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Is ketamine therapy set to become the next workplace perk?

While employer-sponsored psychedelic treatment is rare, that might change as the regulatory environment shifts.
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Francis Scialabba

· 5 min read

Ketamine is an anesthetic that is perhaps better known as a party drug. But some studies have indicated that it can be effective as a treatment for some types of clinical depression.

It’s also the only psychedelic that’s currently legal for medical use nationwide, and is starting to be offered as an employee benefit by a handful of companies, including soap-maker Dr. Bronners, HempLucid, which sells CBD and wellness products, and 15Five, an HR management firm.

Dr. Bronner’s, which has donated millions of dollars to drug research and advocacy, started covering ketamine-assisted therapy for its employees last year in what it called the “first ever partnership between [a] health plan administrator and leading US company to offer employee coverage for ketamine-assisted therapy to promote mental health.” Some 7% of employees on the company’s health plan have taken advantage of the benefit to treat conditions like post-traumatic stress disorder and major depressive disorder, according to a recent report by Enthea, a third-party administrator working with Dr. Bronner’s.

Enthea is currently the only licensed provider of health benefit plans nationwide covering medication-assisted therapies like ketamine. While ketamine therapy as a work perk remains rare, Enthea and other advocates expect that to change in the coming years as the regulatory environment seems to be shifting in favor of the treatments.

Ketamine as a mental health benefit. Enthea currently has 10 customers who are working to offer ketamine-assisted therapy (KAT) as an ancillary benefit for their employees, Sherry Rais, its co-founder and CEO, told HR Brew. Another 50 have signed letters of intent. Other employers working with Enthea aside from Dr. Bronner’s include benefit administration software company Plexis, Austin-based Onnit Gym, and 1906, a cannabis company.

Employers have come to Enthea after picking up on mental health issues in their workforce, according to Rais. She said employers who offer KAT may see more presenteeism and retention among their staff.

A full course of ketamine treatment typically costs $6,000 to $8,000, and depending on the benefit design, companies may spend between $35 to $200 per employee annually to cover it, Rais said.

To be sure, HR departments should proceed with caution if they’re considering offering KAT as an employer benefit. The FDA issued an alert in October warning against the use of “compounded ketamine products” without monitoring by a healthcare provider, noting that doing so “may put patients at risk for serious adverse events.” It added there are “known safety concerns” associated with ketamine, including abuse and misuse, or psychiatric events.

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A 2018 Stat News investigation documented “wide-ranging inconsistencies” among ketamine clinics, “from the screening of patients to the dose and frequency of infusions to the coordination with patients’ mental health providers.”

Rais said Enthea has partnered with about 60 ketamine clinics. The providers have to be licensed to administer ketamine, and undergo a credentialing process to ensure they haven’t encountered legal issues, Rais said. Enthea also reviews details such as training background, time spent in practice, and how much therapy providers incorporate into their offerings, she added, before partnering with any providers.

Changes on the horizon. While psychedelics like MDMA and psilocybin remain illegal federally, there are clinical trials underway examining their use for conditions like PTSD and depression, also with potentially promising results. Rais said she expects both drugs to be rescheduled over the next two years, opening up a legal pathway to offer the treatments.

Even though Enthea is offering KAT as an employer benefit, many insurance companies generally aren’t covering psychedelics right now. Though large insurers will generally cover esketamine, a derivative of ketamine that was approved by the FDA for treatment-resistant depression in 2019, there’s usually a prior approval process to access it because it’s expensive, Jeff Levin-Scherz, a population health leader in WTW’s health management practice, told HR Brew.

As research on ketamine’s therapeutic potential develops, Levin-Scherz predicted more traditional health insurers could become interested in including it in their coverage.

“There is a reasonable amount of good clinical research going on and most of it looks quite promising,” Levin-Scherz said. He cited recent research published in the New England Journal of Medicine that showed ketamine was as effective as electroconvulsive therapy when treating patients with treatment-resistant depression (the latter therapy is considered the “gold standard” for patients with this condition, Stat News reported).

“I think it’s likely that at some point in the future, there will be greater access,” Levin-Scherz said of ketamine treatment. “Some of that process could be that Enthea will get much bigger, some of that could be because there will be competitors. And some of that could be because traditional medical carriers and pharmacy benefit managers will start to provide coverage.”

Quick-to-read HR news & insights

From recruiting and retention to company culture and the latest in HR tech, HR Brew delivers up-to-date industry news and tips to help HR pros stay nimble in today’s fast-changing business environment.