A Cost-Effectiveness Analysis of a Ketamine-assisted Psychotherapy Program Compared to Online Group Psychotherapy in British Columbia, Canada
Bibliographic record
Abstract
Introduction Depression continues to present significant economic burdens to the Canadian healthcare system. Novel therapies, including those that incorporate psychoactive substances such as ketamine, present an opportunity to evaluate both clinical and economic effectiveness against current standards of care, which may be repeatedly proving ineffective in treating depression for some individuals. Objectives This paper evaluates the cost-effectiveness of the Roots to Thrive ketamine program compared to group psychotherapy covered through the medical services plan in British Columbia, Canada. Methods A discrete-time Markov-model is used to estimate depressive states over five cycles for a treatment cohort and a synthetic control cohort. The transition probabilities for the treatment cohort are calculated from Roots to Thrive program data (n = 62) over the past 3 years, with the control cohort using published values from the literature. Both cohorts use the same starting state distribution, excess healthcare utilization rates for each severity level of depression, and utility outcomes based on depression state severity. Results Compared to the control cohort, the Roots to Thrive program was less expensive and produced better outcomes as measured by PHQ-9 scores and Quality-Adjusted life years over 5 treatment cycles. On average, the Roots to Thrive program would save $14,481 and produce 0.94 additional QALY’s per individual compared to group psychotherapy of three patients per provider in the current standard of care. Conclusions From an economic perspective, incorporating the Roots to Thrive program - or a program like it - into care in British Columbia would provide both an improvement in health outcomes and reduce expenditure by the ministry of health. These funds could be reinvested into other areas of the healthcare system to improve the lives of all British Columbians, even those that do not engage in psychedelic-assisted psychotherapy. Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".