Up to 90% of Schizophrenia Expenses Stem From Indirect Costs

Indirect costs drive 50% to 90% of the total costs associated with schizophrenia, yet most studies investigating the economic burden of the condition report only direct costs, according to a study results published in the Journal of Medical Economics.

“The substantial underreporting of indirect and intangible costs undervalues the true economic burden of schizophrenia from a payer, patient, and societal perspective,” researchers wrote.

The finding stems from a literature review of 64 studies and other reviews published between 2006 and 2021 that focused on costs associated with schizophrenia in 10 countries: the United States, the United Kingdom, France, Germany, Italy, Spain, Canada, Japan, Brazil, and China.

With the exception of the United States, individual countries had limited cost data, researchers reported. Furthermore, most data focused on direct costs, such as hospital visits, health care appointments, and medications, rather than indirect costs, such as lost productivity and premature death. No data addressed intangible costs, such as pain, stress, and anxiety.

Total per-person per-year (PPPY) costs associated with schizophrenia varied vastly among countries, from $2004 in China to $94,229 in the United States, according to the study.

“Although it was not an objective of this study to evaluate reasons for between-country differences in costs, we suggest that the divergences may be due to differences in the underlying study population that are inevitable when independent studies are compared,” the authors wrote. “Most notable reasons for the cost differences may include study methodology (study design, data source used, methodologies used to recruit patients), time frame for data collection, cost components, methods of estimating costs, and differences in health care systems.”

Indirect costs, which ranged from $1852 to $62,431 PPPY, appeared to be the main driver of total costs, accounting for half to as much as 90% of all costs, the study found.

Additionally, evidence suggested that total schizophrenia-related costs were higher in patients with negative symptoms compared with patients with positive symptoms, mainly due to higher costs for medications and medical appointments.

F. Hoffmann-La Roche Ltd. funded the literature review.

Reference:
Kotzeva A, Mittal D, Desai S, Judge D, Samanta K. Socioeconomic burden of schizophrenia: a targeted literature review of types of costs and associated drivers across 10 countries. J Med Econ. Published online ahead of print December 12, 2022. doi:10.1080/13696998.2022.2157596