Spravato (esketamine) is a groundbreaking treatment for individuals struggling with treatment-resistant depression (TRD). It is an FDA-approved nasal spray designed specifically to address treatment-resistant depression. Unlike conventional antidepressants, which primarily target serotonin or norepinephrine, Spravato works by modulating the NMDA (N-methyl-D-aspartate) receptors in the brain.
But how much does Spravato Treatment cost? If you are considering this advanced treatment, it is essential to understand the costs and influencing factors to ensure you make an informed decision.
To accurately determine how much Spravato treatment will cost you, you should consider several critical factors. Understanding these factors can help you and your family prepare financially and explore available support options.
The initial phase, known as the induction phase, typically involves higher-frequency dosing. Patients usually receive two treatments a week for the first four weeks. This phase is more intensive and, therefore, more costly. Once patients transition to the maintenance phase, treatments are less frequent—usually once a week or even biweekly—reducing the overall cost.
Spravato cannot be self-administered at home. It must be administered under medical supervision at a certified treatment center due to the potential for side effects, such as sedation and dissociation. The associated facility fees can vary depending on your geographical location, the type of healthcare facility, and the level of monitoring required. These costs are often in addition to the medication.
Most insurance plans, including private insurers and Medicare, provide some level of coverage for Spravato. However, the extent of coverage often varies. For example, co-payments, deductibles, and co-insurance rates influence out-of-pocket costs. Additionally, insurance companies typically require prior authorization before approving coverage. This process often involves documenting the patient’s history of unsuccessful treatments with other antidepressants and confirming a diagnosis of treatment-resistant depression.
Pharmaceutical companies and nonprofit organizations offer financial assistance programs to make Spravato more accessible. For instance, Janssen Pharmaceuticals, the manufacturer of Spravato, provides the Janssen CarePath program, which offers resources and support to help eligible patients reduce their out-of-pocket expenses. Additionally, some nonprofit organizations and foundations provide grants or subsidies for individuals who meet specific criteria.
If you are concerned about the cost of Spravato, our dedicated team can help you explore options to reduce out-of-pocket expenses.
Spravato can be expensive, particularly during the induction phase. Without insurance coverage, patients can expect to pay between $4,700 and $6,800 per month for this initial phase. Although maintenance therapy, which involves fewer treatments, is generally less expensive, it still requires a significant financial commitment. For patients with insurance, out-of-pocket costs are typically much lower, ranging from $300 to $700 per treatment session, depending on the specific plan and benefits.
Insurance companies often mandate prior authorization to verify the medical necessity of the treatment. This process usually involves submitting documentation that demonstrates previous treatment failures and confirms a diagnosis of treatment-resistant depression. Patients should work closely with their healthcare team to ensure that all necessary documentation is submitted accurately and promptly to avoid delays or denials of coverage.
Although the costs can be considerable, insurance coverage and financial assistance programs could help you access this effective treatment. By gaining a clear understanding of the factors influencing how much Spravato treatment costs, patients can make informed decisions about pursuing this type of treatment. If you have any questions or concerns about Spravato, enlist the help of the psychiatric team at The Holiner Psychiatric Group.