Health
Esketamine spray to treat depression is “not cost effective”
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The difficult-to-treat nasal esketamine spray for depression was rejected twice for use in the NHS due to cost uncertainty.
Despite the need for new treatments for adults, it’s also unclear how long-term the drug will work, said NICE, a healthcare watchdog.
Esketamine is a type of ketamine that targets chemicals related to learning and memory.
Treatment was initially rejected in January By NICE.
According to the comments of experts and clinicians, Second consultation Information on draft guidance for England and Wales has been released.
Nasal drops containing esketamine, also known as Spravato, manufactured by Janssen cost about £10,000 per course of treatment.
Despite concerns over lack of adequate testing, it was approved for sale in the United States last year as a treatment for depression.
Patient monitoring
“There is a clear need for effective alternative treatment options for people with treatment-resistant depression,” said Meindert Boysen, deputy director of NICE’s Center for Medical Technology Evaluation.
But he said the outcomes and costs of patients using the drug were not yet understood.
NICE says this treatment cannot be recommended because it is not known if depression symptoms continue to improve after discontinuation of treatment and the cost of providing repeated courses of treatment.
Professor David Curtis, a former consultant psychiatrist and emeritus professor at University College London and Queen Mary University, said he wasn’t surprised by NICE’s position.
“Many experts felt that esketamine was more effective than traditional antidepressants and was licensed without really strong evidence that it could bring real benefits to patients,” he said.
“Additionally, the administration of esketamine to patients is inherently problematic because it requires monitoring for some time after administration, which requires setting up a special clinic just for this purpose.”
Professor Curtis added further. “And remember that esketamine is essentially just an active form of the party drug, ketamine, and so there are concerns about its potential for abuse.”
The cost of setting up a special treatment clinic for patients who use esketamine is also unknown.
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