Status, September 2026 ORCHID is no longer being pursued as originally envisioned. This deck is kept for reference. See SEF’s current research →

ORCHID

The evidence states need to fund psychedelic care.

Project Overview

Sheri Eckert FoundationIncubator and founding partner

UC BerkeleyCollaborative for the Economics of Psychedelics

UCSFCarhart-Harris Lab

02 Why this matters

I’ve spent my career asking whether health interventions are worth what they cost. It’s the question that decides whether something stays a boutique service or becomes part of the system.

Legal is not the same as affordable; people still pay thousands out of pocket, and the states running these programs are being asked to sustain them without knowing what they cost or what they save.

Elliot Marseille, DrPH, MPPDirector, Collaborative for the Economics of Psychedelics

03 The reality

Psychedelic care works.
But millions can’t access it.

Millions are suffering, current treatments often fall short, and legal access hasn’t made this care reachable.

The scale

280M+

people worldwide live with depression

World Health Organization

What clinical trials show

67%

of treatment-resistant depression patients responded to psilocybin

Johns Hopkins

2 / 3

patients don’t achieve remission with their first treatment*

Cleveland Clinic Journal of Medicine

71%

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

“Does psychedelic care reduce healthcare costs and improve outcomes in the real world?”

Only the state-regulated programs can answer it today:

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

The state-regulated programs let us evaluate the health economics of psychedelic care today.

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

Claims tracked from 24 months before care through 12 months after.

06 How it works

Two studies. One pipeline.

We track broad health claims data from 24 months prior to 12 months after their experience: mental health care, primary care, prescriptions, ER visits, hospitalizations, and more.

ORCHID ILooking back

Retrospective

~1,500 people who received psilocybin care 12+ months ago
Recruited through our relationships with facilitators, service centers, and health record providers
Tracks ER visits, hospitalizations, prescriptions, behavioral health care, primary care, and more

ORCHID II · CANOPYLooking forward

Prospective

In partnership with the UCSF CANOPY Project in Robin Carhart-Harris’ lab
People enrolled as they enter care
Connects wellbeing and health outcomes to healthcare utilization and cost

Our method: 3:1 matched controls · difference in differences · national health data aggregators (Komodo Health or IQVIA).

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.

State-regulated · our focus Ibogaine therapy Anywhere consent + a service date exist

07 The population

Who we’re studying

Our primary analysis focuses on the conditions where psilocybin has shown the most promise and where healthcare costs run highest.

Where we focus first

Confirmed

Depression · PTSD · alcohol use disorder
Opioid use disorder · anxiety and panic
Adjustment disorder

Also under consideration

Not yet confirmed

Nicotine dependence
Chronic pain
Eating disorders

Everyone else who enrolls stays in the study

Nobody is dropped

Same core analysis across the full sample
Individual conditions analyzed where numbers allow
Focusing first preserves statistical power without narrowing who can take part

Everyone else who enrolls stays in the study: same core analysis across the full sample, individual conditions analyzed where numbers allow.

08 Impact

ORCHID unlocks three pathways to access

The evidence ORCHID generates is the key that opens many doors to reimbursement, simultaneously.

01

State-Funded Access

Near-term public investment

Data like this strengthens the case for adopting and resourcing state-regulated programs.

02

Employer Health Plans

Already available, waiting on data

Gives companies the data they need to evaluate and potentially extend coverage.

03

Insurance Coverage

The long game

Provides 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

States fund what they legalized
Access beyond those who can pay out of pocket
Evidence that serves the whole field

Without ORCHID

We risk

No evidence that state-regulated care is cost effective
No viable route to coverage
Programs stay legal but unfunded

Boutique care⟶Access for many

Accessible care⟶A privilege for the few

10 The team behind ORCHID

Health economists, trial leaders, and the people who built the field.

Elliot Marseille, DrPH, MPP Director of CEP · Principal, Health Strategies International

Stefano Bertozzi, MD-PhD Professor of Health Policy & Management, UC Berkeley School of Public Health

Robin Carhart-Harris, PhD Professor, UCSF · Founder of the Carhart-Harris Lab

Will Lucas Clinical Research Coordinator, Weill Institute for Neurosciences

Jim Kahn, MD, MPH Emeritus Professor of Health Policy, Epidemiology & Global Health, UCSF

Nathan Howard Executive Director, Sheri Eckert Foundation

Advisory board

Tyler Norris, MDiv Advisor on community health, wellbeing & social impact

Aaron Loehr Board Chair, Mission to Live · ED, Better Community Health

David Bronner Cosmic Engagement Officer, Dr. Bronner’s

Tamar Todd Lecturer, Berkeley Law · Psychedelics law & drug policy expert

Britt Rollins Co-Founder, National Psychedelics Association

Bob Jesse Founder, Council on Spiritual Practices

Adie Rae, PhD Co-Director, Open Psychedelic Evaluation Nexus (OPEN)

A collaboration between Sheri Eckert Foundation

CEPCollaborative for the Economics of Psychedelics

11 Investment

Fund the shift

$458KPHASE 1 · RAISING NOW

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.

2025 Complete

IRB approved; seed funding. $60K diligence raised and completed; key partnerships secured.

2026 Now

Phase 1 demonstration pilot. Recruitment, data collection, and medical-records linkage prove out.

2027

Pilot outcomes and ORCHID I outcomes. The go/no-go decision; Phase 2, the full study, begins.

2028

ORCHID II outcomes. Prospective wellbeing and cost data from people enrolled as they entered care.

2029

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.

Sam ChapmanExecutive Director, Center for Psychedelic Policy · Campaign Manager, Oregon Psilocybin Services Ballot Measure 109 · Founding ED, Healing Advocacy Fund

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.

Seth Mehr, MDFounder, Cascade Psychedelic Medicine · Health & Safety Director, InnerTrek Psilocybin Service Center · Diplomate, American Board of Emergency Medicine

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.

Tamar ToddLecturer, Berkeley Law · Psychedelics Law and Drug Policy Reform Expert

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.

Tom Eckert, MSFounder & ED, InnerTrek · Architect of Oregon Measure 109 · Founding Chair, Oregon Psilocybin Advisory Board · Founder, Sheri Eckert Foundation

The states have 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.