NICE rejects Spravato a second time as an adjunctive treatment for depression.- Janssen

THe National Institute for Health and Care Excellence (NICE) has rejected Spravato (esketamine) from Janssen for a second time and the company may be obliged to reduce its price further. In second draft guidance NICE stated Spravato, with a selective serotonin reuptake inhibitor (SSRI), or serotonin-norepinephrine reuptake inhibitor (SNRI) is not recommended for treatment resistant depression. This is the second time that Spravato has been rejected following a draft decision earlier this year. “Introduction of esketamine into clinical practice in the [National Health Service] will be complex because the structure and delivery of services would need to be changed,” Meindert Boysen, director of the center for health technology evaluation at NICE, said in a statement. “Estimates of the costs of providing the clinical service for esketamine were highly uncertain, as are the costs of repeated courses of the drug.”