depressed teen holding her head

The first really new antidepressant in decades recently won FDA approval for treatment-resistant depression. Esketamine nasal spray will be sold under the brand name Spravato. Physicians and patients have been eagerly awaiting the arrival of this new type of antidepressant. That’s largely because there has been a lot of hype around the new drug. Perhaps another reason is that traditional antidepressants take weeks to go to work. This nasal spray should start working within hours or days. But at what cost? Will the high cost of Spravato prevent patient access?

The High Cost of Spravato Could Be a Deterrent:

Patients may be shocked by the high cost of Spravato. People starting on this medication will need twice-a-week dosing for the first month. The list price is roughly $600 to nearly $900 per dose. That means the initial month could cost as much as $6,800.

After that, people will require once weekly or twice monthly nasal spray administration. Those costs would range from $2300 to $3500. At the end of a year, Spravato could end up costing $45,000. Some insurance companies may balk at that expense.

What’s the Story on Spravato?

Is the high cost of Spravato worth it? Most people never find out the actual effectiveness of a drug their doctor prescribes. They may also miss out on the side effects. 

Here is a link to a recent article we have written on this topic:

What Should You Know about New Antidepressant Spravato?

If you take the time to read the article above you will learn that two clinical trials with esketamine did not demonstrate that it was better than placebo. The FDA apparently ignored those studies. 

What About Ketamine Nasal Spray?

What the FDA is not talking about is the generic drug ketamine. It has been on the market since 1970. Here are some articles we have written about ketamine and depression:

Could Suicide Be Prevented with Better Access to Ketamine?

You can get an insider’s view of the history of ketamine at this link:

Surprising Ketamine Side Effects and Anti-Suicide Benefits

Some physicians are prescribing ketamine as a nasal spray. It is prepared by compounding pharmacies. This is completely off label. We suspect that the FDA would frown at such use. Although we have done no real cost comparison we suspect that such products are far less expensive than the high cost of Spravato. 

Share your own experience with depression below in the comment section. Has your doctor prescribed ketamine? How well did it work? What about side effects? If your doctor has prescribed Spravato, did your insurance company pay for it without objection? 

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  1. Walt Lupo
    South Carolina

    you wanna talk price!!! me as an individual [not a huge BigPharma corp.] can purchase enough ketamine to produce over 1700 bottles [1 dose = 1 bottle = 2x 28mg sprays] for under $600.00 Now that is not totally accurate… Ketamine is made up of two isomers [as well as every other molecule on the planet] the R-isomer and the S-isomer [organic chemistry i wont bore you!!] now es-ketamine is the “es”-isomer of ketamine…get it. The point, 56mg ketamine and 56mg esketamine not exactly the same but very close you could think of 56mg ketamine being made up of 28mg R and 28mg S isomers which is pretty accurate most times. If you dont have time to do math thats roughly 0.35 cents a bottle !

  2. Angela

    Sounds like another Opioid crisis waiting to happen. Heroine like medications, now ketamine like medications? How can these addictive substances help ? Without creating another problem.

  3. Jane

    There sure seems to be a lot of “mights” and “maybes” in the studies drug companies use to tout their new “wonder” drugs. One thing we can always be SURE of is lots of money for the company.

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