Esketamine: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
DMC (Denmark), G-BA (Germany) and SMC (Scotland), among others, recommended or restricted esketamine, while AOTMIT (Poland), AWMSG (Wales) and NYE METODER (Norway), among others, did not recommend it.
HAS (France) has been harder on esketamine than on its own caseload: it refused 3 of 7 decisive submissions here (43%), against a base rate of 11% across everything it has assessed.
Assessment has run over 11.9 years, from 6 Dec 2013 at AWMSG (Wales) to 19 Nov 2025 at DMC (Denmark).
HAS (France) changed its position: not recommended on 24 Jun 2020, recommended by 17 Jul 2024, after a resubmission.
No assessment is on file from TLV (Sweden), which is among the eight highest-volume agencies here.
Not every gap is a refusal: for esketamine, 1 submission was never made and 1 was withdrawn or terminated before a decision — an outcome set by the company rather than the assessor.
The file is active: 12 of 33 records date from 2023 or later.
Against its own class, esketamine is an outlier: 46% of its decisive outcomes were positive, where molecules sharing ATC class N06A average 71%.
The programme is broad: 8 distinct indication wordings are recorded for esketamine by the agencies that label one in English (AWMSG, NICE, PBAC and SMC).
5 of these 33 records carry a year of decision but no day, so any interval quoted here is approximate to within a year.
AWMSG (Wales) was first to assess esketamine, on 6 Dec 2013; NICE (England) did not open a file until 6 Jun 2023 — an unusually long tail of 9.5 years between the earliest and latest system to look at it.
The record arrives in waves: 5 separate years each carry two or more decisions, spread across 8 years in total.
9 of the 13 agencies here assessed esketamine more than once, HAS (France) most often at 7 entries — repeat review is the norm for this molecule rather than the exception.
esketamine has been through 13 of the 18 agencies in this archive — among the most widely assessed molecules on file.
The full ledger for esketamine reads 14 not recommended, 12 recommended, 2 deferred to NICE and 1 other, with 4 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| HAS (France) | 17 Jul 2024 | Re-assessment of SMR | SMR moderate · ASMR V | source |
| PBAC (Australia) | 2024 | Treatment‑resistant depression (TRD) | Deferred | source |
| PHARMAC (New Zealand) | 2 May 2024 | treatment resistant depression, post augmentation | PTAC advice: Decline · decision reached | source |
| NYE METODER (Norway) | 11 Feb 2024 | Kombinasjon med oral antidepressiv behandling til voksne med en moderat til alvorlig episode av klinisk depresjon, som a… | decision recorded | source |
| G-BA (Germany) | 21 Sep 2023 | Spravato — benefit assessment §35a | added benefit: considerable (hint) | source |
28 further decisions for esketamine, across 13 agencies, are not shown here. They include the most recent record on file, 19 Nov 2025 from DMC (Denmark); its outcome is in the subscriber dataset. They link to 20 further source documents.
Related molecules
- escitalopram — same ATC class N06A — Psychoanaleptics
- duloxetine — same ATC class N06A — Psychoanaleptics
- venlafaxine — same ATC class N06A — Psychoanaleptics
- vortioxetine — same ATC class N06A — Psychoanaleptics
- paroxetine — same ATC class N06A — Psychoanaleptics
- mirtazapine — same ATC class N06A — Psychoanaleptics
Coverage: 33 decisions for esketamine from 13 agencies, 2013 to 2025. Data to 7 Sep 2026. ATC class N06A — Psychoanaleptics. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.