Interview with Prof. Agata Szulc, head of the Psychiatric Clinic at the Faculty of Health Sciences of the Medical University of Warsaw.
Prof. Agata Szulc: treatment with esketamine is for patients who are very severely affected by drug-resistant depression
Published June 30, 2023 14:44
How big a change in the treatment of drug-resistant depression is the reimbursement of esketamine in the drug program?
This is certainly a big change. The drug program is governed by its own rules and it imposes some restrictions, but many patients have already asked about it. The drug is registered for this indication as of 2019, but its cost is very high and out of reach for most patients. The drug program is indeed a change. The treatment is to make the patient feel better and, above all, not to suffer. Classical treatment, yes, also helps, but there is a group of patients (some say about 30 percent) who do not respond to it. Drug-resistant depression is indeed a problem, because it creates additional difficulties in life, social, family and professional (school, work), increases the already high risk of suicide. And the patient, with a sense of hopelessness and lack of improvement, has more frequent suicidal thoughts. Until now, we have had different ways to treat drug-resistant depression, but the reimbursement of esketamine gives us great opportunities. First of all, to help a certain group of patients who are heavily burdened with the disease.
Who is this therapy for?
For patients diagnosed with drug-resistant depression. As for the inclusion criteria, the health minister's regulation talks about them. There will also be guidelines for the centers that can run the program. The national consultant and the ministry, among others, are working on this. It is mainly about patients with drug-resistant severe depression, but also (hopefully) moderate depression. This was weighed up until the last minute, but as far as I know, these patients have also been included, because they will meet special criteria, namely drug resistance. So this is a sizable group of patients, counting that it's 30 percent of the one and a half million people suffering from depression. Such a large group will certainly not be able to be included in this program right away, but even the availability for a smaller group to begin with is already a value.
