How much is Spravato without insurance?

In this article:

• Is Spravato covered by insurance?
• How much does Spravato cost without insurance?
• How to get Spravato without insurance

In this article

• Is Spravato covered by insurance?
• How much does Spravato cost without insurance?
• How to get Spravato without insurance

Spravato (esketamine) is a prescription nasal spray used for treatment-resistant depression. Treatment-resistant depression is when you have major depressive disorder, or depression, that has not responded to at least two antidepressant medications. Spravato is also used to treat symptoms of depression in adults with depression who are having suicidal thoughts or behaviors. Spravato is a brand-name drug, and there is no generic available. Spravato was approved by the U.S. Food and Drug Administration (FDA) in 2019 and is made by the pharmaceutical company Janssen Pharmaceuticals. 

Because of the risk of serious problems associated with this drug, including extreme drowsiness, dissociation (a sense of disconnection from thoughts and identity), breathing problems, abuse, and misuse, Spravato is only available through a restricted Risk Evaluation and Mitigation Strategy (REMS) program called the Spravato REMS. Spravato is a controlled substance. This medication is administered under the supervision of a healthcare provider, generally in an office or clinic setting, with close monitoring for at least 2 hours after the dose is administered.

Without insurance, Spravato can be very costly. The cost will depend on the dosage, and can add up to thousands per month. In this article, we’ll explore some ways to save on Spravato.

Related: Spravato coupon | Spravato details 

Is Spravato covered by insurance?

Spravato is different from many drugs in that you do not get this medicine at your local pharmacy or by mail order. You can only get Spravato at treatment centers from healthcare providers who are enrolled in the Spravato REMS program. 

In terms of insurance coverage, Spravato coverage may be under your medical or pharmacy benefit, so you can check with your insurance company or ask your healthcare provider about insurance coverage and any related out-of-pocket costs. Not all Spravato-certified treatment centers may be in-network with your insurance plan, so if you have insurance, you will save money by using an in-network provider. 

You can also check the manufacturer’s website for information about the Spravato withMe Savings Program. If you still have trouble paying for your treatment, you can also look into a patient assistance program, such as the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF). You can also check to see if your state has a Pharmaceutical Assistance Program.

If you have Medicare coverage, you can contact Medicare, or you can also contact Janssen CarePath or Spravato withMe to learn more about what costs Medicare will cover for your Spravato treatment. You can also find out more information about other programs that may help with your costs, such as Medicare Extra Help for those who qualify.

How much does Spravato cost without insurance?

For individuals with insurance or Medicare coverage, the cost of Spravato treatment may vary based on your plan details and coverage. For those without insurance, the cost will depend on your Spravato dosage, as well as any other additional costs such as healthcare provider visit costs.

The out-of-pocket cost for Spravato 56 mg is $1,025 for a 2, 28 mg/device therapy pack. Each pack provides one dose of 56 mg. 

The out-of-pocket cost for Spravato 84 mg is $1,589 for a 3, 28 mg/device therapy pack. Each pack provides one dose of 84 mg. 

The quantity you will need depends on your treatment regimen, so you can ask your healthcare provider to help you figure out your costs. 

For example, when Spravato is used for treatment-resistant depression, the dosage is:

• Weeks 1 through 4 (induction phase): The first treatment (day 1) is 56 mg, then the dosage is 56 mg or 84 mg twice per week.
• From weeks 5 through 8, the dosage is 56 mg or 84 mg once per week.
• From week 9 and after that, the dosage is 56 mg or 84 mg once per week or once every 2 weeks.

Now, let’s break that down by cost, using the lower dose of 56 mg as an example:

• Weeks 1 through 4: 56 mg twice per week = $1,025 per dose x 2 doses per week x 4 weeks = $8,200 for the first four weeks
• Weeks 5 through 8: 56 mg once per week = $1,025 per dose x 1 dose per week x 4 weeks = $4,100 for weeks 5 through 8
• Week 9 and after that: 56 mg once per week = $1,025 per dose x 1 dose per week x 4 weeks = $4,100 per month

As you can see, Spravato can be costly without any type of assistance. In addition to exploring ways to pay for Spravato without insurance, you can also talk to your healthcare provider for medical advice about alternatives to Spravato that may be appropriate for you. The table below lists some commonly prescribed alternatives to Spravato.

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.

How to get Spravato without insurance

It can be difficult to pay for an expensive 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 some alternatives to paying full price for Spravato. Here are some ways to save money on Spravato if you do not have insurance.

Look into insurance

If you do not currently have insurance, check healthcare.gov to find out if you can enroll in a plan on the Health Insurance Marketplace. While looking at insurance plans, make sure the one you choose offers coverage for Spravato treatment. Getting on an insurance plan can offer many benefits, such as protecting you from surprise medical costs, and paying for preventive care, including vaccines, screenings, and some types of appointments, even if you are still paying toward your deductible. 

See if you are eligible for Medicaid

Medicaid, as well as the Children’s Health Insurance Program (CHIP), offer low-cost or free coverage to those who qualify based on financial need or certain health conditions. You can check your eligibility to see if you qualify, and apply online. 

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. 

Ask your healthcare provider about an alternative medication

If you have tried all options and still have trouble paying for your Spravato treatment, it is a good idea to ask your healthcare provider if there is a different medication that may be just as effective, but more affordable. For example, paying for a generic medication with a free SingleCare discount can save you up to 80% of the cost of your prescription. As you can see in the table above, a one-month supply of brand-name Geodon can cost over $2,100. However, if you apply a SingleCare discount, you can pay as little as $21 for generic Geodon, or ziprasidone, at a local participating pharmacy.