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Esketamine for treating treatment-resistant depression

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2 Information about esketamine

Marketing authorisation indication

2.1 Esketamine (Spravato, Janssen) in combination with a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI), is indicated 'for adults with treatment-resistant major depressive disorder who have not responded to at least 2 different treatments with antidepressants in the current moderate to severe depressive episode'.

Dosage in the marketing authorisation

2.2 The dosage schedule for esketamine is available in the summary of product characteristics.

Price

2.3 The device is single use and delivers 28 mg of esketamine in 2 sprays, one 14 mg spray per nostril. Costs per dose are:

  • £163 for a 28 mg dose (one 28 mg device)

  • £326 for a 56 mg dose (two 28 mg devices)

  • £489 for an 84 mg dose (three 28 mg devices).

    Based on the company's economic model, an average course of therapy costs £10,554. Costs may vary in different settings because of negotiated procurement discounts. After consultation, the company proposed a confidential patient access scheme discount.