A deeper understanding of affordability, insurance and accessibility

One of the biggest concerns for the psychedelic industry is affordability.

The question of converting psychedelic therapy from clinical trials to community clinics is being discussed widely on various platforms and forums — but the right answer is unclear.

Last week, Balázs Szigeti, a research associate at Imperial College London, UK, tweeted that the long time required for psychedelic-assisted therapy, a modality currently being studied, “will skyrocket the cost of treatment” rather than being widely available. SSRI supplies are cheaper and do not require a therapist to sit down during administration.

Many responses poured in, expanding Szigeti’s doubts and discussing what might help make psychedelic-assisted therapy affordable and equitable for patients. Scalability, secure provisioning, trained professionals, and commercialization seem to be some of the recommendations. These conversations underscore the importance of this topic in the development of the industry.

Can insurance help?

Currently, a 12-week ketamine-assisted treatment costs an average of $6,000—a treatment that only those with sufficient privilege can afford.

Shirley Rice, Co-Founder EnciaTell microdosing This psychedelic-assisted therapy lasted an average of six months. “It’s not a multi-year treatment, and the treatment is over, unlike traditional treatments that can last for years,” Rais said.

Enthea, a nonprofit organization, is a health plan administrator that helps healthcare providers, employers and patients develop insurance plans to expedite psychedelic-assisted treatment coverage. The organization’s vision is to provide safe, affordable psychedelic paramedical care.

With psychedelics still a controlled substance, insurance companies haven’t stepped up to offer coverage. Meanwhile, psychedelic-assisted therapy is gaining mainstream attention as an alternative to treating various mental health problems.

But it’s not just the material costs that make treatment unaffordable. Conversely, a lack of trained professionals and long administration times can drive up treatment prices. For example, a phase III trial of adjuvant MDMA showed a cost per patient of $11,537.

Each patient in the trial received three 90-minute preparation sessions, three 8-hour active MDMA or placebo sessions, and nine 90-minute combined sessions.

this study Noting that “the model conservatively allocates health care cost reductions over five years: no cost reductions in the first year after MDMA adjuvant therapy, and a 25% reduction each year for four consecutive years.”

Over a 10-year period, adjuvant MDMA averted 27.5 deaths and saved $46.6 million compared to standard care. Treatment costs break even at 3.8 years, the study said.

Likewise, adjuvant psilocybin puts patients in a cost frame of $2,000 to $5,000. The cost of psilocybin mushrooms is very low, but the promotion cost is high. expert It is believed that the costs will be offset in the long run, similar to MDMA adjuvant therapy.

In other words, psychedelic-assisted therapy may be more affordable in the long run, with quicker results and possibly staying in patients longer.

However, if the upfront cost of treatment continues to remain high, it will deprive many marginalized communities and everyday patients of access to psychedelics, making them no different from traditional and expensive mental health treatments.

Rais noted that “it’s important to remove cost barriers to treatment, and we know that larger insurers won’t offer coverage for years to come,” and with psychedelic law reform slow (some Key supplier begins offering ketamine treatmentbut the list is small and access is still difficult).

Earlier this year, Enthea in collaboration with Dr. Bronner Create a benefit health care program that includes ketamine-assisted treatment for soap company employees—a first of its kind.

Rais said that since the agreement with Dr. Bronner, many employers were stepping up to create similar insurance plans for their employees. She added that this model could eventually expand to include MDMA and psilocybin adjunctive therapy coverage.

More than 13 million people in the U.S. are battling a serious mental health disorder, with economic implications $300 billion Per year. A Lancet Commission report predicts that mental health problems will cost the global economy at least $16 trillion by 2030. The numbers were released before the pandemic and may now be an underestimate of the problem.

Affordable psychedelic-assisted therapy could help prevent a growing number of mental health problems, which could be positive for both patients and the bottom lines of insurers and employers. Psychedelic therapy, or ketamine-assisted treatment, has been shown to “improve employee productivity by reducing absenteeism due to mental health issues,” Rais said.

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A company committed to the safe supply of psychedelics

Scalability could solve part of the affordability problem by increasing the safe supply of psychedelic substances including psilocybin and MDMA. Companies such as Filament Health, Psygen and Optimi Health are working to expand the standardized quantities of natural psychedelic substances to help researchers, healthcare workers and patients use them safely.

At the same time, fewer regulatory restrictions will help reduce the cost of treatment and help companies expand drug supply more efficiently. But it will take a while to achieve scalability.

Experts believe this will require at least three to five years Before psychedelics were seen in mainstream clinical settings, it was used as a viable treatment for mental health problems such as treatment-resistant depression, post-traumatic stress disorder, and severe anxiety.

Furthermore, a Global Initiative for the Economics of Psychedelic Science (GIPSE)) is working with MAPS, Johns Hopkins University and the Usona Institute on the economic and budgetary implications of expanding access to psychedelic-assisted therapies, including psilocybin and MDMA.

Oregon’s Peer Promotion Model

The lack of trained therapists and healthcare professionals has begun to create a bottleneck for emerging psychedelic treatments. But the upcoming regulatory framework for psilocybin use in Oregon may give the answer.

The Oregon Psilocybin Advisory Board (OPAB) proposed in its draft regulations that under Measure 109, facilitators do not have to have a health care background. Although, they need at least 120 hours of training, including courses in preparation, management, group facilitation, etc.

Counselors do not require an additional degree to participate in the training program, other than a high school diploma. The concept of paraprofessional facilitation of psilocybin sessions would lower cost barriers and train a large number of peer facilitators that would otherwise be costly for psychologists and healthcare professionals.

Although Oregon has yet to see how the facilitator model works, training programs have begun to flourish in the state.For example, Fluence, a provider of psychedelic-assisted therapy training, offers Graduate Certification In psilocybin adjunctive therapy, qualifying as a facilitator under M109 costs between $9,550 and $10,400.

The issue of therapist training is critical to the future of the industry and requires a delicate balance: increasing the number of therapists to reduce costs and improve accessibility; while also ensuring that high standards of therapist qualifications are maintained to ensure patient safety.

Stay tuned to Microdose to learn more as it evolves.

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