Norway sets precedent on national reimbursement of generic ketamine for depression

Norway has taken an important step in mental health care: its regulator has decided to reimburse the off-label use of generic intravenous ketamine for treatment-resistant depression (TRD).

This follows years of research and clinical experience. Since 2020, around 400 patients with severe depression have been treated at three hospitals under a nationally standardised protocol. In 2023, the Norwegian Rapid Acting Antidepressant Network (NORAAD) was created to connect professionals across health regions, harmonise protocols, and coordinate research. NORAAD is currently running a €2.2 million national study across ten hospitals.

A recent health technology assessment by the Norwegian Medical Products Agency concluded positively on ketamine’s clinical value and informed the regulator’s decision.

Importantly, Norway’s model requires that ketamine treatment be combined with psychotherapy. While ketamine’s benefits are often short-lived on their own, combining it with psychotherapy can help patients achieve longer-lasting change.

Early findings also suggest that, in a controlled therapeutic environment, risks of misuse are minimal.

The Norwegian decision marks the first time a European country has introduced nationwide reimbursement for off-label ketamine in depression. Beyond direct patient benefit, it shows how health systems can create structured pathways for innovative treatments.