How Much Does Ketamine Cost in Australia? A Complete Guide
The cost of ketamine in Australia varies dramatically depending on whether you are accessing it through the PBS, receiving off-label generic ketamine, or encountering it on the illicit market. Esketamine nasal spray (Spravato) is now PBS-subsidised at $31.60 per dose for general patients and $7.70 for concession card holders, but the administration fees remain a significant out-of-pocket expense. Consequently, understanding the full cost structure is essential for anyone seeking treatment.
The PBS Subsidy: Esketamine Nasal Spray
The most significant recent development in Australian ketamine pricing is the PBS listing of esketamine nasal spray (Spravato) for treatment-resistant depression (TRD), effective 1 May 2025.
Medication Costs
Under the PBS, a single dose of Spravato costs $31.60 for general patients and $7.70 for pension or concession card holders. Before this subsidy, single doses were reported to cost anywhere between $500 and $900. The maximum safety net for general patients is $25.00.
Administration and Supervision Costs
The PBS subsidy only covers the medication itself. Patients must still pay for the supervised administration sessions, which are not covered by Medicare or typically by private health insurance. Professor Colleen Loo from UNSW and the Black Dog Institute notes that treatment sessions cost patients around $300-$400 per session. Another estimate places the cost at $300–$350 per treatment session.
Total Treatment Cost
A typical initial course involves multiple sessions per week. One clinic estimates that for the first 8 weeks of treatment, the total cost would be approximately $3,063.20 (combining the PBS medication cost and service fees).
Generic Ketamine: The Low-Cost Alternative
Generic racemic ketamine presents a starkly different cost profile. The medication itself costs only $5 to $20 per dose. This makes generic ketamine far cheaper than esketamine on a per-dose basis.
However, generic ketamine is not TGA-approved for depression and must be used off-label. Because there is no Medicare Benefits Schedule (MBS) code covering the staffing costs for ketamine treatment administration, the service delivery costs are not reimbursed. A study led by UNSW Sydney and the Black Dog Institute confirmed that longer-term use of generic ketamine for severe depression is safe and effective, but researchers noted that access to this low-cost option remains limited by funding gaps.
Professor Loo highlighted the disparity: “There’s a huge difference in costs, but both have been shown to be really effective. But only one is subsidized by the government and formally approved, while the other more affordable option is used off-label”.
Initial Assessment and Screening Costs
Before commencing ketamine treatment, patients must undergo a comprehensive psychiatric assessment. The Black Dog Institute states that the initial screening assessment with a psychiatrist costs $420, and this may be bulk billed for concession card holders. Additional preparatory, progress review, and follow-up appointments may also incur costs, though some may be bulk billed.
For ketamine and lidocaine infusions specialists, the cost to see a specialist in Doonside, Greater Western Sydney ranges from A$450.00 for an initial consultation, with follow-up appointments ranging from A$220.00.
Non-Prescribed Ketamine: The Illicit Market
For non-prescribed ketamine, pricing data comes from law enforcement and drug monitoring sources. The National Drug and Alcohol Research Centre (NDARC) monitors the median price of non-prescribed ketamine per gram nationally as part of its Ecstasy and Related Drugs Reporting System.
Historical data shows the median reported price of ketamine per gram decreased from $200 in 2003 to $135 in 2006, returning to the same median price from 2014-2020. In 2021, there was a significant increase in price, with participants reporting a median of $220 per gram (IQR=200-250; n=157; $200 in 2020).
The 2025 ACT report tracks the median price of non-prescribed ketamine per gram in Canberra from 2017-2025. Illicit ketamine carries not only financial costs but also significant legal risks and no quality assurance.
Private Health Insurance Coverage
Private health insurance generally does not cover the costs of esketamine treatment beyond what Medicare and the PBS already provide. Mind Connections, a Sydney psychiatry practice, states that “private health insurance generally does not cover outpatient TMS or esketamine treatment costs beyond Medicare and PBS support”.
For inpatient psychiatric care, some private hospital policies may include cover for psychiatric services, but this depends on the specific policy and the level of cover purchased. Ketamine treatment is not covered by private health insurance or under the Pharmaceutical Benefits Scheme under Medicare.
Summary
The cost of ketamine in Australia depends entirely on the access pathway. PBS-subsidised esketamine costs $31.60 per script for general patients and $7.70 for concession card holders, but administration fees of $300-$400 per session are not covered, bringing the total for an 8-week course to approximately $3,000. Generic ketamine costs only $5-$20 per dose, but the service delivery costs are not reimbursed without an MBS code. Initial psychiatric assessment costs $420. Non-prescribed ketamine carries additional legal risks and varies in price according to illicit market conditions monitored by NDARC, with a median of $220 per gram in recent years.
The most affordable option for eligible patients is PBS-subsidised esketamine, though the “hidden” administration costs remain a barrier for many Australians seeking treatment.