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It depends on the drug and it's usage, but "because of their size and comparatively long duration, Phase III trials are the most expensive, time-consuming and difficult trials to design and run" [1].

[1] https://en.wikipedia.org/wiki/Phases_of_clinical_research#Ph...

It's possible to get the nasal spray prescribed and filled by a compounding pharmacy. Those doctors will want you to spend $3,000 for the initial infusions. It won't matter to them that you had the initial infusions elsewhere. They want the full treatment experience as well.

It's possible that the J&J spray will be approved in 2018.

In some countries in Europe it's already possible for a psychiatrist to request (legally) such preparation from a pharmacy and they will prepare it. Legend has it some first responders are carrying ketamine nasal sprays as a first help for depressed people wanting to commit suicide. I wonder if it's true.