Access and real-world use patterns of esketamine nasal spray among patients with treatment-resistant depression covered by private or public insurance.
Curr Med Res Opin August 3, 2023 DOI: 10.1080/03007995.2023.2239045 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective observational cohort study Peer reviewed |
|---|---|
| Sample size | 535 |
| Population | Adults with treatment-resistant depression and at least one esketamine nasal spray pharmacy claim in a US real-world insurance claims database |
| Intervention | Esketamine nasal spray |
| Duration | Mean follow-up of 11.8 months |
| Topics | Depression Esketamine |
| Key findings | Initial access to esketamine nasal spray was frequently blocked: only 34.6% of first pharmacy claims were approved, with rejections often due to lack of plan coverage, claim errors, or prior authorization requirements, though approval reached 85.2% by the second session. Among 273 patients who initiated esketamine, use generally deviated from label recommendations, with only 17.6% completing induction per label; most of those who did complete label-recommended induction continued to maintenance. |
Abstract
Objective: To describe access and real-world use patterns of esketamine nasal spray among adults with treatment-resistant depression (TRD) with private or public insurance.
Methods: Adults with ≥1 claim for esketamine nasal spray were selected from Clarivate's Real World Data product (January 2016-March 2021). Patients with evidence of TRD initiating esketamine (index date) after 05 March 2019 were included. Esketamine access, as measured by pharmacy claim approval rate for each treatment session, and use patterns were described post-index (follow-up period).
Results: Among 535 patients with pharmacy claims for esketamine nasal spray (mean age 49.1 years; 65.4% females), 534 had the first esketamine claim being a pharmacy claim, of which 34.6% were approved, 46.3% were rejected, and 19.1% were abandoned. Main reasons for rejection included "claim not covered by plan" (57.1%), "claim errors" (52.6%), and "prior authorization required" (22.7%). The approval rate increased to 85.2% by the second esketamine treatment session. A total of 273 patients initiated esketamine (mean age 49.3 years; 66.3% females). Patients had a mean ± standard deviation (SD) of 11.8 ± 13.3 esketamine sessions over a mean ± SD of 11.8 ± 6.4 months; 47.6% of patients completed ≥8 sessions (i.e. the number of sessions in induction phase) over a mean ± SD of 80.1 ± 71.9 days (per label, 28 days); 48 (17.6%) patients completed induction per label, and among them 93.8% continued treatment.
Conclusions: Initial access to esketamine nasal spray may be hindered by prior authorization or claim filing errors. Among patients who initiated esketamine, treatment compliance generally deviates from label recommendations; yet, most of those who received induction per label successfully transition to maintenance with esketamine.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.