[Solved] Health insurers, reimbursement and psychedelic therapy

Posted by: @money

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Why do health insurers not yet reimburse therapies with psychedelics? Surely it is clear that psychedelic sessions are effective?

Health insurers do not currently reimburse psilocybin-based therapies, such as psilocybin therapy, for various reasons. Firstly, psychedelic therapy has not yet been officially recognised as a medical treatment. In the Netherlands, psychedelic therapy is currently regarded as coaching whilst under the influence of a psychoactive substance, rather than as a recognised medical treatment. This is due to current legislation and regulations, which have not yet been amended to recognise psychedelics as therapeutic agents.

Furthermore, there are not yet enough large-scale, long-term scientific studies demonstrating the effectiveness and safety of psychedelic therapies in a clinical setting. Although there are promising results from recent studies, such as those on psilocybin for depression and MDMA for post-traumatic stress disorder (PTSD), there is a need for further evidence that these therapies consistently deliver positive outcomes. Recognition of these therapies by health insurers is unlikely to occur until more rigorous scientific research has been carried out and the results analysed.

However, the European Parliament has recently allocated a substantial sum of money for research into psilocybin, which is a positive sign for the future. This may contribute to the recognition and regulation of psychedelic therapies in the coming years. It is expected that, as more studies are completed and the acceptance of psychedelics as therapeutic agents grows, health insurers may in future be prepared to partially reimburse these therapies, perhaps around 2025 or 2026.

See also: Psychedelic therapies 

To add to Marcel’s very detailed answer: it is indeed frustrating that effective treatments are not yet reimbursed, but it is important to understand the reasons behind this. Health insurers are bound by strict regulations and can only reimburse treatments that are included in what is known as the ‘basic package’. This is an official list of recognised treatments that are available to all insured persons.

Psychedelic therapies are not yet included on that list because they have not yet been officially recognised as medical treatments by regulatory bodies such as the Central Hospital Board. This is not something that health insurers can decide on their own, even if they wanted to. They must adhere to the legal framework.

What is changing, however, is that the scientific evidence is becoming increasingly robust. Studies into MDMA for PTSD and psilocybin for depression are showing an increasing number of positive results. But healthcare decision-makers want certainty: consistent evidence that it is safe and effective over the long term, in large numbers of people.

The positive aspect is that things are already moving forward within the system. The Dutch government is providing funding for research, and research centres are carrying out studies. Once those studies have been completed and the results are clear, the regulatory process can begin. This is likely to happen around 2027.

Until then, anyone interested will indeed have to pay for it themselves. But bear in mind that you may be able to claim it as a deduction on your tax return: many therapies qualify as additional expenses for the purposes of the medical expenses allowance.