For people with severe, chronic PTSD that does not respond to standard treatments, MDMA-assisted psychotherapy (MAP) appears to be cost-saving for health care payers while delivering substantial clinical benefit. A decision-analytic model based on pooled results from six phase 2 trials with 105 subjects and a four-year follow-up of 19 subjects estimated that, over 30 years, MAP for 1,000 individuals generates net discounted savings of $103.2 million and 5,553 additional quality-adjusted life-years (QALYs) compared to continued standard care. MAP breaks even on cost at 3.1 years. Even under the conservative assumption that benefits last only one year, MAP costs $26,427 per QALY gained.
Expanding access to MDMA-assisted psychotherapy (MDMA-AT) for US patients with chronic and severe PTSD would likely provide substantial health and financial benefits. A decision-analytic model compared three coverage targets (25%, 50%, and 75% of eligible patients) against standard care. All three targets were cost-saving and projected to avert 43,618 to 106,932 deaths and gain 3.3 to 8.2 million quality-adjusted life years over 10 years. Sensitivity analyses confirmed that MDMA-AT remained dominant under various assumptions, though the precise magnitude of benefits depends on the number of eligible patients and other inputs.