The Potential Economic and Public Health Impact of MDMA-Assisted Group Therapy for PTSD in Ukraine

The war in Ukraine has led to widespread trauma, with 6.4 million people suffering from severe, chronic posttraumatic stress disorder (PTSD). This study evaluates the cost-effectiveness and societal impact of implementing modified group MDMA-assisted therapy (MAT), with supplemental individual therapy for PTSD treatment in Ukraine. Using a decision analysis model, we estimated clinical benefits, costs, and cost-effectiveness of MAT for 1000 PTSD patients in Ukraine. The model incorporates PTSD severity, mortality rates, healthcare costs, productivity effects, and caregiver costs. We analyzed outcomes from healthcare payer and societal perspectives over 1-, 3-, and 5-year horizons, projecting scaled-up impacts for 25%, 50%, and 75% of eligible patients over 10 years. Assuming 3 years of MAT efficacy, treating 1000 patients would cost $1.1 million, avert 19.2 deaths and gain 717 quality-adjusted life years (QALYs). From a healthcare payer's perspective, MAT is cost-effective with an incremental cost-effectiveness ratio of $1537 per QALY gained and a net monetary benefit of $2843. From a partial societal perspective, MAT generates net savings of $2.6 million. Scaled to 50% of eligible patients over 10 years, MAT could save 48,000 lives and gain 1.5 million QALYs, with net societal savings of $5.6 billion. Making MAT available for PTSD treatment in Ukraine is likely to be cost-effective or cost-saving, while substantially improving health outcomes. These findings support consideration of MAT as part of Ukraine's strategy to address widespread mental health needs.