Funding of psychiatry in France, the problem of expensive drugs. Example of Esketamine in the case of resistant depressive episodes

Encephale. 2023 Nov 30:S0013-7006(23)00204-X. doi: 10.1016/j.encep.2023.09.007. Online ahead of print.ABSTRACTIn France, the funding of mental health institutions relies on an annual budget allocation. Esketamine, a non-competitive NMDA glutamate receptor antagonist, has been approved for adults with treatment-resistant major depressive disorder since 2019. However, due to its high cost (€200 per 28 mg device, excluding tax), the aim of this work was to evaluate whether the income received by an institution for the management of a patient treated with Esketamine could cover the purchase of devices, based on real clinical data. Within our institution, seven patients underwent treatment with Esketamine during the study period resulting in a total usage of 714 devices, amounting to a purchase cost of €142,800. Over the course of the follow-up period, the institution received €149,054 in revenue for the treatment of these patients. Our analysis reveals that the expense associated with Esketamine constitutes 95.8 % of the income generated from caring for these patients. This not only raises questions about the pricing of this drug but also highlights the lack of a funding system for costly psychiatric drugs. This concern extends to somatic treatments associated with psychiatric care.PMID:38040510 | DOI:10.1016/j.encep.2023.09.007
Source: L Encephale - Category: Psychiatry Authors: Source Type: research