Spravato™ (esketamine nasal spray)

Spravato (esketamine nasal spray) is covered only for adults (≥18) for the FDA‑approved indications — treatment‑resistant depression (as monotherapy or with an oral antidepressant) and major depressive disorder with acute suicidal ideation or behavior (must be used with an oral antidepressant) — and is not covered for patients <18 or when the specific clinical/documentation criteria are not met. Key requirements include a psychiatrist prescriber, PDMP check, documented diagnosis and prior-treatment history (for TRD: ≤25% response to ≥2 antidepressants from different classes each at therapeutic dose ≥6 weeks), specified intranasal dosing/monitoring, and approval durations of 6 months for TRD and 2 months for the suicidality indication.

"Depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior in conjunction with an oral antidepressant."