Psychedelic therapy in Australia likely costs thousands

Patients in Australia will soon have legal access to the psychedelic drugs psilocybin and MDMA under a plan announced by regulators last month. However, with no approved source for the drug available to therapists, patients are likely to face tens of thousands of dollars in bills to get the promising treatment.

Last month, the Therapeutic Goods Administration (TGA), the Australian government’s regulator of medicine and therapy, announced that qualified psychiatrists will be able to prescribe the psychedelic drugs psilocybin and MDMA to treat certain mental illnesses from the end of this year. But the agency hasn’t approved any products containing the promising psychedelics, leaving it up to mental health professionals to source the drugs themselves. Without a government subsidy to cover the cost of the drugs, psychiatrists estimate that patients may have to pay up to AU$25,000 (almost $17,000) and more out of pocket for psychedelics-assisted therapy.

“For the actual patient, it could be $25,000 or $30,000 for one treatment,” said Dr. Stephen Bright, Lecturer at Edith Cowan University and Director of the charity Psychedelic Research In Science & Medicine.

“I honestly don’t think these treatments will be widely used at all in the next 12 to 18 months after July 1,” he added. “Because of the tight control of therapy, there are very few psychologists who raise their hands. There will be a few clinics that open, but I don’t think we’ll see the floodgates open.”

dr Paul Liknaitzky, the director of the Clinical Psychedelic Lab at Monash University, announced last month that he and other mental health professionals will be working with investors to open a psychedelics-assisted therapy clinic in Melbourne. However, training requirements for therapists and detailed guidelines for such therapy have yet to be enacted by state regulatory agencies.

“There is a lack of detailed clarity from the TGA to help us understand how it will be implemented. We are concerned but cautiously optimistic,” he said.

Liknaitzky said he and his colleagues will help establish protocols that set high standards for ethical and effective psychedelics-assisted therapy. However, he warned that the high cost of treatment could make the treatment inaccessible to most Australians.

“Reasonable and safe treatment approaches, based on decades of best practice development, include extensive screening, psychotherapy and other support. A typical treatment spread over a few months can be on the order of $25,000 plus or minus $10,000,” he said. “If it turns out to be cost effective, it’s in the interest of the government to fund it.”

Psychedelics-assisted therapy shows promise

Ongoing research has shown that psilocybin, the primary psychoactive compound in magic mushrooms, has the potential to be an effective treatment for several serious mental illnesses, including PTSD, major depressive disorder, anxiety, and substance abuse disorders. A 2020 study published in the journal JAMA Psychiatry found that psilocybin-assisted psychotherapy was a fast-acting and effective treatment for a group of 24 participants with major depressive disorders.

Separate research published in 2016 found that treatment with psilocybin resulted in significant and sustained decreases in depression and anxiety in patients with life-threatening cancer. And in 2021, a study published in the journal NatureMedicine found that MDMA, commonly known as ecstasy, is a highly effective and safe treatment for individuals with severe PTSD.

However, Professor Chris Langmead of the Monash Institute of Pharmaceutical Sciences says public health officials are unlikely to cover the cost of such a treatment until further research, including a cost-benefit analysis, is completed.

“We’re trying to get a wave of research and funding so we can do the research, clinical trials and implementation [to ensure] that this is not a purely market-based solution that neglects the most disadvantaged sections of the population,” he said. “The TGA has put Australia at the top of the world and we really need to seize the opportunity and make the most of it.”

Associate Professor Gillinder Bedi of the University of Melbourne said that a lack of clinical staff trained in psychedelics-assisted therapy will also make treatment difficult for patients.

“The infrastructure is being built. There will be clinics. But the problem is that we don’t have any staff. People can’t even see psychiatrists under normal conditions,” she said. “If you put two clinical psychologists in a room for eight hours to a [Medicare] At a rate of $120 an hour – that’s not what people charge, they charge $200-$300 – you have an enormously expensive treatment. I think it could go higher [than $25,000].

“Any way you look at it, it’s going to take time away from other treatments and it’s going to cost a whole lot of money. It’s unclear who will foot the bill, some organizations are trying to set up philanthropic funding,” Bedi added. “But it will be for people with money, at least in the early stages.”