Real-World Effectiveness and Cost-Differential of Intranasal Esketamine Versus Intramuscular Ketamine.
Intramuscular ketamine was non-inferior to intranasal esketamine for depressive symptoms in Veterans with treatment-resistant depression, at lower cost.
Real-World Effectiveness and Cost-Differential of Intranasal Esketamine Versus Intramuscular Ketamine.
This study evaluated whether intramuscular (intramuscular) ketamine is non-inferior to intranasal (intranasal) esketamine for treatment-resistant depression (treatment-resistant depression) and assessed differences in safety and healthcare costs.
In a retrospective, observational sequential cohort at the VA San Diego, 179 Veterans with treatment-resistant depression received eight treatments of either intranasal esketamine ( n = 89) or intramuscular ketamine ( n = 90).
PHQ-9 difference between ketamine and esketamine was negligible, essentially no gap in depression relief
Reductions in Post-Traumatic Stress Disorder symptoms were also non-inferior.
Incidence of sentinel adverse events were comparable, with no significant differences in emergency department visits or hospitalizations.
Cost analysis revealed a significant disparity: the total cost per eight-treatment course was $6069 for intranasal esketamine versus $647 for intramuscular ketamine, with this difference driven primarily by the cost of intranasal esketamine.
Intramuscular ketamine demonstrated comparable clinical effectiveness and safety to FDA-approved intranasal esketamine while offering a significant reduction in cost.
These findings suggest intramuscular ketamine may be a high-value alternative to intranasal esketamine that could significantly expand access to psychiatric care for individuals with treatment-resistant depression.