Cost-effectiveness of esketamine for depression
Researchers find this nasal spray for treatment-resistant depression is currently too expensive for widespread use

Date:
July 13, 2020
Source:
McLean Hospital
Summary:
A study has determined that esketamine, a nasal spray to treat
severe depression, is currently too expensive for widespread use.



FULL STORY ==========================================================================
A paper authored by researchers from McLean Hospital has determined that esketamine, a nasal spray to treat severe depression, is currently too expensive for widespread use. Titled "Cost-Effectiveness of Esketamine
Nasal Spray for Patients With Treatment-Resistant Depression in the
United States," the paper was published on July 7 in Psychiatric Services.


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The study compared the costs and benefits of esketamine, an antidepressant approved by the U.S. Food and Drug Administration (FDA) last year for
use in treatment-resistant major depressive disorder. Unlike ketamine,
a drug delivered intravenously to treat severe depression, esketamine
is a nasal spray.

Lead author Eric L. Ross, MD, reported that "most medications don't
work as well for people with treatment-resistant depression." However,
he said, "Esketamine has been effective in a population where many
other treatments haven't worked." Ross said, "I want people to use
esketamine, but it's important that it be cost-effective. I don't want
it to put a real strain on our mental health care system." To estimate
the cost-effectiveness of the drug, Ross and his colleagues used a "decision-analytic model" to simulate the effects of treatment with
esketamine versus oral antidepressants over five years. The model looked
at both societal and health care sector perspectives of using the drug.

Ross explained that the study built on previous investigations of
esketamine but added information about cost. Also, he said, the
model accounted for issues such as "How much does it cost to have
uncontrolled depression?" and "How much does it impact your quality
of life?" The simulations found that, over five years, esketamine was projected to improve quality of life by increasing time in remission
for patients. Societal costs and health care sector costs, however, were projected to go up substantially. The authors estimated a greater than
95% likelihood that intranasal esketamine would not be cost-effective
in the United States, according to commonly applied standards. Also,
they concluded that the price of esketamine must fall by more than 40%
from its current price of approximately $240 per dose to be cost-effective
for the management of treatment-resistant depression in the U.S.

"Esketamine is too expensive, but it does work," Ross asserted. "The
question now is 'How do we get the price down?'" Ross said that he hopes
the paper will encourage policymakers, insurers, and health care leaders
to work to reduce the price of esketamine and make it more available to
those in need. "At the end of the day, it's not about saving money," he
said. "The goal is to make sure we're getting the most clinical benefit
we can for the money we spend."

========================================================================== Story Source: Materials provided by McLean_Hospital. Note: Content may
be edited for style and length.


========================================================================== Journal Reference:
1. Eric L. Ross, Djo/ra I. Soeteman. Cost-Effectiveness of Esketamine
Nasal
Spray for Patients With Treatment-Resistant Depression in the
United States. Psychiatric Services, 2020; appi.ps.2019006 DOI:
10.1176/ appi.ps.201900625 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200713144413.htm

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