Research
Advancing Insurance Coverage for Ketamine Treatment
Ketamine is a decades-old, generic medication originally developed as an anesthetic. Because no major pharmaceutical company holds a financial stake in its use for conditions like Complex Regional Pain Syndrome (CRPS), there has been little industry incentive to fund the research needed to secure insurance coverage for this off-label application. Expanding coverage will require stronger, more robust clinical evidence.
In June 2021, we submitted an application to the Centers for Medicare & Medicaid Services (CMS) requesting a National Coverage Determination (NCD) for racemic ketamine as a treatment for CRPS and related pain conditions. An approved NCD would prevent insurers from denying coverage on the grounds that ketamine is "experimental" for treating CRPS. CMS ultimately denied this application, citing insufficient supporting research.
In November 2022, we submitted a second application seeking an NCD for ketamine as a treatment for major depression. Within a month, Medicare denied this request as well, again citing the need for stronger clinical evidence.
A New Chapter: University Partnership
The Ketamine Taskforce is proud to announce a new research partnership with a major university to help close this evidence gap. This collaboration includes two significant studies:
A clinical study designed to demonstrate that ketamine infusions can reduce CRPS-related pain by at least 50%, while decreasing reliance on other medications, including opioids.
A longitudinal study evaluating the efficacy of ketamine as a treatment for major depression. This study will enroll 250 veterans and involve five community partner sites across Florida to support patient treatment and data collection.
These studies represent a critical step toward building the scientific foundation necessary to secure broader insurance coverage for ketamine therapy.