Frontiers in Psychiatry
December 5, 2022
Elliot Marseille, Stefano Bertozzi, James G Kahn
51 citations
Psychiatry is seeing renewed interest in using psychedelic drugs to treat mental health disorders like depression, PTSD, and addictions, with clinical evidence showing substantial potential. New therapies could become available by 2024 for patients who do not respond to traditional treatments. However, research on economic factors such as costs, cost-effectiveness, pricing, and the economic effects of widespread implementation has lagged. These issues are critical for making psychedelic therapies widely accessible. The authors describe six types of economic analyses relevant to decisions and planning, including the needs of healthcare payers, and outline desirable features of such research, including scientific rigor, long-term horizons, equity, and a global perspective.
PLoS ONE
February 25, 2022
Elliot Marseille, Jennifer Mitchell, James G. Kahn
49 citations
For patients with severe or extreme chronic PTSD, MDMA-assisted therapy (MDMA-AT) costs $11,537 per patient and generates net health care savings of $132.9 million over 30 years per 1,000 patients, while accruing 4,856 quality-adjusted life-years (QALYs) and averting 61.4 premature deaths compared with standard care. The therapy breaks even on cost at 3.8 years. A three-session MDMA regimen yields greater medical savings and health benefits than a two-session regimen. Even if no health care cost savings are assumed, the incremental cost-effectiveness ratio is $2,384 per QALY gained. MDMA-AT is cost-saving from a payer's perspective and delivers substantial clinical benefit.
Frontiers in Psychiatry
December 6, 2023
Elliot Marseille, Manish Agrawal, Paul Thambi et al.
40 citations
Group psychedelic-assisted therapy, compared with individual therapy, reduces clinician costs by 50.9% for MDMA treatment of PTSD and 34.7% for psilocybin treatment of major depressive disorder, saving $3,467 and $981 per patient respectively. Using 2023 data from two trial sites and published prevalence estimates, treating all eligible U.S. adults with PTSD or MDD over ten years with group therapy would require 6,711 fewer full-time clinicians for MDMA-PTSD and 1,159 fewer for psilocybin-MDD, saving up to $10.3 billion and $2.0 billion. Adopting group protocols could lower costs, ease clinician shortages, and expand patient access.
Translational Psychiatry
August 29, 2025
Anton L.v. Avanceña, Linh N. Vuong, James G. Kahn et al.
8 citations
Psilocybin-assisted therapy (PAT) may offer economic value compared to standard care for treatment-resistant depression when its cost is $5000 or less. A simulation model of representative US adults with treatment-resistant depression found that adding PAT to standard care (pharmacotherapy, psychotherapy, electroconvulsive therapy, and esketamine nasal spray) over 12 months yielded an additional 0.031 quality-adjusted life years and $3639 in costs, resulting in an incremental cost-effectiveness ratio of $117,517 per QALY gained. At a $150,000 cost-effectiveness threshold, PAT had a 75% probability of being cost-effective. Results were sensitive to PAT's cost: at $10,000 the probability dropped to 1%, at $3000 it rose to 95%.
Psychedelics.
September 13, 2024
Syed F. Rab, Charles L. Raison, Elliot Marseille
5 citations
Between 24% and 62% of U.S. patients with major depressive disorder or treatment-resistant depression may be eligible for psilocybin-assisted therapy, depending on how strictly exclusion criteria are applied. The lower estimate uses stringent criteria from clinical trials; the mid-range (56%) reflects likely real-world scenarios; the upper bound (62%) accounts for patients with multiple comorbidities. The main reason for ineligibility is disqualifying conditions such as alcohol and substance use disorders. Actual demand will also depend on insurance coverage, state regulations, and availability of trained providers, highlighting the need for careful policy planning.
Frontiers in psychiatry
January 1, 2025
Sofia Abramsky-Sze, Elliot Marseille, Richard Matzopoulos et al.
4 citations
A cross-sectional survey of 6,869 American adults found that those who used psychedelic mushrooms in the past year reported lower mental health scores and higher levels of anxiety and depression than non-users. The 256 psychedelic users (3.7% of the sample) included 122 who used only psilocybin mushrooms and 134 who used multiple psychedelics; the multi-psychedelic group had the poorest mental health. These differences persisted even after controlling for past-year anxiety and depression, suggesting that psychedelic use is associated with poorer mental health in some contexts. The authors call for more population-based research on exclusive psilocybin and combined psychedelic use.
Psychedelics
August 5, 2025
Elliot Marseille, Jennifer Mitchell
2 citations
A commentary on a cost-effectiveness analysis of MDMA-assisted therapy for PTSD, published after the FDA declined to approve the treatment in 2024, identifies two key limitations that reduce its relevance for healthcare decision-makers. The analysis compared MDMA therapy to placebo-based therapy instead of standard-of-care treatments, and it used a pricing strategy of $36,000 for the three MDMA doses that threatens accessibility. Alternative modeling indicates that at a price of approximately $10,500, MDMA therapy could be extremely cost-effective, around $160 per quality-adjusted life year (QALY), or even cost-saving. Future research should incorporate realistic treatment comparators, comprehensive healthcare utilization data, and pricing models balancing economic viability with public health goals.
Journal of Psychedelic Studies
September 4, 2025
Kevin D. Lam, Caroline Griffin, S. Kantipudi et al.
1 citation
Eighteen low- and middle-income countries on five continents show promise for implementing psychedelic-assisted therapies, with South Africa, Thailand, Mexico, Brazil, and Jamaica ranking in the top tertiles across seven of eight readiness domains. Readiness depends on high mental health burden, adequate infrastructure and insurance coverage, less stringent legal prohibitions, and cultural familiarity with psychedelics. Twenty-five countries did not achieve top rankings in any domain. The assessment used thirty-four criteria across eight domains, including disease epidemiology, mental health infrastructure, workforce, and legal status, to evaluate 136 countries.
World Medical & Health Policy
August 21, 2025
Elliot Marseille, Olga Chernoloz, О. И. Орлов
1 citation
Providing group MDMA-assisted therapy (MAT) with supplemental individual sessions for PTSD in Ukraine is likely cost-effective and could save lives. Modeling 1000 patients, treatment costs $1.1 million, averts 19.2 deaths, and gains 717 quality-adjusted life years (QALYs) over 3 years. From a healthcare payer perspective, MAT costs $1537 per QALY gained, considered cost-effective. From a societal perspective, it generates net savings of $2.6 million. Scaling to half of eligible patients over 10 years could save 48,000 lives and gain 1.5 million QALYs, with net societal savings of $5.6 billion. The findings support including MAT in Ukraine's mental health strategy.
Exploratory Research in Clinical and Social Pharmacy
February 4, 2026
Shreya Shiju, Rohan Tirumala, Elliot Marseille
People are increasingly using psychedelics like psilocybin and LSD without medical supervision to treat health conditions, a practice called self-medication. A review of existing reviews found that individuals most often use these substances for cluster headache and chronic pain, frequently in microdosed regimens. About 40% of users achieved full remission of symptoms, and 70% reported preventive benefit. Adverse effects were rare and brief. Motivations for self-use included coping, desperation, and dissatisfaction with conventional care. The evidence remains limited by scarce and heterogeneous data, and more rigorous research is needed.
Frontiers in psychiatry
January 1, 2026
Sofia Abramsky-Sze, Elliot Marseille, Richard Matzopoulos et al.
correction
This is a correction notice for a previously published article. It does not present new findings, arguments, or data.