Psychiatric services (Washington, D.C.)
October 22, 2026 · via Europe PMC
Ketamine Versus Electroconvulsive Therapy for Nonpsychotic Treatment-Resistant Depression: A Cost-Effectiveness Analysis.
Lebenbaum M, Mulsant B, Parikh SV, +6 more, Bhat V.
AI summary — for doctors, generated from the abstract only
In a Canadian model, ketamine was cheaper and slightly more effective in quality-adjusted life-years than ECT for nonpsychotic treatment-resistant depression.
What was studied
Decision-tree cost-effectiveness analysis over 29 weeks comparing racemic ketamine with ECT from health care and societal perspectives in Canada.
Key findings
- Ketamine gave higher quality of life (incremental QALY 0.024).
- Costs were lower with ketamine from the health care (CA$-1,663) and societal (-$3,413) perspectives.
- Ketamine remained cost-effective in nearly all one-way sensitivity analyses.
Clinical relevance
Payers and psychiatrists weighing ketamine against ECT get an economic argument for covering ketamine.
Who should care
Limitations
A model-based analysis over a short 29-week horizon in Canada that relies on input assumptions, with a very small QALY difference.
Support coverage of ketamine alongside ECT for treatment-resistant depression, while choosing treatment on clinical grounds.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Electroconvulsive therapy (ECT) is a highly effective intervention for treatment-resistant depression; however, its use has been limited partly because of concerns about cognitive side effects. Evidence for the sustained (>1 month) efficacy of ketamine versus ECT for treatment-resistant depression has only recently been demonstrated. This study aimed to examine the cost-effectiveness-that is, the costs and benefits measured as quality-adjusted life-years (QALYs)-of racemic ketamine versus that of ECT for treatment-resistant depression.
Methods
Using a decision tree model, the authors examined the incremental QALYs and costs of ketamine in comparison to ECT over 29 weeks from both health care and societal perspectives in Canada. Deterministic and probabilistic sensitivity analyses were used to account for uncertainty.
Results
Compared with ECT, ketamine resulted in higher health-related quality of life (incremental QALY=0.024) and lower costs from both a health care (CA$-1,663) and a societal (incremental cost=-$3,413) perspective. In nearly all one-way sensitivity analyses, ketamine was found to be cost-effective relative to ECT.
Conclusions
Ketamine provided additional QALYs while saving costs relative to ECT for treatment-resistant depression. Health insurance plans that cover all costs of ECT should also cover all costs of ketamine treatment for treatment-resistant depression.
DOI
10.1176/appi.ps.20240407
PMID
42908073
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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