Payer & Reimbursement Stakeholders

U.S. private payer with published medical policy and prior-authorization requirements for esketamine (Spravato) in treatment-resistant depression pathways.

U.S. private payer with published psychiatry coverage-position criteria and prior-authorization form requirements specific to Spravato.

Nationwide federal-employee health benefits payer channel (Blue Cross Blue Shield FEP) with published pharmacy policy criteria for Spravato.

Germany’s highest joint self-governing HTA decision body for coverage and evidence appraisal, including esketamine/Spravato dossiers.

IHPI (Ibogaine Healthcare Policy Institute) is a 501(c)(3) nonprofit building policy infrastructure for regulated ibogaine care in the United States. Its work focuses on decision-grade resources for healthcare leaders, including safety and delivery standards, regulatory pathways, reimbursement mechanics, payment/coding roadmaps, coverage criteria, and implementation planning. The organization was founded on 1 January 2026 and is incubated by Delphi.

U.S. value assessment organization that publishes comparative effectiveness and cost-effectiveness reports used by payers and policymakers, including assessments relevant to esketamine.

Massachusetts Medicaid payer program with published prior-authorization resources and pharmacy updates that include Spravato-related coverage changes.

Nevada's Medicaid authority publishing pharmacy and physician-administered drug policy materials used for access and prior-authorization decisions, including Spravato-related references in archived DUR and update documents.

State-level Oregon pharmacy and therapeutics decision body supporting evidence-driven formulary and utilization policy.

Australia’s HTA and reimbursement advisory body for PBS listing decisions, including esketamine (Spravato) assessment materials.

U.S. private payer with national provider-facing prior-authorization criteria for Spravato and medical policy criteria that include ketamine/esketamine use conditions.

U.S. Veterans Health Administration payer and formulary authority publishing criteria-for-use and national protocol documents for intranasal esketamine (Spravato).

Canadian pan-jurisdictional payer negotiation body that coordinates joint drug price negotiations for public plans, including completed negotiations for Spravato (esketamine).