Spravato, or esketamine, provides a ground-breaking option for patients battling severe depression. In the future, it will get a lot cheaper for Australian patients. Esketamine is a chemical cousin of ketamine that works directly on a brain chemical called glutamate. This mechanism excludes it from classical antidepressant drugs, which mainly target monoamines such as serotonin, noradrenaline and dopamine. The listing of Spravato on the Pharmaceutical Benefits Scheme (PBS) is a major breakthrough. It provides real encouragement to patients who suffer from intractable major depression – including the one-third of patients who do not respond to standard therapies.
Beginning on November 1, 2023, patients can expect the price of Spravato to be significantly reduced. It will be sold at about $31.60 per dose, and only $7.70 for pensioners and concession card holders. Ensuring that treatment options are more accessible to over 30,000 Australians living with severe and debilitating depression is the motivation behind this amendment. Unlike other methods of Spravato administration, it occurs within a clinical setting involving a multidisciplinary team of practitioners. Each of her treatment sessions takes about two hours.
Professor Colleen Loo, a leading researcher at the Black Dog Institute, has emphasized the mounting evidence supporting ketamine’s efficacy in treating severe depression over the past two decades. Research has demonstrated that the effects of Spravato begin to work quickly, alleviating the most severe symptoms. Traditional antidepressants can take several weeks or even months to have an effect.
One of the first experimental studies to come out of the US found an even more incredible surprise. Even those with four or more failed medication trials and electroconvulsive therapy had positive responses to ketamine,” adds the study’s senior author Professor Loo.…that it induces an intense, acute shift in what’s happening in your brain. A good analogy is rebooting your computer.
Spravato’s novel mechanism of action provides new hope for people like Samuel Hockey. He battled debilitating depression and had very few effective options left with mainstream medicine. “Trialling different medications and therapies, nothing was really sticking,” said Hockey. “You just felt incredibly disheartened.”
Hockey described the debilitating effects of his condition: “You feel lethargic. Your body feels fatigued and actually sort of aches. You might lose weight because you’re not eating. You feel headachey, overall sluggish, and you just can’t move from where you are.”
The inclusion of the Spravato on the PBS is a major milestone in Australian mental health care. Minister for Health and Aged Care Mark Butler praised the new listing, which will be life-changing for thousands of Australians. Most importantly, he underscored the difference it will make in their everyday lives. He said that bringing this new depression treatment into a more affordable range could start to offset the productivity losses caused by major depressive disorder.
Severe depression can completely disrupt a person’s ability to function in their daily life, noted Professor Ian Hickie. The productivity costs associated with depression are high and can affect education, training, and work. He further underscored the broader societal impact. These are driven by major concerns such as drug and alcohol misuse and higher rates of suicide.
Yet, despite this progress, very real issues persist when it comes to treatment accessibility. Hockey expressed concern about the financial barriers still faced by many Australians: “Where I feel the government now needs to step up more is being able to cover those costs for those from low socioeconomic backgrounds who can’t afford treatments that would help them turn a corner.”
It was a sentiment that was shared by Professor Loo. He added that although the PBS listing makes Spravato more affordable, it doesn’t help fund the money needed for expensive clinic treatment. “What we really need is Medicare funding for the clinic treatment cost,” she stated.
