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Key takeaways
Spravato (esketamine) is a prescription nasal spray given to people with treatment-resistant depression or depressed people who are at risk of suicide.
Without insurance, Spravato can be expensive. Each dose costs over $1,000, but other fees are incurred as well.
People without insurance can save money on Spravato with alternative treatments, healthcare provider discounts, or payment plans.
Spravato (esketamine) is a prescription nasal spray used for treatment-resistant depression. Spravato is also FDA-approved to relieve depressive symptoms in people with major depressive disorder who are actively thinking about killing themselves. The cost can add up to thousands per month.
RELATED: What is Spravato?
How much does Spravato cost without insurance?
For those without insurance, the cost will depend on the dosage and any other additional costs, such as healthcare provider costs. By law, this medication is administered under the supervision of a healthcare provider, generally in an office, clinic, or other healthcare setting. This prescription is not dispensed at the pharmacy or administered by the patient at home.
The average retail price for Spravato 56 mg is $1,059 for a 2 28 mg/device therapy pack, which provides one dose of 56 mg. The average retail price for Spravato 84 mg is $1,663 for a 3 28 mg/device therapy pack, which provides one dose of 84 mg.
If the healthcare professional uses the lowest possible dose (56 mg), the cost of Spravato nasal spray for treatment-resistant depression is:
- First month: $8,473 (8 total doses, given twice-weekly)
- Second month: $4,246 (4 total doses, given weekly)
- Third month and after: $2,118 or $4,236 per month (given every other week or once a week)
People without insurance can ask the healthcare professional about alternative treatments. Since oral antidepressants are already being used, healthcare providers typically add an antipsychotic drug to the treatment plan for these severe and hard-to-treat forms of depression.
How much does brand-name Spravato cost?
Spravato is a premium-priced brand-name medication with no generic alternatives. The earliest a generic may be available is 2028.
Compare Spravato prices to related drugs |
|||
|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Spravato
(esketamine) |
$1,059 for a 2, 28 mg/device therapy pack (56 mg dose)
$1,663 for a 3, 28 mg/device therapy pack (84 mg dose) |
$761 for a 2, 28 mg/device therapy pack (56 mg dose) of brand-name Spravato
$1,131 for a 3, 28 mg/device therapy pack (84 mg dose) of brand-name Spravato |
See latest prices (56 mg)
See latest prices(84 mg) |
| Abilify | $895 for 30, 5 mg tablets | $13 for 30, 5 mg tablets of generic Abilify | See latest prices |
| Geodon (ziprasidone) | $884 for 30, 40 mg capsules | $13 for 30, 40 mg capsules of generic Geodon | See latest prices |
| Rexulti (brexpiprazole) | $2,024 for 30, 1 mg tablets | $1,420 for 30, 1 mg tablets of brand-name Rexulti | See latest prices |
| Seroquel (quetiapine) | $154 for 30, 25 mg tablets | $6 for 30, 25 mg tablets of generic Seroquel | See latest prices |
| Vraylar (cariprazine) | $2,069 for 30, 1.5 mg capsules | $1,371 for 30, 1.5 mg capsules of brand-name Vraylar | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs. The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see updated drug prices.
Spravato costs by dose
Spravato prices vary by dose. Spravato is sold only to the clinic or healthcare provider, so pricing may vary significantly by clinic. However, the medication cost is only part of the total cost. Administrative and provider costs add additional costs.
Compare Spravato prices by strength |
|
|---|---|
| Strength | SingleCare price of brand-name Spravato |
| 56 mg of Spravato | $381 |
| 84 mg of Spravato | $377 |
| See our lowest price for Spravato without insurance | |
Save up to 80% on Spravato with SingleCare
Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.
Is Spravato covered by insurance?
Spravato is different from other prescription drugs. This medicine cannot be purchased at your local pharmacy or by mail order. You can only get Spravato at treatment centers from specific healthcare providers who are enrolled in the Spravato REMS program.
In terms of health insurance coverage, Spravato may be covered under your medical benefits or your pharmacy benefits. Check with your insurance company or ask your healthcare provider to verify coverage. The insurance provider can also estimate any out-of-pocket costs due after a deductible has been met. Not all Spravato-certified treatment centers may be in-network with your insurance plan, so choose an in-network provider to reduce the copay and other additional costs.
People with Medicare coverage are usually covered for Spravato treatment in their Medicare Part B coverage. Not all Medicare Part B plans cover Spravato therapy, but some Medicare Part D drug coverage plans do cover the cost of the drug. If you are unsure, contact your Medicare insurance provider to check your coverage and out-of-pocket costs.
The out-of-pocket cost of Spravato treatment for individuals with health insurance or Medicare coverage will vary depending on the specific plan.
Some state Medicaid programs cover Spravato therapy for eligible patients.
How to get Spravato covered by insurance
Before starting Spravato, contact the insurance company to verify coverage. Insurance plans will not cover Spravato for diagnoses other than treatment-resistant depression (TRD) or major depressive disorder (MDD) with acute suicidal ideation. You may be denied coverage if you don’t meet the diagnostic criteria for either of these mental health disorders.
Approval usually requires prior authorization. The clinician will submit this paperwork, but insurance coverage may still be denied. Step therapy is already a requirement based on the diagnosis.
If all these requirements are met and coverage is still denied, you can file an appeal with the insurance company. The healthcare provider must supply a letter of medical necessity to justify the treatment. This process may be cumbersome and take a few weeks.
How to get Spravato without insurance
It can be difficult to pay for a premium-priced brand-name medicine like Spravato without insurance, especially taking into account associated costs such as healthcare provider visits. The good news is that there are other options:
1. Use a SingleCare discount card
SingleCare can save people up to 80% on prescription medications. However, Spravato is never sold to patients at retail pharmacies. Many retail pharmacies, however, have specialty pharmacies. Talk to the treating clinician about using a SingleCare discount.
2. Talk with your healthcare provider
Many healthcare providers will work with patients on financial matters. You can ask your provider if they offer payment plans or other types of financing options. Some healthcare providers may offer a discounted price for patients without insurance.
3. Ask your healthcare provider about an alternative medication
If you have not exhausted all other options, ask your healthcare provider if there is a different medication that may be just as effective. However, you may experience troublesome side effects with some of these medications. Ask the clinician for medical advice before trying alternative drugs.
4. Ask the provider about financial assistance programs
The clinician or treatment center staff may know about rebates, financial assistance, or patient assistance programs that can help pay for your treatment.
- Management of treatment-resistant depression: Challenges and strategies, Neuropsychiatric Disease and Treatment (2020)
- Medications for treatment-resistant depression in adults, American Family Physician (2021)
- Spravato, Janssen Pharmaceuticals, Inc. (2024)
- Spravato esketamine hydrochloride solution prescribing information, DailyMed (NIH National Library of Medicine)
- Spravato drug patent profile, Drug Patent Watch
- Spravato savings program, Johnson & Johnson