Great question. The cost of drugs in pharmacy is usually down to multiple factors but one main one is whether it is under patent or not. In this case ketamine racemic has been used for more than half a century and is not under any licensing restrictions. However, the S Isomer aka esketamine has a patent and therefore is associated with the development costs from industry which they try to recoup through increased price. One big question here, is that the licensee only got the patent on the molecule as it proved at that time that it was more effective. However, now as more data has come out about its relative efficacy to normal ketamine, is this price still justified?

We dont prescribe esketamine you will need to talk to a psychiatrist.

Hi Laura, the nasal spray cant be directly purchased as you need a prescription. I will put you on our mailing list so you can keep updated on prescribers.

Hi Frank, it is likely that when esketamine comes to the UK it will mirror the prescribing category for which it was initially intended in the US. This often saves the pharmaceutical firm time and money. The official prescribing category comes from the granted application of the drug from the FDA which states “for the treatment of treatment-resistant depression (TRD) in adults.“. However, this potential catergorisation does not mean it cannot be prescribed for bipolar disorder, it could be prescribed “off label“. Off label is when the prescriber has sufficient information as to the efficacy of a medicine outside of its common use. You might want to search scientific databases for papers which contain the keywords “bipolar” and “esketamine” for more information on this.