While the spray has been approved for use in Scotland, however, NICE have now twice rejected the medication for use in England and Wales, citing uncertainty over its cost-effectiveness. 

“Janssen is pleased with the SMC’s swift decision to accept the use of esketamine nasal spray in eligible patients, and we applaud the SMC’s pragmatic approach and flexibility in reaching this positive recommendation,” said Amanda Cunnington, director of health economics of Janssen, the pharmaceutical company which made the treatment.

“We recognise this outcome results in a discrepancy in access between patients in Scotland and those in the rest of the UK and are currently working closely with NICE in the hope that patients will also be able to access esketamine nasal spray routinely in England, Wales and Northern Ireland.”

On the funding priority given to mental health treatments, a spokesperson for Janssen told the Telegraph: “We are still some way off achieving true parity of esteem between mental and physical health. Mental health service design, funding and commissioning must be brought up to date with the same advances that have encouraged the uptake of new innovations in physical healthcare. 

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