This health economics study (n=14.8 million) estimates the potential demand for psilocybin-assisted therapy (PSIL-AT) for major depressive disorder (MDD) and treatment-resistant depression (TRD) in the United States. It finds that 24% (lower-bound; 2.2m), 56% (mid-range; 5.1m), and 62% (upper-bound; 5.6m) of patients with MDD or TRD may be eligible for PSIL-AT, with variance largely influenced by exclusion criteria and comorbidity considerations.
Abstract of An estimate of the number of people with clinical depression eligible for psilocybin-assisted therapy in the US
“This study aims to estimate the lower, middle, and upper bounds of potential demand for psilocybin-assisted therapy (PSIL-AT) for major depressive disorder (MDD) and treatment-resistant depression (TRD) in the United States. We calculated potential PSIL-AT demand for MDD and TRD by estimating the number of U.S. patients with MDD, identifying those in treatment, and determining who qualifies as having TRD. We established a range of estimates using the exclusion criteria from the largest trials to date on PSIL-AT for MDD or TRD. Estimates ranged from lower-bound through stringent criteria, mid-range by focusing on likely real-world scenarios, to upper-bound by accounting for double counting for patients with multiple comorbidities. A significant portion of patients with MDD and TRD is ineligible for PSILAT due to disqualifying conditions. Percentage of patients who are eligible are 24% (lower-bound), 56% (mid-range), and 62% (upperbound). Variance was largely influenced by the removal of alcohol and substance use disorders as exclusion criteria, as well as removing the double counting from comorbid psychiatric and cardiovascular conditions. The analysis outlines the public health implications of providing PSIL-AT for MDD and TRD, emphasizing that the effective demand will be shaped by insurance coverage, state-level regulations, and the availability of trained providers. These findings suggest the need for careful policy planning and resource allocation to ensure equitable access and effective implementation of PSIL-AT across diverse populations and regions.”
Authors: Syed F. Rab, Charles L. Raison & Elliot Marseille
Summary of An estimate of the number of people with clinical depression eligible for psilocybin-assisted therapy in the US
Psilocybin-assisted therapy (PSIL-AT) has been designated by the Food and Drug Administration (FDA) as a breakthrough therapy for patients diagnosed with major depressive disorder (MDD) or treatment-resistant depression (TRD). TRD is defined as having at least two treatments with antidepressant medications at adequate doses and duration in the current depressive episode, without significant symptom relief. Recent clinical trials have established specific inclusion and exclusion criteria for TRD and MDD studies involving psilocybin.
As FDA approval and potential legalisation for medical use of psilocybin are being considered, it is crucial to understand the possible public health impact of introducing PSIL-AT in the United States. This requires an estimation of the potential demand for this novel treatment. The researchers defined clinical lower-bound, mid-range, and upper-bound estimates of the demand for PSIL-AT as a treatment for MDD or TRD.
Results
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https://doi.org/10.61373/pp024r.0025
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Cite this paper (APA)
Rab, S. F., Raison, C. L., & Marseille, E. (2024). An estimate of the number of people with clinical depression eligible for psilocybin-assisted therapy in the United States. Psychedelics. https://doi.org/10.61373/pp024r.0025
Study details
Compounds studied
Psilocybin
Topics studied
Economics
Depression
Study characteristics
Theory Building
Authors
Authors associated with this publication with profiles on Blossom
Elliot MarseilleElliot Marseille is a health economist specializing in psychedelics and HIV/AIDS, focusing on cost-effectiveness in global health challenges.
Charles Raison
Charles "Chuck" L. Raison is an American psychiatrist and professor of psychiatry. Next to his academic affiliation, he is also affiliated with the Usona Institute.
