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The first major depression treatment to hit the U.S. market in decades may be a new option for patients who fail to respond to existing therapies, but a preliminary analysis shows the price of the medicine would have to be shaved by 25 percent in order to be cost effective.

Known as esketamine and marketed as Spravato, the nasal spray was developed by Johnson & Johnson (JNJ), which set a list price of $590 to $885 per treatment session, depending on dosing and number of sessions, which can vary by patient. The initial month of therapy can cost from $4,720 to $6,785, while subsequent treatment can cost $2,360 to $3,540. Put another way, the annual tab might run from $33,000 to about $49,200.


But at that price range, the treatment fails to provide sufficient value based on an economic benchmark known as QALY, or quality-of-life years, which measures both the quantity and quality of life generated by providing a treatment or some other health care intervention.

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  • ? I m’ a 52 years old man. Since very young age I suffered from anxiety, OCD and intrusive thoughts and panic attacks. When I was 21 years old I started with tricyclic antidepressant anafranil, since then I switched to many other antidepressants and benzodiazepines, it was in 1998 when I switched to sertraline life seemed a little better off. Still from time to time those anxieties and intrusive thoughts persist and when the dose is lowered the panic could return. Now having learnt about medication like esketamine sounds like a godsend to a guy like me. I ‘m excited to be treated with this medication, I wonder if someone could tell me more about how to approach for this but the cost is fantastically high, when can lay people like me be able to afford for medication like this? Thank you.

  • The first sentence sums up the problems with ICER’s conclusion: “The first major depression treatment to hit the U.S. market in decades…”

    Also, ICER used the WAC (list) price, thereby ignoring Medicaid rebates and 340B discounts. See page 65 of ICER report.

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