Following the approval of Esketamine from the FDA in the US in combination with oral antidepressants earlier this year,

Alessio Brunello, Pharma Analyst at GlobalData offers his view on the efficacy of esketamine in treatment-resistant depression:

“Spravato (esketamine), developed by J&J, is a nasal spray with a novel mechanism of action that was approved by the FDA in March and has the potential to make a significant impact on the treatment of many Major Depressive Disorder (MDD) patients who have been unresponsive to current antidepressant therapy, as none of the previous marketed products for depression can demonstrate rapid antidepressant effects.

“However, the high price of the therapy can limit its uptake as evidence showed non-significant benefit in terms of cost-effectiveness. Results from a ICER study showed that Spravato is estimated to cost $198,000 per quality-adjusted life year (QALY) gained, exceeding the commonly cited cost-effectiveness thresholds of between $50,000–150,000 per QALY.

“Moreover, the similarity of Spravato to ketamine, a relatively inexpensive anesthetic that has been prescribed off-label by some psychiatrists, can significantly affect the market of Spravato.”