[Opgelost] Ketamine therapy Netherlands

In the Netherlands, ketamine treatment is only reimbursed under specific conditions, and only when provided within the regular mental health care system (GGZ) under medical supervision.

Ketamine can be reimbursed when it is prescribed and administered by a psychiatrist or anesthesiologist within a recognized mental health institution. This applies mainly to patients with treatment-resistant depression (TRD) — meaning that previous treatments with antidepressants or psychotherapy have not been effective. Examples of institutions that sometimes offer reimbursed ketamine treatment include psychiatric hospitals, university medical centers, and GGZ organizations such as Parnassia or PsyQ. The reimbursement falls under the basic health insurance because it is part of an official treatment pathway within the GGZ.

Currently, reimbursement is limited to proven indications, such as severe or treatment-resistant depression, and in some cases, bipolar depression under strict medical supervision. In a few hospital pain clinics, ketamine may also be covered for chronic pain treatment, but not when used for psychotherapy or personal development purposes.

The form of administration also matters. Only medical formats such as intravenous ketamine or intranasal esketamine (brand name Spravato) qualify for reimbursement. Treatments using oral ketamine or ketamine analogues outside of medical institutions — such as in ketamine-assisted therapy sessions — are not covered by health insurance.

Since 2019, the Spravato nasal spray has been approved in the Netherlands and can be reimbursed under the following conditions:

1. Only for treatment-resistant depression

2. Only when other antidepressants have failed

3. Only in combination with ongoing psychological therapy

4. And only under the supervision of a psychiatrist in a registered institution.

Treatments with ketamine analogues or guided ketamine therapy sessions outside the GGZ, such as those offered by us, are not yetcovered by insurance We're working on that for now). However, these sessions remain legally accessible without a referral. Participants pay for the sessions themselves, although partial reimbursement may sometimes be available through supplementary health insurance (alternative medicine coverage) or through employer-funded wellbeing or vitality programs.

Summary:

1. Ketamine is reimbursed only for treatment-resistant depression within a medical setting and is not for people who are not Dutch citizens.

2. Esketamine (Spravato) is reimbursed only under strict psychiatric supervision.

3. Ketamine analogues and guided therapy sessions outside the GGZ are not reimbursed but are freely accessible.

4. Chronic pain treatments with ketamine may be covered only through hospital pain clinics under specialist indication.