The Economic Burden of Schizophrenia in the United States in 2013

The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade. A prevalence-based approach was used to assess direct health care costs...

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Published in:	The journal of clinical psychiatry Vol. 77; no. 6; p. 764
Main Authors:	Cloutier, Martin, Aigbogun, Myrlene Sanon, Guerin, Annie, Nitulescu, Roy, Ramanakumar, Agnihotram V, Kamat, Siddhesh A, DeLucia, Michael, Duffy, Ruth, Legacy, Susan N, Henderson, Crystal, Francois, Clement, Wu, Eric
Format:	Journal Article
Language:	English
Published:	United States 01.06.2016
Subjects:	Adult Aged Aged, 80 and over Chronic Disease Cohort Studies Cost of Illness Cross-Sectional Studies Disease Management Female Health Care Costs Health Expenditures - statistics & numerical data Humans Male Middle Aged Retrospective Studies Schizophrenia - economics Schizophrenia - epidemiology
ISSN:	1555-2101, 1555-2101
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Abstract	The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade. A prevalence-based approach was used to assess direct health care costs, direct non-health care costs, and indirect costs associated with schizophrenia (ICD-9 codes 295.xx) for 2013, with cost adjustments where necessary. Direct health care costs were estimated using a retrospective matched cohort design using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate databases. Direct non-health care costs were estimated for law enforcement, homeless shelters, and research and training. Indirect costs were estimated for productivity loss from unemployment, reduced work productivity among the employed, premature mortality (ie, suicide), and caregiving. The economic burden of schizophrenia was estimated at $155.7 billion ($134.4 billion-$174.3 billion based on sensitivity analyses) for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia. The largest components were excess costs associated with unemployment (38%), productivity loss due to caregiving (34%), and direct health care costs (24%). Schizophrenia is associated with a significant economic burden where, in addition to direct health care costs, indirect and non-health care costs are strong contributors, suggesting that therapies should aim at improving not only symptom control but also cognition and functional performance, which are associated with substantial non-health care and indirect costs.
AbstractList	The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade.OBJECTIVEThe objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade.A prevalence-based approach was used to assess direct health care costs, direct non-health care costs, and indirect costs associated with schizophrenia (ICD-9 codes 295.xx) for 2013, with cost adjustments where necessary. Direct health care costs were estimated using a retrospective matched cohort design using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate databases. Direct non-health care costs were estimated for law enforcement, homeless shelters, and research and training. Indirect costs were estimated for productivity loss from unemployment, reduced work productivity among the employed, premature mortality (ie, suicide), and caregiving.METHODSA prevalence-based approach was used to assess direct health care costs, direct non-health care costs, and indirect costs associated with schizophrenia (ICD-9 codes 295.xx) for 2013, with cost adjustments where necessary. Direct health care costs were estimated using a retrospective matched cohort design using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate databases. Direct non-health care costs were estimated for law enforcement, homeless shelters, and research and training. Indirect costs were estimated for productivity loss from unemployment, reduced work productivity among the employed, premature mortality (ie, suicide), and caregiving.The economic burden of schizophrenia was estimated at $155.7 billion ($134.4 billion-$174.3 billion based on sensitivity analyses) for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia. The largest components were excess costs associated with unemployment (38%), productivity loss due to caregiving (34%), and direct health care costs (24%).RESULTSThe economic burden of schizophrenia was estimated at $155.7 billion ($134.4 billion-$174.3 billion based on sensitivity analyses) for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia. The largest components were excess costs associated with unemployment (38%), productivity loss due to caregiving (34%), and direct health care costs (24%).Schizophrenia is associated with a significant economic burden where, in addition to direct health care costs, indirect and non-health care costs are strong contributors, suggesting that therapies should aim at improving not only symptom control but also cognition and functional performance, which are associated with substantial non-health care and indirect costs.CONCLUSIONSSchizophrenia is associated with a significant economic burden where, in addition to direct health care costs, indirect and non-health care costs are strong contributors, suggesting that therapies should aim at improving not only symptom control but also cognition and functional performance, which are associated with substantial non-health care and indirect costs. The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the disease management and health care structural changes of the last decade. A prevalence-based approach was used to assess direct health care costs, direct non-health care costs, and indirect costs associated with schizophrenia (ICD-9 codes 295.xx) for 2013, with cost adjustments where necessary. Direct health care costs were estimated using a retrospective matched cohort design using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate databases. Direct non-health care costs were estimated for law enforcement, homeless shelters, and research and training. Indirect costs were estimated for productivity loss from unemployment, reduced work productivity among the employed, premature mortality (ie, suicide), and caregiving. The economic burden of schizophrenia was estimated at $155.7 billion ($134.4 billion-$174.3 billion based on sensitivity analyses) for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia. The largest components were excess costs associated with unemployment (38%), productivity loss due to caregiving (34%), and direct health care costs (24%). Schizophrenia is associated with a significant economic burden where, in addition to direct health care costs, indirect and non-health care costs are strong contributors, suggesting that therapies should aim at improving not only symptom control but also cognition and functional performance, which are associated with substantial non-health care and indirect costs.
Author	Wu, Eric Ramanakumar, Agnihotram V Guerin, Annie DeLucia, Michael Legacy, Susan N Cloutier, Martin Kamat, Siddhesh A Aigbogun, Myrlene Sanon Francois, Clement Nitulescu, Roy Duffy, Ruth Henderson, Crystal
Author_xml	– sequence: 1 givenname: Martin surname: Cloutier fullname: Cloutier, Martin organization: Analysis Group, Montreal, Quebec, Canada – sequence: 2 givenname: Myrlene Sanon surname: Aigbogun fullname: Aigbogun, Myrlene Sanon email: myrlene.sanon@otsuka-us.com organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 3 givenname: Annie surname: Guerin fullname: Guerin, Annie organization: Analysis Group, Montreal, Quebec, Canada – sequence: 4 givenname: Roy surname: Nitulescu fullname: Nitulescu, Roy organization: Analysis Group, Montreal, Quebec, Canada – sequence: 5 givenname: Agnihotram V surname: Ramanakumar fullname: Ramanakumar, Agnihotram V organization: Analysis Group, Montreal, Quebec, Canada – sequence: 6 givenname: Siddhesh A surname: Kamat fullname: Kamat, Siddhesh A organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 7 givenname: Michael surname: DeLucia fullname: DeLucia, Michael organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 8 givenname: Ruth surname: Duffy fullname: Duffy, Ruth organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 9 givenname: Susan N surname: Legacy fullname: Legacy, Susan N organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 10 givenname: Crystal surname: Henderson fullname: Henderson, Crystal organization: Otsuka America Pharmaceutical, Princeton, New Jersey, USA – sequence: 11 givenname: Clement surname: Francois fullname: Francois, Clement organization: Lundbeck LLC, Deerfield, Illinois, USA – sequence: 12 givenname: Eric surname: Wu fullname: Wu, Eric organization: Analysis Group, Boston, Massachusetts, USA
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PublicationTitle	The journal of clinical psychiatry
PublicationTitleAlternate	J Clin Psychiatry
PublicationYear	2016
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Snippet	The objective of this study was to estimate the US societal economic burden of schizophrenia and update the 2002 reported costs of $62.7 billion given the...
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SubjectTerms	Adult Aged Aged, 80 and over Chronic Disease Cohort Studies Cost of Illness Cross-Sectional Studies Disease Management Female Health Care Costs Health Expenditures - statistics & numerical data Humans Male Middle Aged Retrospective Studies Schizophrenia - economics Schizophrenia - epidemiology
Title	The Economic Burden of Schizophrenia in the United States in 2013
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