Figure 6.
Estimated quarterly (3 months) costs (L = low, M = medium, H = high) for daily administration of non-hallucinogenic take-home traditional antidepressants (blue) and intermittent dosing of clinically administered, dissociative psychoplastogen (ketamine) treatments (red). Note: generic ketamine costs include drug, administration (IV), and required monitoring, while Prozac®, Zoloft®, Celexa®, and Spravato® costs are for the drug only. Retail costs for SSRIs reflect the low and high branded price published on goodrx.com2 with the medium price being calculated as an average of the two. To estimate the total cost, we used medium doses for each drug (Prozac® 20 mg, Zoloft® 50 mg, and Celexa® 20 mg,) and assumed daily dosing for 90 days. Ketamine infusion cost was sourced from ketamineclinicsdirectory.com/ketamine-infusion-cost/.3 This site estimates the low and high cost of a complete set of 4–6 generic ketamine infusions to be $1,600–$4,800, respectively. The medium cost was calculated as an average of the two ($3,200). Our estimate for the 3-month cost of generic ketamine assumes that no additional doses are needed beyond the initial 4–6 doses. Retail Spravato® costs were estimated based on the price of a 56 mg dose ($900) published on goodrx.com3 and dosing was based on the package insert (Revised 7/2020). The label indicates Spravato® should be dosed twice a week during the induction phase (weeks 1–4; $900 × 2 × 4 = $7,200), once a week during the maintenance phase (weeks 5–8; $900 × 1 × 4 = $3,600), and once a week thereafter (weeks 9–12; $900 × 1 × 4 = $3,600). The estimated low cost of Spravato® includes the induction phase only. The estimated medium cost of Spravato® includes the induction phase and the maintenance phase. The estimated high cost of Spravato® includes the induction phase, maintenance phase, and 4 weeks of additional treatment. Note: the cost of administration and monitoring for Spravato are not publicly available, and thus not included, but these costs are anticipated to be significant.