Policy changes could make esketamine more affordable for treatment-resistant depression

A joint research team comprising the LKS Faculty of Medicine from the University of Hong Kong, The Chinese University of Hong Kong, New York University, and Newcastle University has uncovered potential pathways to make esketamine, a rapid-acting treatment for treatment-resistant depression (TRD), more affordable in Hong Kong.

TRD occurs when an individual fails to respond to at least two different antidepressant treatments, resulting in persistent symptoms that severely impact daily life and increase dependence on healthcare services. Professor Shirley Li Xue, lead researcher from HKUMed, emphasized the pressing need for innovative treatment options to help those who have exhausted conventional therapies.

The study, employing a comprehensive economic evaluation using a Markov cohort model, compared esketamine treatment with six other third-line treatment strategies for TRD over a five-year period. While esketamine demonstrated superior health gains in comparison, its higher costs necessitated smart health care policies to enhance affordability.

The research suggests that esketamine's value can be improved through price negotiations, optimized service delivery, alternative dosing strategies, appropriate patient selection, and value-based reimbursement. By taking a comprehensive value-based framework, healthcare decisions can ensure that patients who would benefit the most can access this medication in a sustainable manner.