Spravato (esketamine) — United Healthcare
Major depressive disorder (treatment-resistant)
Initial criteria
- Diagnosis of major depressive disorder (treatment-resistant)
- Patient has not experienced a clinically meaningful improvement after treatment with at least two different antidepressants
- Provider and/or the provider’s healthcare setting is certified in the Spravato REMS program
Reauthorization criteria
- Documentation of positive clinical response to Spravato therapy
- Provider and/or the provider’s healthcare setting is certified in the Spravato REMS program
Approval duration
12 months