Yes. Kela, Finland's national social insurance institution, has reimbursed esketamine nasal spray (Spravato) since August 2023 under two restricted entitlements — code 3062 (basic reimbursement, 40 per cent of the medicine's price) and code 1539 (special reimbursement, 100 per cent) — with the strictest published criteria in Europe. The delivery model is just as distinctive: you buy the reimbursed spray at a pharmacy and self-administer it under supervision at a healthcare unit, which allows treatment in outpatient and private settings, not just hospitals. This page covers exactly who qualifies, how the B-statement application 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
Kela reimburses Spravato for treatment-resistant depression under two restricted entitlements introduced from August 2023: code 3062, a restricted basic reimbursement covering 40 per cent of the medicine's price, and code 1539, a restricted special reimbursement covering 100 per cent for patients whose severe mental disorder is demonstrated as in entitlement 112. The medical criteria for esketamine itself are the same under both.
The pharmacy-dispensing model is what makes Finland genuinely unusual. In most of Europe, Spravato is a hospital-dispensed medicine, which chains treatment to hospital sites. In Finland the reimbursed spray is dispensed at a pharmacy to the patient, who brings it to a healthcare unit and self-administers it there under supervision, with the standard post-dose observation — so supervised treatment can happen in outpatient psychiatric clinics, including private ones.
Who qualifies
The criteria are precise, and they are the strictest published in Europe:
- An adult with treatment-resistant depression, treated in combination with an ongoing SSRI or SNRI;
- A MADRS score of at least 31 — a severe episode — at the start of esketamine treatment;
- At least three different antidepressant treatments, with attached psychotherapy or another psychosocial treatment, have failed to produce a response;
- One of the three must have been a combination: two antidepressants, an antidepressant plus an antipsychotic, or an antidepressant plus lithium;
- All of it documented in a psychiatrist's B-statement.
Note the detail most patients miss: psychotherapy or psychosocial treatment attached to the medication attempts is itself part of the requirement, not an optional extra. Under criteria this specific, a complete written treatment history — medications, doses, durations, outcomes, psychotherapy episodes — decides the case, so assemble it before the first appointment.
Who decides and how to apply
The B-statement is the application. The entitlement is granted on the basis of a physician's B-statement (lääkärinlausunto B) written by a specialist psychiatric unit or a psychiatrist, describing the illness, every prior treatment and its outcome, and a treatment plan consistent with good clinical practice; Kela decides on the entitlement based on it. The route runs through a psychiatrist — via referral from your health centre or occupational health, or directly in the private sector. The entitlement is time-limited to at most one year at a time, and continuation is granted only if your MADRS total score has at least halved from the starting point (while remaining 13 or above; below that, the treatment goal is considered reached). For the full picture of every legal route in the country, see our Finland access guide; to see who is listed, browse providers in Finland.
What it costs you
Under code 3062, Kela covers 40 per cent of the medicine's price; under code 1539, 100 per cent — reimbursement is applied at the pharmacy counter when you fill the prescription. Treatment-visit fees depend on the setting: if you use a private clinic, Kela reimburses the medicine on the same terms, but the clinic's own visit fees are yours to pay, so ask for a written per-visit price before starting.
If you do not qualify
Finland has no named exceptional or individual-case reimbursement mechanism for esketamine — the standard Kela criteria govern. The honest fallbacks are limited:
- Off-label ketamine is occasionally used in psychiatric settings — typically in hospital care, at the treating department's discretion — but Finland has no established private ketamine-infusion market, so it is not a service you can book. If you compare providers for supervised esketamine instead, our clinic-choice guide lists the questions to ask.
- Clinical trials are free by definition, but the current Finnish moment is a lull: ten trials are tracked for Finland and none is active or recruiting as of July 2026, so the realistic options are trial sites elsewhere in Europe — see the trials guide for how to search.
Frequently asked questions
Is Spravato reimbursed in Finland?
Yes — Kela has reimbursed it since August 2023 under restricted entitlements 3062 (40 per cent of the medicine's price) and 1539 (100 per cent). The criteria are strict: treatment-resistant depression on an SSRI or SNRI, a MADRS score of at least 31, and at least three failed treatments with attached psychotherapy, one a combination, all documented in a psychiatrist's B-statement.
What is the difference between codes 3062 and 1539?
Code 3062 is restricted basic reimbursement — 40 per cent of the medicine's price. Code 1539 is restricted special reimbursement — 100 per cent — for patients whose severe mental disorder is additionally demonstrated as required for entitlement 112. The medical criteria for esketamine itself are the same under both.
Can I be treated at a private clinic?
Yes — this is the point of the pharmacy-dispensing model. The reimbursed spray is dispensed to you at a pharmacy and administered under supervision at a healthcare unit, which can be an outpatient or private psychiatric clinic. Kela's reimbursement covers the medicine either way; the private clinic's visit fees are self-paid.
Why is Finland's bar so much higher than Germany's?
Germany reimburses after two failed antidepressants; Finland requires three failed treatments with attached psychotherapy, one a combination, plus a MADRS of at least 31 — it reimburses late, but then pays properly, up to 100 per cent. The Europe-wide reimbursement map compares every country's criteria side by side.
Sources
- Kela: entitlement 3062 — esketamine, restricted basic reimbursement (criteria)
- Kela: entitlement 1539 — esketamine, restricted special reimbursement (criteria)
- Blossom: Medical access in Finland
- Blossom: Finland country report
- 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.