Yes — and it is free. Esketamine nasal spray (Spravato) is fully funded in Poland through NFZ drug program B.147 for treatment-resistant depression, with no co-payment for the drug, the administration visits, the observation or the monitoring, for a maximum of 34 weeks. The criteria are narrow — ages 18–75, a moderate-to-severe episode, and at least two but no more than five failed antidepressants in the current episode — and qualification happens at one of around 64 contracted centers, which you may choose freely nationwide. This page covers exactly who qualifies, how enrollment works, what the 34-week cap means, 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
Drug programs (programy lekowe) are how the NFZ funds expensive medicines under strict protocols, and B.147 — "Leczenie chorych na depresję lekooporną" — has funded esketamine since 2023, the first drug program in Polish psychiatry. Within the program, the drug, administration visits, observation and monitoring are all NFZ-funded — there is no co-payment for the medicine. Treatment is outpatient, in two phases: a four-week induction with two visits a week, then maintenance with tapering frequency, up to a maximum of 34 weeks. Esketamine in the program is combined with a continuing oral antidepressant, and the center tracks your response with structured assessments.
Who qualifies
The published criteria are precise:
- Age 18–75, with a depressive episode of moderate or severe intensity;
- No improvement after at least two different antidepressants at adequate dose and duration in the current episode — but no more than five tried;
- At least a second episode of depression, with the current episode lasting at least 6 months from the first medical visit for it;
- Exclusions include bipolar disorder, psychotic symptoms and a history of substance dependence.
Experts have publicly argued the criteria are too narrow — enrollment ran around 250 patients a year instead of the projected 1,000 — and revisions have been under discussion, so check the current wording with a program center before ruling yourself out. Gather your records first: diagnoses, every antidepressant tried in the current episode with doses and durations, and hospitalizations. A documented treatment history decides more cases than anything else, and the person who decides is the qualifying psychiatrist, not a form on a website.
Who decides and how to apply
Qualification happens at a contracted B.147 center: only sites with an NFZ contract for the program can enroll patients. No referral is formally needed to see a psychiatrist in Poland, so the first practical step is contacting a program center directly. At the qualification visit a psychiatrist checks you against the criteria, orders baseline tests, and enrolls you in the NFZ system if eligible.
Two features make the Polish route unusually navigable. First, you may choose any contracted center nationwide, regardless of where you live. Second, waiting times are public: every contracted facility reports its first available appointment to the NFZ, so you can compare queues in the national Informator o Terminach Leczenia or via pacjent.gov.pl, and the NFZ patient hotline (800 190 590) can help locate the nearest center with the shortest queue. Big-city sites often have queues while some regional centers admit quickly, so comparing before your first call can save weeks. To see who is listed near you, browse providers in Poland; for the full picture of every legal route, see our Poland access guide.
What it costs you
Nothing, within the program: the drug, administration visits, observation and monitoring are financed by the NFZ for insured patients, with no co-payment. The real costs are practical — two visits a week of several hours each during induction, no driving afterwards, and travel if your chosen center is far away. Many patients add psychotherapy alongside the program, arranged and paid for separately.
If you do not qualify
Poland has no documented exceptional or individual-case funding route around the B.147 criteria in our sources, so the honest fallbacks are:
- Private off-label ketamine clinics, concentrated in Warsaw, Wrocław and other large cities. Off-label prescribing by a licensed physician is legal, but everything is self-pay and screening quality varies widely — apply the checks in our clinic-choice guide before paying.
- Private esketamine is legal but self-paid and rarely offered outside the program.
- Clinical trials are free by definition; Polish sites took part in international psychedelic programs, and a publicly funded psilocybin trial runs at the Medical University of Warsaw — see the trials guide.
Frequently asked questions
Is Spravato reimbursed in Poland?
Yes — fully. NFZ drug program B.147 funds esketamine for treatment-resistant depression free of charge for eligible insured patients, covering the drug, visits, observation and monitoring, for up to 34 weeks at around 64 contracted centers.
What happens after 34 weeks?
The program caps treatment at 34 weeks. Continuation beyond that is not funded under B.147; your psychiatrist plans maintenance treatment, and re-qualification rules should be discussed with the center.
Can I pick any center in the country?
Yes — any facility with a B.147 contract, nationwide, regardless of your address. The NFZ waiting-time portal publishes each center's first available appointment, which makes comparing queues easy.
How does Poland compare with other countries?
Poland is one of the few systems where treatment is entirely free — no co-payment for the drug or visits — but the criteria are among the narrowest and the 34-week cap is strict. See the Europe-wide reimbursement map for the full comparison.
Sources
- Programy Lekowe: Leczenie chorych na depresję lekooporną (B.147)
- NFZ: Informator o Terminach Leczenia
- Prof. Piotr Gałecki: Depresja lekooporna — poradnik (PDF)
- Rynek Zdrowia: Pierwszy program lekowy w psychiatrii — eksperci chcą zmian
- Blossom: Poland country report
- 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.