A REVIEW OF HEALTH ECONOMIC ANALYSES OF PSILOCYBIN, MIDOMAFETAMINE(MDMA), AND KETAMINE-BASED TREATMENTS FOR MENTAL HEALTH CARE
Author(s)
Matthew Sidovar, MA, MASc1, Shane J. O'Connor, MASc2, Lucinda Orsini, MPH3;
1Compass Pathways, Director, New York, NY, USA, 2COMPASS Pathways, Vienna, Austria, 3COMPASS Pathways, Skillman, NJ, USA
1Compass Pathways, Director, New York, NY, USA, 2COMPASS Pathways, Vienna, Austria, 3COMPASS Pathways, Skillman, NJ, USA
OBJECTIVES: This review characterizes and compares health economic evaluations of psychedelic compounds for the treatment of serious mental illness.
METHODS: MEDLINE was searched from 2015 to 2025 for articles. Studies were eligible for inclusion if they were a health economic evaluation of a psychedelic compound for the treatment of a serious mental illness. Given their psychoactive effects, esketamine and ketamine were also included. Studies were limited to the United States. A qualitative comparison was performed to evaluate the studies for condition treated, interventions compared, modeling aspects, costs, and outcomes.
RESULTS: We identified 11 published studies that evaluated the economic impact of psychedelic treatments. Five analyzed midomafetamine (MDMA), 4 esketamine, and 2 were conducted on psilocybin. Treatment-resistant depression (6 studies) and chronic post-traumatic stress disorder (5 studies) were the only conditions evaluated. The majority (9/11) of the studies utilized a Markov model over a lifetime time horizon to analyze outcomes. However, the 2 studies evaluating psilocybin were both short-term studies covering 6 months using a decision tree analytic model or 1 year using a Markov model. The primary outcome of interest for most articles was the incremental cost-effectiveness ratio (ICER), with one study examining deaths avoided and quality-adjusted life-years gained.
CONCLUSIONS: After several decades with little research, psychedelic drugs are experiencing a resurgence in clinical studies for a variety of mental health disorders. However, few studies have been done to understand the economic implications of these compounds. Further research is needed to better evaluate the benefits, risks, costs, and appropriate methods to capture the value associated with these novel therapeutics.
METHODS: MEDLINE was searched from 2015 to 2025 for articles. Studies were eligible for inclusion if they were a health economic evaluation of a psychedelic compound for the treatment of a serious mental illness. Given their psychoactive effects, esketamine and ketamine were also included. Studies were limited to the United States. A qualitative comparison was performed to evaluate the studies for condition treated, interventions compared, modeling aspects, costs, and outcomes.
RESULTS: We identified 11 published studies that evaluated the economic impact of psychedelic treatments. Five analyzed midomafetamine (MDMA), 4 esketamine, and 2 were conducted on psilocybin. Treatment-resistant depression (6 studies) and chronic post-traumatic stress disorder (5 studies) were the only conditions evaluated. The majority (9/11) of the studies utilized a Markov model over a lifetime time horizon to analyze outcomes. However, the 2 studies evaluating psilocybin were both short-term studies covering 6 months using a decision tree analytic model or 1 year using a Markov model. The primary outcome of interest for most articles was the incremental cost-effectiveness ratio (ICER), with one study examining deaths avoided and quality-adjusted life-years gained.
CONCLUSIONS: After several decades with little research, psychedelic drugs are experiencing a resurgence in clinical studies for a variety of mental health disorders. However, few studies have been done to understand the economic implications of these compounds. Further research is needed to better evaluate the benefits, risks, costs, and appropriate methods to capture the value associated with these novel therapeutics.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE127
Topic
Economic Evaluation