Economic Burden of Schizophrenia in the US Exceeded $155 Billion in 2013, New Study Finds
May 16, 2016
A research team including Analysis Group Managing Principal Eric Wu, and Vice Presidents Annie Guérin and Martin Cloutier, has completed a follow-up study to their landmark 2002 work analyzing the economic cost of schizophrenia in the US. “The Economic Burden of Schizophrenia in the United States in 2013,” forthcoming in the Journal of Clinical Psychiatry, is an important update to the existing literature on the economic burden of schizophrenia, supporting previous findings that schizophrenia is associated with substantial costs.
Using a methodology that was similar to the original study, the authors estimated the economic burden of schizophrenia in the US at $155.7 billion in 2013 where the largest components were costs related to unemployment (38%), caregiver-related productivity loss (34%), and direct healthcare costs (24%).
Several factors may have contributed to explain this increase versus the burden estimate of 2002 (62.7 billion). First, the prevalence of schizophrenia being better documented than a decade ago, the new study based their estimates on a prevalence estimate of 1.1% (versus 0.5% in the original study). In addition, several structural changes over the past decade also likely impacted the economic burden of schizophrenia as well as the repartition of the costs across components. Important changes include coverage changes in Medicare programs, new legislations on healthcare coverage (e.g., Patient Protection and Affordable Care Act, 2010) and coverage quality (e.g., Mental Health Parity and Addiction Equity Act, 2008), changes in pharmacologic therapy (i.e., introduction of new drugs and availability of some generic atypical antipsychotics), and a continuing trend of de-institutionalization. Indeed, the 2013 study found substantially greater caregiving costs to family members, perhaps driven by continuing de-institutionalization of patients as part of the “reintegration” focus of the Americans with Disabilities Act. “A push for increased family intervention for schizophrenia patients can be beneficial and is recommended by many international clinical guidelines,” according to the authors, “but this intervention comes at a high economic price to caregivers.”
This study found that direct non-healthcare costs of law enforcement and incarceration are significant contributors, and that indirect costs of unemployment and caregiving contribute even more to the societal costs of schizophrenia than direct healthcare costs. Authors observed that while “healthcare spending for schizophrenia appears to continue to have a large focus on crisis-oriented direct costs typically seen in inpatient and emergency care, results from this study suggest that effective treatments and interventions to increase the stability and functional performance of schizophrenia patients should also be targeted to better address non-healthcare and indirect costs.”