{
  "meta": {
    "name": "European Ketamine & Esketamine Therapy Cost Index",
    "version": "2026.09",
    "updated": "2026-09-04",
    "update_cadence": "quarterly",
    "next_verification": "2026-10",
    "license": "https://creativecommons.org/licenses/by/4.0/",
    "attribution": "PsyAccess: European Ketamine Therapy Cost Index, psyaccess.health/costs/ (CC BY 4.0)",
    "method": "Prices are taken from clinics' published price lists and public reimbursement decisions only, cross-checked against the PsyAccess provider catalog (each priced record carries its own source links and last-verified date). Where a market has no published prices we say so instead of estimating. Reimbursement criteria cite the national regulator."
  },
  "ketamine": [
    {
      "country": "United Kingdom",
      "country_code": "gb",
      "private_session": "£265–595 per IV infusion",
      "kap_programme": "from ~£6,000 (six-week programme); ~£3,000/year at an NHS self-funded service",
      "public_route": "Scotland: Spravato accepted by the SMC (SMC2258); England & Wales: NICE declined (TA854), private only",
      "n_clinics_published": 3,
      "note": "£265 is the self-funded ketamine service inside Oxford Health NHS Foundation Trust (infusion and initial psychiatrist assessment priced at £265 each); £595 is a London infusion with consultation packages of £890–1,340.",
      "source_class": "clinic price lists; NICE/SMC decisions",
      "sources": [
        {
          "label": "Oxford Health NHS FT: ketamine service pricing",
          "url": "https://oxfordhealth.nhs.uk/ips/ketamine-trd/pricing/",
          "checked": "2026-08-01"
        },
        {
          "label": "Save Minds: fee guide",
          "url": "https://saveminds.co.uk",
          "checked": "2026-07-27"
        },
        {
          "label": "Eulas Clinics: programme pricing",
          "url": "https://eulasclinics.com/ketamine-therapy-pricing/",
          "checked": "2026-07-27"
        },
        {
          "label": "NICE TA854 (esketamine not recommended)",
          "url": "https://www.nice.org.uk/guidance/ta854",
          "checked": "2026-08-19"
        },
        {
          "label": "SMC2258: esketamine accepted, restricted (Scotland)",
          "url": "https://www.scottishmedicines.org.uk/medicines-advice/esketamine-spravato-full-smc2258/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Germany",
      "country_code": "de",
      "private_session": "€200–300 per IV infusion",
      "kap_programme": "~€15,000 six-week private day-clinic programme (private insurance often covers in full)",
      "public_route": "Spravato via GKV for on-label TRD, incl. office-based practices since 10/2023 (GOP 01549); nationwide Praxisbesonderheit keeps it out of the doctor's budget",
      "n_clinics_published": 2,
      "note": "Hospital providers (per-day billing) and several practices publish no single price; that is structural, not evasive.",
      "source_class": "published clinic prices; G-BA / KV documents",
      "sources": [
        {
          "label": "MainOP Frankfurt: published infusion price",
          "url": "https://mainop.de",
          "checked": "2026-08-01"
        },
        {
          "label": "OVID Clinic Berlin: day-clinic programme",
          "url": "https://ovid-clinics.de",
          "checked": "2026-08-05"
        },
        {
          "label": "KV Berlin: GOP 01549 billing code",
          "url": "https://www.kvberlin.de/fuer-praxen/aktuelles/praxis-news/detailansicht/pn231024-5",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Switzerland",
      "country_code": "ch",
      "private_session": "~CHF 300–500 per infusion (typical range from secondary sources, no directory clinic publishes a list price)",
      "kap_programme": null,
      "public_route": "Spravato via OKP at 52 BAG-designated centers; insurer pre-approval (Vertrauensarzt), 10-month cap",
      "n_clinics_published": 0,
      "note": "Swiss practices state esketamine can be billed via insurers after cost approval, while off-label IV ketamine is self-pay with tariffs on request. The CHF range is a documented typical range, not a published price list.",
      "source_class": "secondary sources; BAG documents",
      "sources": [
        {
          "label": "Blossom: Switzerland reimbursement overview",
          "url": "https://www.moreblossom.com/countries/switzerland/reimbursement",
          "checked": "2026-08-19"
        },
        {
          "label": "BAG: Spravato Limitatio and designated-center list",
          "url": "https://www.bag.admin.ch/de/bag/de/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/Arzneimittel/Referenzdokumente-zur-Spezialitaetenliste.html",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Norway",
      "country_code": "no",
      "private_session": "NOK 4,250–7,590 per session",
      "kap_programme": "published packages NOK 12,750–47,640",
      "public_route": "World first: public funding of generic IV ketamine for TRD since 25/08/2025 (Nye Metoder ID2022_018), standard co-payments only, counting toward the frikort ceiling",
      "n_clinics_published": 2,
      "note": "Package spread runs from a 3-infusion follow-up (NOK 12,750) to complete 4–6 session programmes (NOK 32,460–47,640).",
      "source_class": "clinic price pages; Nye Metoder decision",
      "sources": [
        {
          "label": "Axonklinikken: price pages",
          "url": "https://axon.no",
          "checked": "2026-08-04"
        },
        {
          "label": "Synapseklinikken: price pages",
          "url": "https://synapseklinikken.no",
          "checked": "2026-08-04"
        },
        {
          "label": "Nye Metoder: Ketamin ID2022_018, decision of 25 Aug 2025",
          "url": "https://www.nyemetoder.no/metoder/ketamin/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Portugal",
      "country_code": "pt",
      "private_session": "initial evaluation €120 (per-session infusion price not published)",
      "kap_programme": "€3,900 KAP programme with insurance / €5,500 without",
      "public_route": "Spravato in hospital settings since 05/2025 (INFARMED financing decision)",
      "n_clinics_published": 1,
      "note": "The €3,900-vs-€5,500 split is the same programme priced by insurance status, see the 'with insurance' trap.",
      "source_class": "published clinic prices; INFARMED",
      "sources": [
        {
          "label": "The Clinic of Change: programmes and published prices",
          "url": "https://theclinicofchange.com",
          "checked": "2026-07-27"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Poland",
      "country_code": "pl",
      "private_session": "1,200–1,450 PLN maintenance infusion",
      "kap_programme": "9,300–15,660 PLN full protocols (e.g. 12 IV infusions + 12 integration sessions)",
      "public_route": "Esketamine FREE via NFZ drug programme B.147 (~64 contracted centers, live waiting-time portal; max 34 weeks)",
      "n_clinics_published": 3,
      "note": "The 15,660 PLN protocol works out cheaper per session than most Western European single infusions.",
      "source_class": "published clinic prices; NFZ programme",
      "sources": [
        {
          "label": "KeyClinic: price list",
          "url": "https://keyclinic.pl",
          "checked": "2026-07-27"
        },
        {
          "label": "Magwise: price list",
          "url": "https://magwise.pl",
          "checked": "2026-08-01"
        },
        {
          "label": "FreeMindClinic: price list",
          "url": "https://freemindclinic.pl",
          "checked": "2026-08-01"
        },
        {
          "label": "NFZ drug programme B.147",
          "url": "https://www.gov.pl/web/zdrowie/choroby-psychiczne",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Czechia",
      "country_code": "cz",
      "private_session": "not published per session",
      "kap_programme": "initial KAP course 17,600–28,600 CZK for contracted-insurer clients / 39,100–49,200 CZK self-pay (up to 72,070 CZK for the English-language two-therapist variant)",
      "public_route": "Spravato reimbursed since 02/2025 for adults under 65 (SÚKL conditions); documented exceptional approvals beyond criteria",
      "n_clinics_published": 1,
      "note": "The only country where insurers put money into KAP: contracts with seven insurers roughly halve the initial course price.",
      "source_class": "published clinic prices; SÚKL",
      "sources": [
        {
          "label": "Psyon: KAT price list (valid from 01/2026) and insurer contracts",
          "url": "https://psyon.cz/en/",
          "checked": "2026-07-27"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Sweden",
      "country_code": "se",
      "private_session": "being verified, no directory provider currently publishes a private session price",
      "kap_programme": null,
      "public_route": "Spravato 'strongly restrained' (NT Council, rev. 11/2024); region-by-region funding decisions",
      "n_clinics_published": 0,
      "note": "Within the public route the drug cost to the region is published (2,089–6,269 SEK per session by dose); patients pay standard fees within the high-cost ceiling, see the esketamine index.",
      "source_class": "regional payer documents; NT Council",
      "sources": [
        {
          "label": "Region Jönköpings län: Spravato treatment and costs",
          "url": "https://folkhalsaochsjukvard.rjl.se/",
          "checked": "2026-07-29"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Austria",
      "country_code": "at",
      "private_session": "€350 ketamine session; €450 with psychotherapy; esketamine session €150–250; first consultation €180–400",
      "kap_programme": null,
      "public_route": "Inpatient covered via hospital financing (LKF); outpatient case-by-case chief-physician approval; Wahlarzt refunds typically €80–110 per session",
      "n_clinics_published": 2,
      "note": "Both priced providers are Vienna Wahlarzt practices, the partial sickness-fund refund is a legal entitlement, not a favour.",
      "source_class": "published practice fees",
      "sources": [
        {
          "label": "Ordination Dr. Buchmayer: fee schedule",
          "url": "https://dr.buchmayer.eu",
          "checked": "2026-07-27"
        },
        {
          "label": "PsyTherapie (Dr. Platz): fee schedule",
          "url": "https://psytherapie.net",
          "checked": "2026-07-27"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Spain",
      "country_code": "es",
      "private_session": "€575 infusion with therapeutic accompaniment (one clinic's published list)",
      "kap_programme": null,
      "public_route": "Spravato as hospital medicine since 11/2022; 18–74, ≥3 failed strategies incl. augmentation; regional variation",
      "n_clinics_published": 1,
      "note": "Other Spanish providers price per treatment plan and publish no list.",
      "source_class": "published clinic prices",
      "sources": [
        {
          "label": "Instituto Dr. Scheib: Mallorca price list",
          "url": "https://medicinapsicosomatica.es",
          "checked": "2026-08-01"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Netherlands",
      "country_code": "nl",
      "private_session": "no private ketamine market",
      "kap_programme": null,
      "public_route": "Spravato in the basic package (basispakket) since 09/2021 at specialized ENC-NL-criteria centers; 2 antidepressants + 1 augmentation failed",
      "n_clinics_published": 0,
      "note": "Treatment counts toward the annual deductible (eigen risico); the center confirms coverage with your insurer.",
      "source_class": "Zorginstituut decision",
      "sources": [
        {
          "label": "Zorginstituut Nederland: package advice esketamine",
          "url": "https://www.zorginstituutnederland.nl/documenten/2020/09/30/pakketadvies-esketamine-neusspray-spravato",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "France",
      "country_code": "fr",
      "private_session": "no private ketamine market",
      "kap_programme": null,
      "public_route": "Spravato hospital-only, under 65, ≥2 antidepressants of 2 classes failed; ketamine compassionate framework for suicidal crisis since 03/2026",
      "n_clinics_published": 0,
      "note": null,
      "source_class": "ANSM/HAS documents",
      "sources": [
        {
          "label": "PsyAccess France reimbursement guide (ANSM/HAS sources)",
          "url": "https://psyaccess.health/guides/reimbursement-france/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    }
  ],
  "esketamine": [
    {
      "country": "Germany",
      "country_code": "de",
      "session_price": "list price ~€345 per 28 mg device; a four-week self-pay induction can reach ~€8,000 before clinic fees",
      "reimbursed": "Yes: GKV for on-label TRD, incl. office-based practices (GOP 01549)",
      "n_clinics_published": 1,
      "note": "The covered route exists for a reason: self-pay esketamine arithmetic is brutal.",
      "sources": [
        {
          "label": "Thieme: esketamine list price and induction cost",
          "url": "https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1500-9805",
          "checked": "2026-07-28"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Austria",
      "country_code": "at",
      "session_price": "€150–250 per private esketamine session (published practice fee); Wahlarzt refund typically €80–110",
      "reimbursed": "Partially, inpatient via hospital financing; outpatient case-by-case",
      "n_clinics_published": 1,
      "note": null,
      "sources": [
        {
          "label": "Ordination Dr. Buchmayer: fee schedule",
          "url": "https://dr.buchmayer.eu",
          "checked": "2026-07-27"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Sweden",
      "country_code": "se",
      "session_price": "drug cost to the region: 2,089 SEK (28 mg) / 4,179 SEK (56 mg) / 6,269 SEK (84 mg) per session; patient pays standard fees within the high-cost ceiling",
      "reimbursed": "Restrained: NT Council advises 'strongly restrained' use; regions decide",
      "n_clinics_published": 1,
      "note": "A rare published look at what the public payer itself pays per session.",
      "sources": [
        {
          "label": "Region Jönköpings län: Spravato treatment",
          "url": "https://folkhalsaochsjukvard.rjl.se/",
          "checked": "2026-07-29"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "country": "Poland",
      "country_code": "pl",
      "session_price": "no consumer price, fully funded via NFZ B.147 (drug, administration, observation and monitoring)",
      "reimbursed": "Yes, free for eligible patients, max 34 weeks",
      "n_clinics_published": 0,
      "note": null,
      "sources": [
        {
          "label": "PsyAccess Poland reimbursement guide (NFZ B.147 sources)",
          "url": "https://psyaccess.health/guides/reimbursement-poland/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    }
  ],
  "pat": [
    {
      "programme": "Switzerland: limited medical use (psilocybin, LSD, MDMA)",
      "country_code": "ch",
      "published_prices": "few publish, none of the 101 SÄPT-listed PAT practitioners in our directory publishes a programme price list",
      "status": "being verified",
      "note": "Treatment is usually self-paid (per-patient FOPH permits; ~100 authorized physicians and 723 patients in 2024). Budget for preparation sessions, supervised dosing days of 6+ hours, and integration sessions. Legal NL truffle retreats are excluded: wellness retreats, not medical treatment.",
      "sources": [
        {
          "label": "PsyAccess Switzerland access guide (BAG/SÄPT sources)",
          "url": "https://psyaccess.health/guides/access-switzerland/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "programme": "Germany: psilocybin compassionate use (Härtefallprogramm)",
      "country_code": "de",
      "published_prices": "the drug is provided free of charge by law; surrounding inpatient or day-clinic care is billed as normal hospital treatment (a Berlin day-clinic programme runs ~€15,000 for 6 weeks, often covered by private insurance)",
      "status": "verified",
      "note": "Two sites (ZI Mannheim, OVID Berlin); TRD only.",
      "sources": [
        {
          "label": "OVID Clinic Berlin: day-clinic programme",
          "url": "https://ovid-clinics.de",
          "checked": "2026-08-05"
        },
        {
          "label": "PsyAccess Europe reimbursement map (Härtefallprogramm sources)",
          "url": "https://psyaccess.health/guides/insurance-reimbursement-europe/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    },
    {
      "programme": "Czechia: medical psilocybin framework",
      "country_code": "cz",
      "published_prices": "no prices exist yet, the law took effect 01/2026, treatment had not started as of spring 2026 and no funding route is defined",
      "status": "being verified",
      "note": null,
      "sources": [
        {
          "label": "PsyAccess Europe reimbursement map (Czech framework sources)",
          "url": "https://psyaccess.health/guides/insurance-reimbursement-europe/",
          "checked": "2026-08-19"
        }
      ],
      "verified_at": "2026-09-04"
    }
  ]
}