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辅助医用大麻疗法治疗中度创伤后应激障碍的成本效益

The Cost Effectiveness of Adjunctive Medical Cannabis Therapy in the Treatment of Moderate Post-Traumatic Stress Disorder.

作者信息

Doucette Mitchell L, Hemraj Dipak, Macfarlan D Luke, Chin Junella, Fisher Emily

机构信息

Health Economics and Outcomes Research Division, Leafwell, 9100 S. Dadeland Blvd. Suite 1701., Miami, FL, USA.

出版信息

Clin Drug Investig. 2025 Apr;45(4):207-220. doi: 10.1007/s40261-025-01424-z. Epub 2025 Feb 25.

Abstract

INTRODUCTION

Research on the benefits of medical cannabis (MC) is emerging and supports its use as a treatment for post-traumatic stress disorder (PTSD). This study aimed to evaluate the cost effectiveness of MC as an adjunctive therapy for moderate PTSD under varying reimbursement scenarios.

METHODS

A cost-utility analysis was conducted from the US payor perspective, using pricing data from the largest multi-state MC producer and established literature on standard PTSD treatments. We analyzed eight MC product types: dried flower, oral solutions, tablets, and edibles, each available in low/moderate (LM) and high-cost formulations. Incremental cost-utility ratios (ICURs) were calculated for these products across reimbursement levels of 100%, 75%, 50%, and 25%. Probabilistic sensitivity analyses with 10,000 Monte Carlo simulations were conducted to assess cost-effectiveness acceptability across willingness-to-pay (WTP) thresholds of $0-$100,000 per quality-adjusted life year (QALY) gained.

RESULTS

Non-flower MC products (edibles, oral solutions, and tablets) consistently demonstrated cost-effectiveness under a WTP threshold of $50,000, even at 100% reimbursement. Dried flower products, while less cost effective due to higher costs, achieved cost effectiveness under 75% or lower reimbursement levels for LM cost formulations. Sensitivity analyses confirmed robust ICURs for non-flower products, with narrower variability compared to dried flower products.

CONCLUSIONS

Medical cannabis products, particularly non-flower formulations, represent a cost-effective adjunctive therapy for moderate PTSD under various reimbursement scenarios. This analysis underscores the importance of evidence-based reimbursement policies to improve patient access to cost-effective treatments while ensuring financial sustainability for payors.

摘要

引言

关于医用大麻(MC)益处的研究正在兴起,并支持将其用作创伤后应激障碍(PTSD)的一种治疗方法。本研究旨在评估在不同报销方案下,MC作为中度PTSD辅助治疗的成本效益。

方法

从美国付款人的角度进行成本效用分析,使用来自最大的多州MC生产商的定价数据以及关于标准PTSD治疗的既定文献。我们分析了八种MC产品类型:干花、口服溶液、片剂和可食用产品,每种产品都有低/中度(LM)和高成本配方。计算了这些产品在100%、75%、50%和25%报销水平下的增量成本效用比(ICUR)。进行了10000次蒙特卡洛模拟的概率敏感性分析,以评估每获得一个质量调整生命年(QALY)支付意愿(WTP)阈值在0美元至100000美元之间时的成本效益可接受性。

结果

非花类MC产品(可食用产品、口服溶液和片剂)即使在100%报销的情况下,在50000美元的WTP阈值下也始终显示出成本效益。干花产品由于成本较高,成本效益较低,但对于LM成本配方,在75%或更低的报销水平下实现了成本效益。敏感性分析证实了非花类产品的ICUR稳健,与干花产品相比变异性更小。

结论

医用大麻产品,特别是非花类配方,在各种报销方案下是中度PTSD的一种具有成本效益的辅助治疗方法。该分析强调了基于证据的报销政策对于改善患者获得具有成本效益的治疗的机会,同时确保付款人财务可持续性的重要性。

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