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Psychedelic Bulletin: The Cost-Effectiveness of MDMA for PTSD; The Challenges Ahead for Psychedelic Medicine

In this week’s Bulletin, we cover a recent study on the cost-effectiveness of MDMA-assisted therapy for PTSD, as well as a number of thinkpieces.

Psychedelic Sector News

The Cost-Effectiveness of MDMA for PTSD

As part of our 2021 Year in Review we identified trends that we’re watching in 2022. One of those was A Closer Eye on Insurance Coverage, where we identified the Global Initiative for Psychedelic Science Economics (GIPSE) as a key group to watch.

Towards the end of February, researchers from this group published an updated cost-effectiveness analysis of MDMA-assisted therapy (MDMA-AT) for PTSD, reporting impressive cost saving estimates (note: the paper adapts a model used in an earlier cost-effectiveness analysis published by Marseille et al. in late 2020).

The researchers estimate that, compared to standard of care, MDMA-AT generates net health care savings of $132.9m over a 30 year period, per 1,000 patients. Importantly, the researchers based the cost of MDMA-AT on the Phase 3 trial costs: $11,537 per patient. This resulted in a promising break even point of 3.8 years.

But, we’re yet to learn the pricing structure for MDMA-AT, which will be devised by MAPS PBC. If it were priced at, say, $20,000 or $30,000, the cost-benefit analysis will be significantly impacted.

It’s also worth noting that this analysis is, of course, based on the stellar efficacy demonstrated in MAPS’ first Phase 3 trial. It’s generally the case that therapies are more effective in trials, given the carefully-selected participant pool.

The Verdict: This is a promising cost-effectiveness analysis, which suggests MDMA-AT for PTSD may be an attractive therapy for payers like insurance companies. However, the key input variables (efficacy and cost) are surrounded by a great deal of uncertainty.

Other Company News

See more on our News page.

Weekend Reading

It’s Time to Start Studying the Downside of Psychedelics

Shayla Love’s latest long read in VICE asks the question: is there enough track for this hype train?

“But to extend Volkow’s metaphor, if the psychedelic train has left the station, how far have the tracks been laid out ahead of it? The early data and research on these substances are promising, but in a cultural climate that has become extremely positive towards psychedelics, there’s reason to worry that there hasn’t been enough preparation for negative outcomes amidst the hype.”

While it is important to accurately clarify psychedelics’ safety profile, the move to insist that they are harmless in controlled environments, combined with the growing hype about how “easily” they can address complex conditions like depression or PTSD, leaves a gap in communicating and understanding the myriad of negative side effects that can—and do—occur.

The challenges ahead for psychedelic ‘medicine’

Muthukumaraswamy et al., 2022

This viewpoint article identifies a number of challenges that the field is facing, or will face in the coming years. These include challenges related to research and trial design (blinding, expectancy, etc.); the impact of funding sources for psychedelic research; the impact of psychedelics’ scheduled nature; issues that will emerge around implementation; and more.

Can magic mushrooms unlock depression? What I’ve learned in the five years since my TEDx talk

Dr. Rosalind Watts on Medium.

“If I could go back in time, I would not now be so foolish as to suggest that a synthesised capsule, by itself, can unlock depression. It takes a village, it takes community, it takes time. A mushroom is simply the tiny visible tip of a vast interconnected web deep underground.”

More People Are Microdosing for Mental Health. But Does It Work?

“Scientists are split over whether the benefits some microdosers experience are a placebo effect or something more.” NY Times.

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