Spravato: invented in a government lab, then Medicare paid $231M for it in 2025

NIH scientists invented the technology behind Spravato, and the government licensed it to Janssen Therapeutics. NIH (its own scientists) reported 2 patents on it to NIH as inventions made with NIH grant money.

Invented in a government labPatent reported as grant-funded

Reported

$231M

Medicare paid, 2025

before rebates

Calculated

$544M

Medicare, 2020–2025

$27K per patient in 2025

Reported

$67M

Medicare, 2026 Q1

the newest quarter CMS has published

Reported

$56M

NIH grants behind the patents

whole-grant totals, not the drug's cost

The public record, link by link

1 · Public research
Invented in NIH labs and licensed to Janssen Therapeutics.
2 · Patent
Patents 8785500, 9539220, 9592207, licensed by NIH.
3 · FDA approval
Approved Mar 5, 2019, sold by Johnson & Johnson (NDA 211243).
4 · Public pays
Medicare paid $231M in 2025 for 8,568 patients; Medicaid paid $171M in 2024.

What Medicare paid for Spravato

Medicare Part D and Part B gross spending by year, before manufacturer rebates.

Plus $67M in the first quarter of 2026, for 5,912 patients.

The government license

From NIH Technology Transfer's list of FDA-approved products built on licenses from NIH, CDC or FDA labs.

NIH to Janssen Therapeutics
Spravato (esketamine) is a nasal spray used in conjunction with an oral antidepressant for the treatment of depression in adults who have tried other antidepressant medicines but have not benefited from them (treatment-resistant depression).
First sold 2019. Licensed patents: US 8785500, US 9539220, US 9592207. See the list

The grants

Totals are everything NIH paid on each grant since 1985. A grant usually funded more than this one invention.

Glutamatergic Modulators for Rapid and Sustained Antidepressant Effect
ZIAMH002857 · National Institute of Mental Health · NIMH, NIH's own lab · 2009–2025
$55M
Glutamatergic Modulators for Rapid & Sustained Antidepressant Effect
Z01MH002857 · National Institute of Mental Health · NIMH, NIH's own lab · 2005–2008
$621K

The patents

Patents the FDA lists for this drug that were also reported to NIH as grant-funded inventions.

US 8785500
Intranasal Ketamine for the treatment of depression
Reported by NIH (its own scientists)
FDA-listed expiry Mar 5, 2033
US 9592207
Intranasal Administration of Ketamine to Treat Depression
Reported by NIH (its own scientists)
FDA-listed expiry Mar 20, 2027

Johnson & Johnson's side

Drug makers pay for the clinical trials that take a compound from the lab to FDA approval, and they pay royalties on licensed patents. Those terms are not public. Separately, Johnson & Johnson received $428M in federal contracts and grants since fiscal 2020, which includes purchases. Johnson & Johnson's page shows its other products on this list, its federal awards, its PAC's giving and its lobbying. If Johnson & Johnson wants to add its account, we will publish it here.

How this is built. A product is listed for one of two public records. Either NIH's Technology Transfer office lists it as an FDA-approved product built on a license from an NIH, CDC or FDA lab, or a patent the FDA lists for the drug was reported to NIH as an invention made with NIH grant money, as the Bayh-Dole Act requires. We then add what Medicare Part D, Part B and Medicaid paid for each product, and for each company, the federal grants and contracts it received, its PAC's donations and its lobbying.

What the numbers mean. Medicare and Medicaid figures are gross spending before the rebates drug makers pay back, which are confidential. Hospital-administered therapies such as CAR-T cell treatments are mostly paid under Medicare Part A and do not appear in these files. "NIH grants" is everything NIH paid on the grants a patent was reported under, from 1985 on; a grant usually paid for more than one invention, so it is not the cost of the drug. Federal contracts include purchases, such as vaccine doses, as well as research. Companies also paid for the clinical trials that took these products to approval. None of these figures shows that public money set a price or bought a decision.

Sources: NIH Technology Transfer: FDA-approved products licensed from NIH, CDC and FDA labs; NIH RePORTER patents reported under NIH grants (from iEdison); NIH RePORTER project funding; FDA Orange Book patent, exclusivity and product files; CMS Medicare Part D and Part B Spending by Drug (annual and quarterly); CMS Medicaid Spending by Drug; USAspending.gov federal grants and contracts. Updated 2026-11-06.