Analysis Estimates 0.45% Schizophrenia Prevalence in United States

More patients with schizophrenia are covered by Medicare and Medicaid compared with commercial payers in the United States, according to results from a 2022 claims analysis presented in a poster at Psych Congress.

“Among the Medicaid subset, patients with schizophrenia incurred greater than $30,000 in annual health care costs, highlighting the high cost of this disease state,” wrote first author Joseph Tkacz, MS, of Inovalon, Bowie, Maryland, and coauthors of the poster.

The observational, retrospective study used administrative claims databases to assess the incidence and prevalence of schizophrenia in the United States. Researchers identified a total 653,666 patients with schizophrenia in 2022. Among them, 97,565 patients had incident schizophrenia.

Per 100,000 people, the weighted prevalence of schizophrenia in the United States was an estimated 448.5, according to the study.

“After weighting, the national prevalence of schizophrenia was estimated at 0.45% and the national incidence of schizophrenia was estimated at 0.08%,” researchers wrote.

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By payer type, the highest prevalence of schizophrenia was among patients with Medicare Advantage, followed by Medicaid Fee-for-Service and Medicaid. By state, California, Florida, New York, Texas, Pennsylvania, Illinois, New Jersey, Arizona, Virginia, Michigan, Ohio, and Louisiana had the largest number of patients with schizophrenia, analysis of the claims databases showed.

All-cause health care expenditures in the Medicaid sample of patients with prevalent schizophrenia averaged a total $31,155 in 2022. The figure consisted of $7744 in inpatient hospital costs, $7324 in pharmacy costs, $2931 in emergency department costs, $784 in physician office costs, and $12,373 in other medical costs.

Meanwhile, the weighted schizophrenia incidence in 2022 was an estimated 83.1 per 100.000 people nationally, researchers reported. Incidence rates were highest for Medicaid, Medicare Advantage, and Medicaid Fee-for-Service. State-level incidence distributions aligned with prevalence distributions.

The study was funded by Karuna Therapeutics, a Bristol Myers Squibb company.

Reference

Tkacz J, Cajigal A, Sidovar M, et al. Current estimates of the incidence and prevalence of schizophrenia in the US. Poster presented at Psych Congress; October 29 – November 2, 2024; Boston, Massachusetts.