A cost-effectiveness analysis examining psilocybin-assisted therapy (PAT) for treatment-resistant depression in the United States found that the approach may offer economic value when costs are controlled. The study used a simulation model comparing PAT to standard treatments for major depressive disorder, evaluating both healthcare and societal perspectives.
The analysis assumed a total cost of PAT at $5000, which was varied in sensitivity analyses ranging from $3000 to $20,000. Results showed PAT leads to an additional 0.031 quality-adjusted life years (QALYs) gained compared to standard care over 12 months, with an incremental cost-effectiveness ratio of $117,517 per QALY gained from a limited healthcare perspective. Using a $150,000 cost-effectiveness threshold, PAT had a 75% probability of being cost-effective, with a lower expected loss than standard care ($301 vs. $1307).
Early clinical trials demonstrated promising results: a 6-week trial with 104 participants found 25% achieved sustained remission with single-dose PAT compared to 9.1% in the active placebo group. Among individuals specifically with treatment-resistant depression, single-dose PAT led to a three-week remission rate of 29%, higher than the 13.7% remission rate for standard third-line antidepressants.
However, cost remains the most influential factor determining PAT’s economic value. When costs reached $10,000 per treatment, PAT had only a 1% probability of being cost-effective. Conversely, when costs were $3000, the probability increased to 95%. The analysis identified future research needs, including longer-term effectiveness data and strategies to reduce costs of both therapist support and the psilocybin itself, while emphasizing concerns about affordability and equity of access across different populations.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.nature.com/articles/s41398-025-03556-4