Cost-effectiveness of psilocybin-assisted therapy for severe depression: exploratory findings from a decision analytic model

Joanna Neill, paul McCrone, Henry Fisher, Clare Knight, Rebecca Harding, Anne Schlag, David Nutt

Research output: Contribution to journalArticlepeer-review


Background: There is growing evidence to support the use of the psychedelic drug psilocybin
for difficult-to-treat depression. This paper compares the cost-effectiveness of psilocybinassisted
psychotherapy (PAP) with conventional medication, cognitive behavioural therapy
(CBT), and the combination of conventional medication and CBT.
Methods: A decision model simulated patient events (response, remission, and relapse) following
treatment. Data on probabilities, costs and quality-adjusted life years (QALYs) were
derived from previous studies or from best estimates. Expected healthcare and societal costs
and QALYs over a 6-month time period were calculated. Sensitivity analyses were used to
address uncertainty in parameter estimates.
Results: The expected healthcare cost of PAP varied from £6132 to £7652 depending on the
price of psilocybin. This compares to £3528 for conventional medication alone, £4250 for
CBT alone, and £4197 for their combination. QALYs were highest for psilocybin (0.310), followed
by CBT alone (0.283), conventional medication alone (0.278), and their combination
(0.287). Psilocybin was shown to be cost-effective compared to the other therapies when
the cost of therapist support was reduced by 50% and the psilocybin price was reduced
from its initial value to £400 to £800 per person. From a societal perspective, psilocybin
had improved cost-effectiveness compared to a healthcare perspective.
Conclusions: Psilocybin has the potential to be a cost-effective therapy for severe depression.
This depends on the level of psychological support that is given to patients receiving psilocybin
and the price of the drug itself. Further data on long-term outcomes are required to
improve the evidence base.
Original languageEnglish
Article number1
Pages (from-to)1-8
Number of pages9
JournalPsychological Medicine
Issue number16
Publication statusPublished - 27 Apr 2023


  • Decision analysis
  • psilocybin
  • psychedelic assisted psychotherapy
  • Treatment-resistant depression


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