Kaiser Permanente needs to cover all proven treatments for depression, including ketamine.
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I am among the millions in this country suffering from clinical depression. About 40% of us are not helped by any of the currently available medications and other strategies. There IS a cost-conscious treatment available that helps 75% of us nonresponders, a group of people who have suffered tremendously for years, often decades. We have lost relationships, family, vocations, financial independence, social contacts, and self respect. We commit suicide with alarming frequency - 20% rare for bipolar2 patients.
That breakthrough treatment is ketamine, an FDA-approved medication that has been around for decades as an anesthetic, and more recently has been shown in trial after trial to help the majority of the 40% of depressives that have not responded to available meds. Ketamine is not readily available for several reasons. First it is not FDA-approved for depression per see. It is legally being used off label in this setting. In this situation, medicare and most insurers refuse to cover it. The problem is that getting FDA approval for a generic medication does not happen. Who is going to pay the bill? To accomplish this for a new drug requires huge amounts of capital to fund three phases of clinical trials in human subjects. With off label ketamine, not ain't gonna happen. This is partly because drug companies are pouring billions into research trying to synthesize knock-off drugs that may be as effective but are patentable and thus are potential goldmines. This goal remains years away.
The second reason ketamine is so slow to become adapted is that it is used as an illegal hallucinogenic party group, so it has potential for abuse. Well, we still prescribe opioids, lots of them, so that objection is rather weak.
We sufferers desperately need what is available now: IV ketanime. Mayo Clinic, Cleveland Clinic and even Kaiser Permanente in the Bay Area have successfully introduced ketamine into their practices for the treatment of severe depression. It needs to be covered by heath insurers throughout the country, but especially by Kaiser-Permanente in Oregon and Washington when their colleagues 500 miles south are enthusiastically reporting fabulous results. Setting up a similar program in Oregon could be done practically over a weekend. Yet they refuse to take the time to have a rational discussion about ketamine with me, one of their retired physicians .
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