The evidence that unlocks reimbursement for psychedelic care.
Project Overview
UC Berkeley · UCSF · Sheri Eckert Foundation
02 Why this matters
Psychedelic care has shown real promise. But without evidence on costs and outcomes, it remains out of reach for most people. Health payers need to understand how this care performs in the real world, and ORCHID is designed to generate exactly that evidence.
With your support, we have a rare opportunity to make psychedelic care accessible to everyone, not just those who can afford it.
03 The reality
Psychedelic care works.
But millions can’t access it.
Millions are suffering, current treatments often fall short, and psychedelic care remains out of reach without coverage.
The scale
people worldwide live with depression
World Health Organization
What clinical trials show
of treatment-resistant depression patients responded to psilocybin
Johns Hopkins
patients don’t achieve remission with their first treatment*
Cleveland Clinic Journal of Medicine
PTSD remission rate with MDMA-assisted therapy in Phase 3 trials
UCSF
*From their first treatment option
04 The missing piece
One question is blocking access for millions
Here’s why asking this question in the state-regulated programs provides the answers we need:
FDA Clinical Trials
Where evidence comes from today
- Not real-world
- Controlled conditions
- Indicate efficacy, but not cost-effectiveness
- Small, diagnosis-specific
FDA-Regulated Care
The pharmaceutical pathway
- Not yet available
- Cost-effectiveness data years away
- Access may be locked to approved diagnoses; reimbursement will be too
- Cost-prohibitive until payers cover it
State-Regulated Programs
Where ORCHID looks
- Real-world and available now
- Live at scale: 20,000+ served
- Open to all adults 21+
- Lower cost than the FDA pathway
05 Introducing ORCHID: the first study of its kind
The first study to track people before and after psychedelic care, link their experience to real medical records, and show whether it actually reduces health-system costs.
What we expect to rise: wellbeing, preventive care use, and quality of life.
What we expect to fall: crisis visits, hospitalizations, and total health-system costs.
First
First study linking psilocybin services to real medical claims.
Real-world
Real populations, not clinical-trial cohorts.
Timely
Preliminary results in 24 months; full evidence in 42.
06 How it works
Two studies. Real-world evidence.
ORCHID ILooking back
Results in ~24 months- ~1,500 people who received psilocybin care 12+ months ago
- Recruited through our relationships with facilitators, service centers, and electronic health record providers
- Tracks ER visits, hospitalizations, prescriptions, behavioral health care, primary care, and more
ORCHID IILooking forward
Complete in ~42 months- In partnership with the UCSF CANOPY Project in Robin Carhart-Harris’ lab; 500+ sign-ups already
- People enrolled as they enter care
- Wellbeing and health outcomes tracked through 6 months after their experience
A platform built for the whole field
ORCHID works across provider types, wherever consent can be obtained and a service date identified, letting us assess the health economics of transformative experiences.
07 The population
Who we’re studying
We study all participants, but the primary analysis focuses on a predefined cohort identified through medical diagnoses, where psilocybin has shown efficacy and healthcare costs run highest.
Predefined focal cohort
Higher-utilization conditions where psilocybin has shown promise
- Depression · alcohol use disorder · PTSD
- Generalized anxiety / panic · opioid use disorder
- Adjustment disorder with serious illness
- Tentative: nicotine dependence · somatic / pain-related · eating disorders
All other participants
Everyone stays in the study
- Everyone outside the predefined ICD-10 cohort remains included
- Same core analysis: utilization, costs, claims, and outcomes across both pools
- Subgroup analysis where numbers are sufficient
Why predefine?
Statistical power, preserved breadth
- Raises the chance of detecting meaningful utilization and outcome shifts
- Preserves the full participant sample
- Diagnoses confirmed via ICD-10 codes in medical records
08 Impact
ORCHID unlocks three pathways to access
The evidence ORCHID generates is the key that opens many doors to reimbursement, simultaneously.
State-Funded Access
Near-term public investment
Data like this strengthens the case for adopting and resourcing state-regulated programs. New Mexico has already committed $630,000 to subsidize psilocybin treatment for low-income and rural residents.
Employer Health Plans
Already available, waiting on data
Employers can already choose to cover state-regulated psychedelic services through Enthea. ORCHID gives companies the real-world outcomes and cost data they need to evaluate, expand, and sustain coverage.
Insurance Coverage
The long game
Insurers cover treatments when real-world data shows reduced costs and improved outcomes. ORCHID will provide supporting evidence for coverage of FDA-regulated care.
09 The stakes
This is the moment that determines access for millions.
If ORCHID succeeds
We unlock
- Coverage comes sooner, and could extend across both state and FDA-regulated care
- State funding for psychedelic care
- Access beyond early adopters
- Legitimacy for state-regulated programs
- Access for millions
Without ORCHID
We risk
- Reimbursement flowing only through the pharmaceutical pathway
- State-regulated services left without a viable route to coverage
- State-regulated systems stagnating
- Millions missing access to effective care
10 The team behind ORCHID
Health economists, trial leaders, and the people who built the field.
11 Investment
Fund the shift
Phase 2, the full study ($1.4M), follows the go/no-go decision. Total program: $1.79M over 3.5 years.
What Phase 1 funds
Proof the pipeline works: we connect real participants to their medical records. A real signal: does care use drop after psilocybin? We’ll see the direction. Confirmed power: variance estimates from this actual population, not borrowed assumptions. ORCHID II already running: prospective enrollment begins at near-zero added cost.
Phase 1 does not claim definitive proof of savings; it is directional evidence to inform the Phase 2 go/no-go decision. Phase 2 adds the full control arm, ORCHID II, subgroup analysis, and dissemination.
Why philanthropy?
No drug company will fund this. No commercial pathway exists. Without this evidence, health payers will not cover state-regulated psychedelic care. ORCHID is a public good, and only philanthropy can catalyze it.
IRB approved; seed funding. $60K diligence raised and completed; key partnerships secured.
Phase 1 demonstration pilot. Recruitment, data collection, and medical-records linkage prove out.
Phase 1 results and the go/no-go decision. Phase 2, the full study, begins.
ORCHID I outcomes. Real, policy-relevant cost data linked to records.
Full publication, policy briefs, presentations to decision-makers.
12 Voices from the field
The people who opened the door agree on what comes next.
Every state weighing public coverage of psychedelic care is running into the same wall: the fiscal case. Legislators want to know what it costs, what it saves, and whether the outcomes justify the spend. ORCHID is the kind of research infrastructure that can answer those questions with payer-grade evidence from Oregon and Colorado… If we want to move psychedelic care from an out-of-pocket service to a covered behavioral-health pathway, this is the evidence base that gets us there.
This project is meaningful because it looks beyond whether psychedelic care can help and asks whether it can change healthcare utilization, costs, and access. Those are the questions that will determine whether this model reaches the people who need it most.
For state-regulated psychedelic care to become accessible beyond those who can pay out of pocket, we need evidence that payers, policymakers, and public programs can trust. ORCHID is the kind of research infrastructure that can help translate real-world psychedelic care into coverage, policy, and access.
ORCHID could be a turning point for the state-regulated model. By producing payer-grade evidence from Oregon and Colorado, it can help move psychedelic care from an out-of-pocket service toward a more equitable healthcare pathway.
Oregon and Colorado opened the door. ORCHID can determine what happens next.
Access for millions
or access for a few.
Fund
Close the funding gap
Fully implement both studies and produce decision-grade evidence.
Connect
Introductions welcome
Introductions to donors, payers, health plans, or research institutions with complementary interests.
Collaborate
Open to joint work
Let’s discuss joint work to make this project a reality and increase its impact.
ORCHID · UC Berkeley · UCSF · Sheri Eckert Foundation · 2026