Inappropriate comparator and high pricing in MDMA-assisted therapy for PTSD: A critique of the Lykos cost-effectiveness analysis
Elliot Marseille, Jennifer Mitchell
Psychedelics August 5, 2025 Peer reviewed DOI: 10.1016/j.psyche.2025.100002 via OpenAlex
Summary
The commentary critiques a cost-effectiveness analysis of MDMA-assisted therapy for PTSD, highlighting its limitations such as inappropriate comparisons and high pricing. It suggests that if priced around $10,500, MDMA therapy could be very cost-effective, potentially costing only about $160 per quality-adjusted life year (QALY). The author calls for future studies to include more realistic treatment comparisons and better pricing models to enhance policy relevance.
Study at a glance
| Key finding | MDMA therapy could be extremely cost-effective at a price of approximately $10,500, costing around $160 per quality-adjusted life year (QALY). |
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Abstract
This commentary examines a recent Lykos Therapeutics-funded cost-effectiveness analysis of MDMA-assisted therapy for PTSD following FDA's 2024 decision to decline approval. While methodologically rigorous in its use of empirical trial data, the study has two critical limitations that undermine its relevance to healthcare decision-makers: an inappropriate comparison to placebo-based therapy rather than to standard-of-care treatments, and a problematic pricing strategy ($36,000 for the three MDMA doses) that threatens accessibility. Alternative modeling suggests that at a more reasonable price point of approximately $10,500, MDMA therapy could be extremely cost-effective, around $160 per quality-adjusted life year (QALY), or even cost-saving. For meaningful policy impact, future research should incorporate realistic treatment comparators, comprehensive healthcare utilization data (beyond PTSD-specific costs), and pricing models that balance economic viability with public health goals.