ICER chastises J&J for overpricing depression drug esketamine ‘where there is such need for treatment’ – Endpoints NewsUsing the esketamine list price of $295 per 28 mg intranasal device, the treatment’s use results in an incremental cost-effectiveness ratio of approximately $198,000 per QALY compared to no additional treatment, exceeding the commonly cited cost-effectiveness thresholds of between $50,000-$150,000 per QALY. Meanwhile, esketamine is estimated to cost approximately $2.6 million per life year gained, ICER found. Esketamine’s approval was also meant to enhance access to treatment — since ketamine is not covered by health insurers — although there is a concern that there may still be high out-of-pocket expenses through deductibles or non-coverage policies. Indeed, “the place for esketamine may depend on the comparative benefits between esketamine and other available treatments, such as ketamine. Unfortunately, such information is not available at this time,” ICER said.