Benefits administrator Enthea makes ketamine-assisted therapy available nationwide

Enthea, an administrator of benefits focused on medication-assisted therapies, has made ketamine-assisted therapy available nationwide as an employee benefit.

Enthea says it is the first and only licensed provider of plans that cover medication-assisted therapies like ketamine and psychedelics. Employers interested in the benefit can add it as an ancillary benefit, similar to dental and vision offerings.

The cost for employers varies depending on how they design the benefit, executives told Fierce Healthcare. They can choose to cover all of the benefit, where the cost will also depend on geography, utilization and size of the company, or opt for a copay. Generally, it could cost anywhere from $30 to $200 per employee per year.

“Nationwide availability represents a pivotal moment in accomplishing Enthea's mission of helping employers with workplace mental health challenges," Enthea co-founder and CEO Sherry Rais said in a press release

Enthea’s turnkey services aim to offer an employer everything needed to deliver the benefit, like a nationwide network of credentialed ketamine-assisted therapy providers, established standards of care, authorization of treatment and provider reimbursement, education for employees and customizable plans.

The plan administrator recently released clinical results from the first year of its ketamine-assisted therapy benefit for employees of Dr. Bronner’s Magic Soaps.

The employer’s staff showed "dramatic improvement" with various mental health disorders using ketamine-assisted therapy, Enthea said. Patients with post-traumatic stress disorder and depression showed an 86% and 67% reduction in symptoms, respectively.

Enthea also recently announced partnerships with Skylight Psychedelics and Innerwell, both offering in-person care to patients across the country.

Ketamine is a legal psychedelic approved for medical use. It has emerged in recent years as a promising alternative to traditional medications used to treat mental health disorders like depression and anxiety. While the exact mechanisms of ketamine in the brain aren’t clear, the psychedelic appears to promote cortical plasticity, or the development of new neural connections.

"Ketamine is a very valuable tool for therapists trying to help with these disorders," Dan Rome, M.D., chief medical officer at Enthea, said in the announcement.  "When programmed mental defenses are lowered, more patients are able to get to the root of their problems. This can result in long-term relief—and not merely symptom suppression, as is too often the case with today's conventional therapy."

Some employers are treating ketamine-assisted therapy "almost like they would treat a gym membership," Rais previously told WorkLife, offering it to all their employees on a per-person subscription model. She cautioned against such an approach because of the risk for abuse of the treatment. Other experts have said ketamine-assisted therapy shouldn't be the first stop for a mental health benefit for employees, but it can be part of a larger arsenal. 

As of April, Enthea was reportedly planning to onboard 100 companies to offer the benefit. Providers must send Enthea prior authorization requests, which are reviewed and approved by its medical affairs department. Enthea selects providers that go through the due diligence of doing robust clinical evaluations to ensure a patient is truly eligible for the treatment.