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Final Funding Blow For J&J’s Spravato In England, Despite Reimbursement In 26 Other Countries

 
• By Eliza Slawther

J&J says it has “exhausted all current viable avenues” to get its antidepressant nasal spray Spravato reimbursed on England’s National Health Service, after NICE decided against re-appraising the drug following numerous funding rejections.

Poor mental health
• Source: Shutterstock

NICE, the health technology assessment (HTA) body for England and Wales, has decided not to re-appraise Janssen’s nasal spray for treatment-resistant major depression (TRD), Spravato (esketamine), prompting its parent company Johnson & Johnson to criticize NICE’s assessment process for mental health therapies.

“The level of evidence available for mental health treatments is not on par with physical health evidence; with less data and reduced understanding of the treatment pathway

Five Year Journey

J&J has attempted to secure reimbursement for Spravato in England and Wales multiple times, but each effort has been unsuccessful.

Its initial filing was made in July 2019, and NICE provisionally rejected Spravato in January 2020 based on a lack of clinical evidence around the benefit it provided compared to other treatment options. This draft rejection was reviewed multiple times up to May 2022, when NICE published a final decision rejecting the nasal spray for reimbursement.

In July 2022, J&J and the Royal College of Psychiatrists officially appealed the NICE decision.(Also see "Janssen May Challenge English Funding Rejection For Depression Nasal Spray" - Pink Sheet, 27 May, 2022.).

The following September, an independent panel ruled NICE did not act fairly when it rejected the nasal spray because it did not fully explain how the evidence uncertainties were taken into account in its decision making.

However, eight other appeal points made by J&J were not upheld. In October 2022, NICE issued another final guidance document in which its original recommendation remained unchanged.(Also see "

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