Dr. Bronner's Offering Its Workers Psychedelic Therapy Coverage – Medpage Today

Dr. Bronner’s is touting itself as being among the first U.S. employers to offer psychedelic-assisted therapy (PAT) to its employees via a health benefit plan.

The soap manufacturer started offering ketamine-assisted therapy (KAT) as a benefit in January. The program is being operated by Enthea, a nonprofit startup aiming to extend PAT to several more employers’ plans by the end of the year and make the trend widespread by 2025.

“High-performing and forward-thinking companies know the importance of employee mental health. We also see the best talent attracted to companies with next-generation benefits,” Enthea CEO Lia Mix said in a press release issued by Bronner’s on Monday. “We anticipate both human and financial return on these organizations’ investment in covering psychedelic healthcare.”

Proponents have argued that PAT can treat several mental health issues, from depression to anxiety to post-traumatic stress disorder (PTSD). Among the psychedelic and other psychoactive substances under scientific study over the last several years, ketamine is the only one allowed for treatment outside of experimental use. Ketamine is not FDA approved, but providers are permitted to use it off label when they think it can help patients.

While ketamine-infusion clinics have sprouted nationally — sans therapy — many psychedelics researchers and other insiders favor combining ketamine with therapy. They hope to copy this model with other substances in the future, predicting that the FDA will approve MDMA (3,4-methylenedioxy-methamphetamine) to treat PTSD by the end of next year and psilocybin for major depressive disorder by 2025.

These substances and similar compounds are being examined for other conditions as well. Several academic centers have launched over the last 2 years to study psychedelics and similar substances as potential mental health treatments, and the U.S. government issued its first such research award in a half-century in September — $4 million for Johns Hopkins researchers to study psilocybin-assisted therapy for tobacco cessation.

PAT is costly and difficult to monitor, essentially emerging as concierge medicine thus far, sources told MedPage Today. Only the wealthy will be able to afford consistent treatment if this is not addressed, Enthea chief business officer Keith Lietzke told MedPage Today.

Enthea launched last year as an eight-person remote nonprofit promising to streamline costs and help providers match with patients.

Bronner’s is the first employer to adopt Enthea’s program. As of Monday, 21 employees had leveraged the service, after president Michael Bronner was inspired by his own experience, the New York Times reported. “I don’t want to oversell ketamine therapy as a miracle cure, but it just stripped the rust away, gave me a reset and got me to a really good space,” he told the Times.

Bronner’s did not return queries from MedPage Today.

Enthea acts as a third-party administrator similar to a rider for Bronner’s, Lietzke said, noting that Enthea is covering KAT only, not ketamine-infusion clinic treatments.

Bronner’s has a more typical health benefit plan managed by Cigna, Lietzke said, but he noted that Cigna is not involved in the Bronner’s-Enthea relationship.

Enthea is offering employers the opportunity to handle provider authorization and reimbursement, and an initial national psychedelic provider network, as well as establishing care standards and monitoring providers (including a member appeal and grievance process).

Enthea is also offering providers credentialing and onboarding, promising to reimburse within 30 days, cut staff payment-chasing by 80%, establish a provider advisory panel with quarterly reviews, and give patients access to a financial assistance fund to subsidize treatment.

Lietzke said he expects that Bronner’s will be the first of multiple employers across 10 states to adopt Enthea’s coverage by the end of the year. There is enough demand for even more employers to add this coverage, he said, but Enthea’s small bandwidth has limited growth. Enthea plans to sell coverage to only early adopters, and has raised $2 million to launch the Bronner’s and other 2022 pilot plans.

Enthea hopes that other, larger insurers follow its model and launch similar plans — though Lietzke thinks that, based on conversations with prospects, that is a few years away. “We don’t want to wait that long,” he said.

Enthea anticipates $7 million in earnings by 2025, planning to donate that money to the patient assistance funds. It projects that employers will spend a combined $500 million nationally on PAT for employees and their families in 2024-2025.

KAT for depression alone is already a billion-dollar industry, the New York Times reported. Some large insurers now cover ketamine, but not a combination of that and therapy.

“Offering coverage for Ketamine Assisted Therapy is in the interest of providing tools to our workforce to have the best quality of life and best options for mental health care,” Michael Bronner said in the release.

Bronner’s already plans to increase its PAT offerings. “After FDA approval,” Enthea “will administer coverage” to Bronner’s employees for MDMA- and psilocybin-assisted therapy, according to the release.

“Offering strong benefits helps with employee retention and recruitment. We hope to inspire and be a model for other companies and organizations to also partner with Enthea,” said David Bronner, the CEO of Bronner’s.

Some observers are skeptical. Zach Lomis, a partner with the industry’s investment fund Palo Santo, predicted “a very long road ahead to become a trend, in the near term.” Many companies are averse to PAT coverage due to legal and compliance concerns, although Lomis expects that a few states such as Oregon may permit the model sooner. Otherwise, the industry is awaiting more positive clinical trial results and FDA approval before acting.

Take the Canadian marketplace, for example, where psilocybin-assisted therapy is permitted in special circumstances. “The [insurance] industry is aware of the[se] developments involving Health Canada. However at this point, the prescribed use of psychedelics in treatment is still very early and quite rare,” Kevin Dorse, a Canadian Life and Health Insurance Association executive, told Truffle Report last year. “Health insurers will continue to monitor developments.”

Bronner’s has been a big financial supporter of psychedelic medicine, the Times reported, donating more than $23 million to advocacy and research organizations since 2015. Bronner’s has pledged $1 million annually over the next 5 years to the Multidisciplinary Association for Psychedelic Studies (MAPS), a research and advocacy group that has supported Enthea and for which David Bronner is a board member.

“Considering all our advocacy on this issue, this [KAT] employee benefit is the next logical step,” Michael Bronner said.

Ryan Basen reports for MedPage’s enterprise & investigative team. He often writes about issues concerning the practice and business of medicine, nurses, cannabis and psychedelic medicine, and sports medicine. Send story tips to r.basen@medpagetoday.com. Follow