Yes. Since 19 November 2025, esketamine nasal spray (Spravato) is recommended in Denmark for adults with moderate-to-severe treatment-resistant depression that has not responded to at least three different antidepressant treatments in the current episode. Medicinrådet — the Danish Medicines Council — reversed its 2020 rejection after new long-term data and a price cut, and treatment is delivered and covered within regional hospital psychiatry. This page covers exactly who qualifies, how the route works, what you pay, and what to do if you fall outside the criteria; the eligibility decision itself always sits with a clinician, and you can begin orienting yourself with our eligibility check.
What is covered
On 19 November 2025, Medicinrådet recommended esketamine for adults with moderate-to-severe treatment-resistant depression after at least three failed antidepressant treatments in the current episode. Two things changed since the council's cautious 2020 assessment, when only four-week data existed: the manufacturer produced new studies evaluating effect over 32 weeks, showing with greater certainty that esketamine helps more patients achieve lasting improvement than current treatment — and it lowered the price.
Know what the recommendation is and is not. It makes esketamine a possible standard treatment that the five Danish regions deliver through hospital psychiatry, with supervised administration and a roughly two-hour observation period; it does not create a network of clinics or a prescription you collect at a pharmacy. And the scale is deliberately modest: Medicinrådet estimates roughly 40–60 candidate patients per year nationwide.
A second track already existed. Since January 2023, Medicinrådet has recommended esketamine — together with an oral antidepressant — as acute short-term treatment for rapid reduction of depressive symptoms in adults admitted with depression and acutely increased suicide risk, reserved for patients who do not tolerate, do not benefit from, or after thorough information do not want electroconvulsive therapy. The council was explicit that there is no documented effect on suicide risk itself — the documented effect is faster symptom reduction in some patients.
Who qualifies
For the routine track, the criteria are:
- An adult with a moderate-to-severe depressive episode;
- No response to at least three different antidepressant treatments in the current episode — a higher bar than the two failures most European countries require;
- Esketamine is combined with a continuing oral antidepressant, per the EU label.
The practical currency is a written treatment history: every antidepressant treatment tried in the current episode, with substance, dose, duration and outcome. Three documented failures is a demanding standard, and assembling proof is often the slower part of the process — start before any appointment.
The acute track has its own logic: it applies to admitted patients with depression and acutely increased suicide risk, and the decision is made by the treating hospital team during an admission, not booked from outside.
Who decides and how to apply
The route runs through your GP (egen læge) to regional psychiatry, or through the psychiatrist already treating you. There is no insurer to apply to: Denmark's five regions deliver the treatment through hospital psychiatric services, and the hospital team applies the criteria — including defined start-stop criteria, so expect your response to be measured and the treatment ended if it is not working.
Expect the rollout to be gradual and uneven. Denmark is starting this route from a low base, so regional capacity — not the recommendation — sets the timeline, plausibly months. To see what is listed, browse providers in Denmark; for the full picture of every legal route in the country, see our Denmark access guide.
What it costs you
For patients who meet the criteria, treatment is covered within public hospital psychiatry — the routine track and the acute inpatient track alike. There is no meaningful private comparison price inside the country: Denmark has no private ketamine-clinic market to speak of, so the public route is, in practice, the route.
If you do not qualify
The honest fallbacks are narrower in Denmark than in most of Europe:
- The acute inpatient track. If the situation is a crisis — depression with acutely increased suicide risk — the door is the psychiatric emergency system, where esketamine has been a recommended acute short-term option for admitted patients since January 2023.
- Clinical trials are free by definition and, in Denmark, the only legal way to receive a classical psychedelic at all: psilocybin studies are recruiting at Bispebjerg Hospital (PsyPal, psychological distress in palliative care) and Rigshospitalet's Neurobiology Research Unit in July 2026. See the trials guide for how to search.
- No private clinic route. No clinic, therapist or association can legally administer psilocybin or MDMA in Denmark outside an authorised trial, and there is no private ketamine market to fall back on.
Frequently asked questions
Is Spravato reimbursed in Denmark?
Yes — since 19 November 2025 Medicinrådet recommends it for moderate-to-severe treatment-resistant depression after at least three failed antidepressant treatments in the current episode, delivered and covered within regional hospital psychiatry. A separate recommendation since January 2023 covers acute short-term use for admitted patients with acutely increased suicide risk.
Why did Denmark say no in 2020 and yes in 2025?
In 2020 only four-week data existed, leaving real uncertainty about effect and side effects. By late 2025 the manufacturer had produced 32-week studies showing more patients achieving lasting improvement, and lowered the price. The recommendation followed the new evidence and the new economics.
How quickly can I actually get it?
Modestly and unevenly — Medicinrådet estimates roughly 40–60 candidate patients per year nationwide, and the regions are building delivery from a low base. Expect the referral, the documentation of three failed treatments, and regional capacity to set your timeline, plausibly months.
Why three failed treatments when Germany or Belgium require two?
Because reimbursement is a national decision made against national evidence and price assessments, criteria differ by country even for the same drug. Denmark's recommendation sets the bar at three failed antidepressant treatments in the current episode — see the Europe-wide reimbursement map for how the criteria compare.
Sources
- Medicinrådet: Efter nye data og lavere pris — nu anbefaler Medicinrådet esketamin til svær behandlingsresistent depression (November 2025)
- Medicinrådet: Esketamin (Spravato) — moderat til svær depression hos voksne med akut øget selvmordsrisiko (recommendation, January 2023)
- Blossom: Medical access in Denmark
- EMA: Spravato (esketamine) EPAR
- Reimbursement Pathways for Psychedelic Therapies in Europe — Magnetar Access × Blossom (2025)
This guide is for general information only and is not medical advice, a diagnosis, or a recommendation of any treatment. Regulations and reimbursement rules change; always verify current requirements with your insurer and discuss your options with a licensed clinician who knows your history. If you are in crisis, contact your local emergency number or a crisis line immediately.
This guide awaits review by a licensed medical professional.