Coverage Policies for Ketamine-Based Depression Therapies Among Major U.S. Commercial Insurers: Cross-Sectional Analysis of 18 Insurers Covering 85.9 Million Members (August 2025)

Abstract

We analyzed written coverage policies for Spravato and off-label ketamine (IV/IM/oral) across 18 major U.S. commercial insurers (61.4% of market; 85,884,059 lives). As verified August 31, 2025, coverage was universal for Spravato (100%; 94.4% with prior auth) versus 1.2% for IV and 0% for IM and oral; policy silence affected 35-47% of market share. All underlying data are publicly available on Zenodo at https://doi.org/10.5281/zenodo.17021491

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