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Inappropriate comparator and high pricing in MDMA-assisted therapy for PTSD: A critique of the Lykos cost-effectiveness analysis

2025/08/05 by Elliot Marseille, Jennifer Mitchell · 1 voice
Medicine · Psychology · #Cannabis and Cannabinoid Research #Psychedelics and Drug Studies #Treatment of Major Depression

paper · doi:10.1016/j.psyche.2025.100002

openalex publication_date 2025/08/05 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/10

Abstract

This commentary examines a recent Lykos Therapeutics-funded cost-effectiveness analysis of MDMA-assisted therapy for PTSD following FDA's 2024 decision to decline approval. While methodologically rigorous in its use of empirical trial data, the study has two critical limitations that undermine its relevance to healthcare decision-makers: an inappropriate comparison to placebo-based therapy rather than to standard-of-care treatments, and a problematic pricing strategy (36,000 for the three MDMA doses) that threatens accessibility. Alternative modeling suggests that at a more reasonable price point of approximately 10,500, MDMA therapy could be extremely cost-effective, around 160 per quality-adjusted life year (QALY), or even cost-saving. For meaningful policy impact, future research should incorporate realistic treatment comparators, comprehensive healthcare utilization data (beyond PTSD-specific costs), and pricing models that balance economic viability with public health goals.

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