Understanding profiles of patients with treatment-resistant depression by stringency of health plan prior authorization criteria for approval of esketamine nasal spray.
Current medical research and opinion September 1, 2024 Lisa Harding, Maryia Zhdanava, Aditi Shah et al. 2 citations
Among US adults with treatment-resistant depression who initiated esketamine nasal spray, those whose health plans had prior authorization criteria stricter than the drug label (stringent cohort, 168 patients) and those with less or equally strict criteria (non-stringent cohort, 400 patients) had similar treatment histories. Both groups completed about four antidepressant treatment courses on average before starting esketamine, and roughly 95% used augmentation therapy, with about 59% using an antipsychotic. These averages exceeded the number of antidepressant trials mandated by the esketamine label, suggesting that requiring additional prior authorization steps beyond the label may not be necessary.