Enthea best-guess cost-effectiveness model
 Share
The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

 
View only
 
 
ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
Input
Input value (best-guess)
Input value (optimistic)
Input value (pessimistic)
SourceNotes
2
Costs
3
4
Ballot initiative
5
Setup costs$50,000$50,000$100,000guess
6
Polling$100,000$50,000$300,000private
7
Signature collection$2,480,000$2,000,000$3,200,000Ballotpedia
8
Advertising & late-stage operations$12,000,000$4,000,000$35,000,000SacBee analysisSee chart at bottom of article
9
Total cost of ballot initiative campaign$14,630,000$6,100,000$38,600,000
10
11
12
Benefits
13
14
Depression
15
Number of people (18+) who had a major depressive episode in CA in 20151,731,0001,731,0001,731,000NSDUH 2015 survey
16
Percent of depressed people who seek treatment57%57%57%Thornicroft et al. 2017See USA results in table on p. 3, column B * column C
17
Number of CA people who sought treatment for their depression991,448991,448991,448calculation
18
Percent of treatment-seekers who would try psilocybin treatment, if it were approved44%63%25%YouGov 2017 surveyBest-guess assumes all of the "definitely would" respondents and half of the "probably would" respondents would use psychedelics if approved.
19
Percent who no longer meet BDI criteria for severe major depression after psilocybin treatment 33%33%33%
Carhart-Harris et al. 2016
Carhart-Harris et al. 2016 – 12 patients, 9 severely depressed at baseline. 4 score as "not depressed", 4 score as "moderately depressed", 1 scores as "severely depressed" at 3 months post-treatment. See fig. 4 of Carhart-Harris et al. 2016
20
Percent who BDI depression criteria was reduced from "severe" to "moderate" after psilocybin treatment33%33%33%
Carhart-Harris et al. 2016
Carhart-Harris et al. 2016 – 12 patients, 9 severely depressed at baseline. 4 score as "not depressed", 4 score as "moderately depressed", 1 scores as "severely depressed" at 3 months post-treatment. See fig. 4 of Carhart-Harris et al. 2016
21
Replicability adjustment20%30%10%guessBest-guess is about the same as GiveWell's 2017 replicability adjustment for deworming
22
Number of CA depressed people who would no longer meet BDI criteria for major depression after psilocybin treatment29,08262,4618,262calculation
23
Number of CA depressed people who would move from BDI criteria for "severe" major depression to BDI criteria for "moderate" major depression after psilocybin treatment29,08262,4618,262calculation
24
2015 DALYs averted by moving from "severe major depressive disorder" to no depression (per person per year)0.6580.6580.6582015 GBD DALY weights
25
2015 DALYs averted by moving from "severe major depressive disorder" to "moderate major depressive disorder" (per person per year)0.2620.2620.262calculationSee "Supplemental calculations" sheet
26
Number of CA DALYs / year from depression300,422300,422300,422calculationSee "Supplemental calculations" sheet
27
DALYs per person per year from depression0.170.170.17calculation
28
Major depression DALYs removed / year by psilocybin treatment7,05715,1572,005calculation
29
30
Alcoholism
31
Number of people (18+) with alcohol use disorder (AUD) in CA in 20152,038,0002,038,0002,038,000NSDUH 2015 survey
32
Percent of AUD drinkers who attempted to quit in the last year50%60%33%guess(Need a source for this!)
33
Percent of attempting quitters who failed to quit90%90%90%Atlantic article on AA(Need a better source for this!) “Peer reviewed studies peg the success rate of AA somewhere between five and 10 percent,” writes Dodes. “About one of every 15 people who enter these programs is able to become and stay sober.”
34
Number of CA people (18+) who attempted to quit drinking and failed917,1001,100,520605,286calculation
35
Percent of treatment-seekers who would try psilocybin treatment, if it were approved44%63%25%YouGov 2017 surveyBest-guess assumes all of the "definitely would" respondents and half of the "probably would" respondents would use psychedelics if approved.
36
Percent who successfully stop drinking after psilocybin treatment50%50%50%Bogenschutz et al. 2015Not confident I'm interpreting this study result correctly
37
Replicability adjustment20%30%10%guessBest-guess is about the same as GiveWell's 2017 replicability adjustment for deworming
38
Number of AUD drinkers who would successfully quit drinking after psilocybin treatment40,352103,9997,566calculation
39
2015 DALY burden of alcohol use in CA222,512222,512222,512calculationSee "Supplemental calculations" sheet
40
DALY burden per CA drinker per year0.10918140930.10918140930.1091814093calculation
41
Alcohol DALYs removed / year by psilocybin treatment4,40611,355826calculation
42
43
Tobacco smoking
44
Number of people (18+) who smoked a cigarette in the last month in CA in 20154,706,0004,706,0004,706,000NSDUH 2015 survey
45
Percent of smokers who attempted to quit in the last year55.40%55.40%55.40%CDC webpage
46
Percent of attempting quitters who failed to quit90%90%90%CDC webpage
47
Number of CA people (18+) who attempted to quit smoking and failed2,346,4122,346,4122,346,412calculation
48
Percent of treatment-seekers who would try psilocybin treatment, if it were approved44%63%25%YouGov 2017 surveyBest-guess assumes all of the "definitely would" respondents and half of the "probably would" respondents would use psychedelics if approved.
49
Percent who successfully abstain from smoking after psilocybin treatment67%67%67%Johnson et al. 2017
50
Replicability adjustment20%30%10%guessBest-guess is about the same as GiveWell's 2017 replicability adjustment for deworming
51
Number of people who would successfully quit smoking after psilocybin treatment138,344297,12639,302calculation
52
2015 DALY burden of smoking in CA343,207343,207343,207calculationSee "Supplemental calculations" sheet
53
DALY burden per smoker per year0.072929593030.072929593030.07292959303calculation
54
Smoking DALYs removed / year by psilocybin treatment10,08921,6692,866calculation
55
56
Post-traumatic stress disorder
57
Number of people with PTSD in CA in a given year971,835971,835971,835calculationSee "Supplemental calculations" sheet
58
Percent of PTSD sufferers who seek treatment57%57%57%Thornicroft et al. 2017See USA results in table on p. 3, column B * column C (assumed to be the same as with depression)
59
Number of people with PTSD in CA who sought treatment in a given year556,628556,628556,628calculation
60
Percent of treatment-seekers who would try MDMA treatment, if it were approved44%63%25%YouGov 2017 surveyBest-guess assumes all of the "definitely would" respondents and half of the "probably would" respondents would use psychedelics if approved.
61
Percent who no longer meet clincal definition of PTSD after MDMA treatment (placebo-adjusted)58.33%58.33%58.33%Mithoefer et al. 2010"Likewise, 10 [of 12] of the
MDMA group no longer met DSM-IV criteria for PTSD
compared with two of the placebo group [2 of 8]."
62
Replicability adjustment20%30%10%guessBest-guess is about the same as GiveWell's 2017 replicability adjustment for deworming
63
Number of CA people with PTSD removed after MDMA treatment28,57461,3688,117calculation
64
2015 DALYs averted by removing PTSD (per person per year)0.170.170.17calculationSee "Supplemental calculations" sheet; assumes PTSD DALY weight is the same as major depression, as the 2015 GBD DALY weights don't have an entry for PTSD
65
PTSD DALYs removed / year by MDMA treatment4,95910,6511,409calculation
66
67
68
Sum of benefits
69
Depression + alcoholism + smoking + PTSD DALYs averted per year26,51158,8327,106calculation
70
"Aggressive behavior" discount25,82257,3026,921Carbonaro et al. 2016A survey of recreational psychedelic users who had bad trips found that 2.6% of them acted aggressively during their trip. We use this figure as a rough estimate of the proportion of patients who would not receive any benefit from psychedelic treatment.
71
Years of benefit before psilocybin & MDMA would be widely available by other means5102guess
72
Total DALYs averted over timespan considered129,110573,02013,843calculation
73
Percent of impact attributable to the ballot initiative campaign
30%45%5%guess
74
Probability that initiative succeeds, conditional on polling well & receiving sufficient funding80%90%60%private / guessPrivate polls we have seen suggest that a drug liberalization ballot intiative would be very popular in most US states.
75
Total DALYs averted, in expectation30,986232,073415
76
77
78
Cost per DALY averted
79
80
Total cost of a CA ballot initiative campaign$14,630,000$6,100,000$38,600,000
81
Total DALYs averted, in expectation30,986232,073415
82
83
Cost per DALY averted$472$26$92,950
84
85
86
87
88
89
90
Benefits not modeled
91
Many of the benefits of the initative (plausibly including the most important) are difficult to model. Some benefits not included in this analysis:
92
93
(for psychedelic users) Alleviation of mild depression and anxiety
94
(for psychedelic users) Anti-addiction aid for behavioral addictions (gambling, online gaming, social media, etc.)
95
(for psychedelic users) Improved psychological openness
96
(for psychedelic users, speculative) Improved relationships between friends, co-workers, and significant others
97
(for psychedelic users, speculative) Improved self-efficacy
98
(societal) Reduced sentences for drug offenders
99
(societal) Increased personal liberty
100
(societal) Pushing US federal drug policy towards a public health model (i.e. away from a crime model)
Loading...
Main menu