If businesses could set prices based solely on the cost of their consumable raw materials, lawn mowing would cost $1 for gas, an Armani suit would cost $50 for fabric, haircuts and psychotherapy would be free, and a ketamine infusion would cost $30. For patients like us ketamine can be a matter of life and death, so we wish the world worked that way – but it doesn’t.

How much does ketamine therapy cost?

In the US, doctors typically charge $400-800 per infusion.  That’s a lot of money, but it’s consistent with the cost of similar procedures.  Unfortunately, insurance doesn’t cover ketamine therapy, so the patient must bear the full cost.  That’s a serious problem since many lifelong sufferers are unable to work.  A great many simply don’t have the means to afford the treatment.

The first reaction of many prospective patients is that $400-800 is exorbitantly high. But compare it to other outpatient treatments that require establishing an IV drip, vitals monitoring, etc. For example, hemodialysis or chemotherapy infusions. They also cost hundreds of dollars per treatment. But patients are rarely on the hook for the full amount thanks to insurance.

In our opinion, lack of coverage is a much more serious problem than pricing. But patients still need to understand the cost. We’ll try to explain.

Why is the cost so high? Is it greed?

Ketamine itself is cheap.  The amount used in a typical infusion for depression costs less than $10.  But consider the other costs the doctor must cover:

  • nursing salaries
  • admin salaries
  • rent
  • malpractice insurance
  • infusion pumps
  • cardiac monitors
  • IV supplies
  • legal fees
  • professional dues
  • marketing/website
  • med school loans
  • and more…

These expenses must be covered before the doctor draws a salary.  It costs a lot of money to operate a ketamine clinic, but the drug itself is only a trivial portion of the total.

Fees above the norm
We are aware of some doctors in affluent areas who charge up to $2000 per 40-minute infusion.  We do not include them in our directory.  These doctors may earn a handsome living treating a few wealthy depressed patients, and we wish them and their patients every success.  But lifelong sufferers are often unemployed, unable to work, and destitute.  So doctors with very high fees are unable to help the vast majority of patients like us.
It’s simply wrong to assume a doctor who charges a few hundred dollars per infusion is motivated by greed. It takes real courage to offer ketamine therapy in the face of resistance from the medical community, big pharma, and elsewhere. Some ketamine providers have been deeply affected by depression in their own families, and they understand how powerful the suffering is. But no one can afford to operate at a loss. True, there may be some ketamine providers who are interested only in padding their bank accounts. We don’t spend time worrying about them, because there’s now a good selection of clinics across the US whose fees fall within the usual range, and their numbers are growing.

A ketamine clinic has to operate in the black, and you can analyze it just like any other business.  Keep in mind each doctor can treat only a small number of patients per day due to the nature of the treatment.  The infusion portion of each appointment lasts 40-60 minutes during which time the doctor must constantly monitor the patient. But the total appointment time can be two hours or more when you include pre-infusion consultation, prep, and post-infusion recovery.  So it’s a low-volume business.

The cheapest option
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It’s easy to build a P&L spreadsheet for a ketamine clinic.  Given the high operating costs and the small volume of patients per day, you can see that $400-800 per infusion doesn’t allow doctors to pay themselves colossal salaries.  Ketamine doctors who charge within this range are not going to get rich.  Anesthesiologists can make far more money doing surgeries and other procedures instead of ketamine therapy.  Many of the pioneering doctors who run today’s clinics are giving up sizeable paychecks elsewhere in favor of helping patients like us.

Why doesn’t insurance cover it?

Insurance doesn’t cover ketamine therapy because it’s not FDA-approved for use on depression.  In order to obtain approval, the FDA requires extensive trials that are hugely expensive, costing billions of dollars.  No one is willing to fund these trials, because the cost can never be recovered.  Ketamine is a cheap generic drug that produces only a small profit margin for manufacturers.  FDA approval won’t change those economics.  Since ketamine can’t produce blockbuster profits, no for-profit corporation is going to invest billions in FDA trials.

But there is reason for hope.  Sometimes a carrier will cover alternative treatments that are not FDA-approved.  This happens when the carrier can make more money by covering it than by denying it.  Ketamine might prove to be one such case.

Consider a lifelong treatment-resistant depression sufferer (or bipolar, PTSD, etc) who has been treated for years without success.  Each year their insurance pays for $1000s in psychotropic drugs that don’t help.  And perhaps tens of $1000s in psychotherapy or counseling sessions that don’t help.  But suppose this patient responds to ketamine therapy.  Based on actual results we’ve seen from fellow patients, it’s possible that much of the never-ending, ineffective treatments could be replaced with a handful of ketamine infusions each year.  In addition to the obvious benefit to the patient, this could provide the insurance carrier with enormous savings.  Once carriers recognize this potential, it’s possible some of them might begin to cover ketamine therapy on an exception basis, which could eventually lead to broad coverage.

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