SPRAVATO

Indicated For

Treatment-resistant depression (TRD), Major depressive disorder (MDD) with acute suicidal ideation or behavior

About This Medication

# SPRAVATO withMe Patient Guide: How to Get SPRAVATO (esketamine) at Low or No Cost SPRAVATO® (esketamine) is a prescription nasal spray used to treat **treatment-resistant depression (TRD)** in adults, either alone or with an oral antidepressant, and **depressive symptoms in adults with major depressive disorder (MDD)** who have acute suicidal ideation or behavior, alongside an oral antidepressant[6]. Janssen, the manufacturer, offers the **SPRAVATO withMe** program to help make this therapy more affordable through savings cards, rebates, and free medication options for eligible patients[1][2][3]. This guide explains eligibility, application steps, and support options in simple terms. SPRAVATO must be given under healthcare provider supervision at certified sites due to its **REMS (Risk Evaluation and Mitigation Strategy) Program**, which ensures safe administration and monitoring for at least 2 hours post-dose—it's never dispensed for home use[4][6][9]. ## Who Qualifies for SPRAVATO withMe? The program has two main paths: a **Savings Program** for commercially insured patients and a **Patient Assistance Program (PAP)** for those with limited income or inadequate coverage[1][7][8]. - **Savings Program**: Eligible if you have **commercial/private insurance** (including Marketplace plans), are 18+, pay out-of-pocket costs, and are enrolled in SPRAVATO REMS. Not for government insurance like Medicare, Medicaid, TRICARE, VA, or DoD[2][5][10]. Pay **as little as $10 per treatment** (up to 3 devices/day), with annual maximum benefits and limits like 23 devices/24-day period. Some plans reduce benefits if they offset copays[4]. - **Patient Assistance Program (PAP)**: Free SPRAVATO for up to **1 year** if you meet **income requirements**, have inadequate insurance coverage (commercial, employer, or government), and are prescribed a qualifying Janssen med. Expanded in 2023 to include insured patients with poor coverage[1][3][7][8]. ## About SPRAVATO SPRAVATO is an **NMDA receptor antagonist** nasal spray for hard-to-treat depression when other antidepressants fail. It's administered 1-2 times weekly initially, then less often, always at a certified clinic under observation due to risks like sedation, dissociation, blood pressure increases, respiratory issues, and suicidal thoughts[4][6]. Discuss risks/benefits with your doctor; see full Prescribing Info for details. ## Income Eligibility Breakdown Specific FPL (Federal Poverty Level) thresholds aren't detailed publicly, but PAP requires meeting **income eligibility** with proof[1][7][8]. Savings Program focuses on commercial insurance, not strict income[2]. Contact Janssen for personalized check (877-CarePath / 877-227-3728). | Household Size | Estimated PAP Income Limit (e.g., ~400-500% FPL, verify current) | Notes | |---------------|---------------------------------------------------------------|-------| | Individual | Up to ~$60,000-$75,000 annually | Based on program norms; exact via application[7] | | Couple | Up to ~$80,000-$100,000 | Income only for med costs, not administration[7] | | Family of 3 | Up to ~$100,000-$125,000 | Free for 1 year if eligible[1][3] | | Family of 4 | Up to ~$120,000-$150,000 | Excludes gov't programs for Savings[10] | *Table estimates from similar programs; call for exact/current FPL %[8].* ## Insurance Requirements - **Commercial/Private**: Primary path for Savings—submit EOB, receipts for rebates if needed. Rebates within 270 days[5][10]. Not for plans eliminating out-of-pocket or copay accumulators (except Maine)[4]. - **Government (Medicare/Medicaid)**: Ineligible for Savings; use PAP if income-qualified[8][9][10]. - **Uninsured/Underinsured**: PAP provides free meds[7]. All require REMS enrollment at certified sites[6]. ## Step-by-Step Application 1. **Talk to your doctor**: Confirm SPRAVATO prescription and REMS enrollment (1-855-382-6022)[6]. 2. **Check eligibility**: Visit **janssencarepath.com/patient/spravato** or call **877-CarePath (877-227-3728)**. Provide insurance/income details[2][10]. 3. **Enroll online/at MyJanssenCarePath.com**: Get savings card ID for commercial ins. For PAP, complete enrollment form with HCP[7][10]. 4. **Gather docs**: Insurance card, ID, income proof (taxes, paystubs), EOB/receipts for rebates[4][10]. 5. **Share with clinic**: Give savings card to REMS-certified site admin before treatment[8]. 6. **Submit rebates if needed**: Mail form + EOB/proof within 270 days for reimbursement[10]. HCP completes prescription section[7]. Janssen verifies coverage. ## Timeline and Delivery - **Processing**: Immediate savings card; PAP approval varies (days-weeks). Rebates post-submission[10]. - **Delivery**: No home delivery—administered **only at certified clinics**. Clinic handles via specialty pharmacy; you attend sessions[6][8]. - **Duration**: Savings annual/calendar year max; PAP up to 1 year, reapply[1][4]. ## Alternatives if Denied - **State foundations**: Check via Janssen site[1]. - **Other assistance**: Independent foundations for depression meds. - **Switch treatments**: Discuss generics/oral antidepressants with doctor. - **Appeal**: Resubmit with more docs or call Janssen[7]. - **Biosimilars**: None currently[program data]. ## Disclaimer This guide is for informational purposes, based on available program details as of latest info. Eligibility/benefits change; Janssen sets terms/discretion. Not medical/financial advice—consult your doctor/insurer. Programs may end without notice. Risks include serious side effects; read Medication Guide. Janssen not liable for misuse. Verify at janssencarepath.com or 877-227-3728. (Word count: 942)

Program information last verified: March 30, 2026