Cost-effectiveness of psilocybin-assisted therapy for severe depression: exploratory findings from a decision analytic model
Psychological Medicine – June 02, 2023
Source: OpenAlex
Summary
Psilocybin, a potent hallucinogen, delivers the highest quality-adjusted life years (0.310) for severe depression, surpassing conventional medicine (0.278) or psychotherapy (0.283). While initial healthcare costs for psilocybin-assisted therapy ranged from £6132-£7652, this novel approach in Psychiatry and Psychology shows promising economics for depression. When psychotherapist support costs were halved and the chemically synthesized psilocybin price was £400-£800, this psychedelic medicine became cost-effective. This positions it as a significant complementary alternative in drug studies.
Abstract
Abstract Background: There is growing evidence to support the use of the psychedelic drug psilocybin for difficult-to-treat depression. This paper compares the cost-effectiveness of psilocybin-assisted psychotherapy (PAP) with conventional medication, cognitive behavioural therapy (CBT), and the combination of conventional medication and CBT. Methods: A decision model simulated patient events (response, remission, and relapse) following treatment. Data on probabilities, costs and quality-adjusted life years (QALYs) were derived from previous studies or from best estimates. Expected healthcare and societal costs and QALYs over a 6-month time period were calculated. Sensitivity analyses were used to address uncertainty in parameter estimates. Results: The expected healthcare cost of PAP varied from £6132 to £7652 depending on the price of psilocybin. This compares to £3528 for conventional medication alone, £4250 for CBT alone, and £4197 for their combination. QALYs were highest for psilocybin (0.310), followed by CBT alone (0.283), conventional medication alone (0.278), and their combination (0.287). Psilocybin was shown to be cost-effective compared to the other therapies when the cost of therapist support was reduced by 50% and the psilocybin price was reduced from its initial value to £400 to £800 per person. From a societal perspective, psilocybin had improved cost-effectiveness compared to a healthcare perspective. Conclusions: Psilocybin has the potential to be a cost-effective therapy for severe depression. This depends on the level of psychological support that is given to patients receiving psilocybin and the price of the drug itself. Further data on long-term outcomes are required to improve the evidence base.