApproximately 300 million individuals worldwide suffer from depression, with PTSD affecting about 7-8% of the US population at some point in their lives.

Health Economics & Reimbursement

Psychedelic-assisted therapies are gaining traction in the health economics domain, with promising findings regarding their efficacy in treating mental health disorders. As the FDA considers approval for compounds like MDMA and psilocybin, the economic implications, including reimbursement models, are increasingly relevant to healthcare systems worldwide.

Full Health Economics & Reimbursement profile

Academic Research

5 papers
Open Accessmeta

Cost-per-remitter for esketamine nasal spray versus quetiapine for treatment-resistant depression

Using ESCAPE-TRD trial data in an Excel-based model, esketamine nasal spray plus an oral antidepressant achieved a 50% remission rate at 32 weeks versus 33% for quetiapine XR plus an oral antidepressant. The model estimated lower cost-per-remitter for esketamine (about $3,102 lower in a commercial setting and $456 lower in Medicaid), suggesting esketamine plus an oral antidepressant is cost‑effective for adults with treatment‑resistant depression.

Published
June 9, 2025
Journal
Journal of Comparative Effectiveness Research
Authors
Clemens, K., Teeple, A., Rive, B., Kirson, N., Desai, U., Doran, J., Eid, D., Qu, A., Bowrey, H., Joshi, K.
Open Accessindividual

Oral esketamine for patients with severe treatment-resistant depression: Effectiveness, safety, and tolerability of a six-week open-label treatment program

In a naturalistic open‑label study of 185 adults with severe treatment‑resistant depression, twice‑weekly individually titrated oral esketamine for six weeks significantly reduced depressive symptoms (HDRS‑17 mean 21.2→15.8, p<0.001) with MCID 47.1%, response 26.8% and remission 15.6%, and a low dropout rate (7.6%). Treatment was generally well tolerated with frequent but manageable side effects and no significant urinary or cognitive adverse effects, suggesting oral esketamine is a safe, patient‑friendly option with effectiveness comparable to other administration routes.

Published
April 25, 2025
Journal
Journal of Psychopharmacology
Authors
Veraart, J. K. E., Smith-Apeldoorn, S. Y., van der Meij, A., Spijker, J., Schoevers, R. A., Kamphuis, J.
Open Accessmeta

Cost-Utility Analysis of Esketamine for Patients with Treatment-Resistant Depression in Italy

This economic analysis (Markov modelling) of esketamine treatment for depression (TRD) in Italy shows that it may be cost-effective from a societal perspective.

Published
January 20, 2023
Journal
PharmaEconomics
Authors
Rognoni, C., Falivena, C., Costa, F., Armeni, P.
Paywallmeta

Cost-effectiveness of esketamine nasal spray compared to intravenous ketamine for patients with treatment-resistant depression in the US utilizing clinical trial efficacy and real-world effectiveness estimates

This economic analysis (2022) finds that esketamine nasal spray (Spravato) is not cost-effective as compared to intravenous (racemic) ketamine for patients with treatment-resistant depression. The analysis uses quality-adjusted life years (QALYs), a common measure of added good years, and finds that esketamine and ketamine both add about two QALYs, but that the costs of the former are disproportionally higher.

Published
December 1, 2022
Journal
Journal of Affective Disorders
Authors
Brendle, M.
Paywallmeta

Blood-based biomarkers of antidepressant response to ketamine and esketamine: A systematic review and meta-analysis

This meta-analysis (n=2,801) explored the association between baseline levels and longitudinal changes in blood-based biomarkers, and response to ketamine/esketamine. Over 460 individual biomarkers were examined and there were no consistent associations between baseline levels of blood-based biomarkers, and response to ketamine. However, a longitudinal analysis revealed ketamine responders had statistically significant increases in brain-derived neurotrophic factor (BDNF) when compared to pre-treatment.

Published
June 27, 2022
Journal
Molecular Psychiatry
Authors
Medeiros, G. C., Gould, T. D., Prueitt, W. L., Nanavati, J., Grunebaum, M. F., Farber, N. B., Singh, B., Selvaraj, S., Machado-Vieira, R., Achtyes, E. D., Parikh, S. V., Frye, M. A., Zarate, C. A., Goes, F. S.

Clinical Trials

2 trials
RecruitingPhase IV

Comparative Effectiveness Study of Two Forms of Ketamine for Treatment-resistant Depression (TREK)

This interventional trial, led by The George Institute, aims to compare the effectiveness of two formulations of ketamine (esketamine (Spravato®) and racemic ketamine), in treating treatment-resistant depression (TRD).

Started
April 1, 2024
Type
interventional
Blinding
single
Randomized
Yes
Registry ID
NCT06278779
Active not recruitingPhase III

A randomised controlled trial of oral S-ketamine as add-on medication for patients with treatment-resistant major depressive disorder

This double-blind, placebo-controlled parallel-group Phase III trial (n=128) evaluates oral S-ketamine capsules as add-on treatment over 6 weeks for patients with treatment-resistant major depressive disorder (TRD).

Started
August 29, 2016
Type
interventional
Blinding
double
Randomized
Yes
Registry ID
2015-003957-16

Explore further

Search all Esketamine papers Search all Health Economics & Reimbursement trials Full Esketamine profile Full Health Economics & Reimbursement profile