Direct Costs of Schizophrenia and Related Disorders in Italian Community Mental Health Services: A Multicenter, Prospective 1-Year Followup Study

Abstract

The behavior that accompanies schizophrenia and related disorders interferes with professional and social activities. As a result, schizophrenia is one of the most costly psychiatric illnesses. Direct medical costs associated with schizophrenia were estimated from the Italian National Health Service perspective. This was a multicenter observational 1-year study conducted in 14 Italian community mental health centers (CMHCs). Eligible patients were those with a diagnosis of schizophrenia or schizoaffective or schizophreniform disorder who had been followed by the CMHCs for at least 2 years at study entry. Exactly 643 patients were enrolled in the study. The mean direct cost per year was 6,964 (27,025 for schizophrenia and 6,587 for patients with related psychotic disorders) (1998 exchange rate U.S.$1 = 1.121). The present study provides further estimates of the cost of schizophrenia treatment in Italian mental health services and highlights the variability in the single cost components across clinically defined subgroups of patients.

The costs of schizophrenia in Spain

“…This has been noted in the international literature [14] and contrasts with the outcomes of studies in which patients and relatives were interviewed. For example, both a Spanish [30] and an Italian study [17] have estimated that three out of four patients with schizophrenia are excluded from the job market (jobless, on sick leave or on early retirement). The use of surveys with samples that are representative of the population with mental illness and the comparison of their income and employment rates adjusted for age and gender to the working population provide information that more closely reflects the reality of lost productivity due to morbidity than the official registers.…”

Economic Burden of Schizophrenia in Italy: A Probabilistic Cost of Illness Analysis

“…8 This percentage was multiplied by the average of the disability compensations paid by the National Social Security Institute in Italy. 36 More specifically, only the disability pensions-and not the attendance allowance or incapacity pensions paid by the State or other forms of financial support-were included.…”

“…1 In fact, it is estimated that the unemployment rate of patients with schizophrenia is more than double than that of the general population, 8 9 and 51% of them receive a disability pension in Italy. 8 As a consequence, indirect costs are a key aspect to estimate the overall impact of schizophrenia due to the precocity and chronic course of the illness, arising in most cases during adolescence. 10 Furthermore, it is fundamental to efficiently allocate the economic resources in the therapeutic area.…”

The personal, societal, and economic burden of schizophrenia in the People's Republic of China: implications for antipsychotic therapy

“…Globally, the use of inpatient facilities is a significant component of the cost of treating schizophrenia 55,59. In a review of cost-of-illness studies for schizophrenia, Knapp et al49 found that hospitalization accounted for between 16.5% and 94% of costs, depending on the country and study methods, with two-thirds of the studies finding that hospitalization accounted for more than 50% of total direct health care costs.…”

“…Medications also account for a significant, but substantially lower, proportion (2.0%–13.0% in Western countries) of direct health care costs compared with inpatient and outpatient services 49,59. One study in Zhejiang province reported that the overall cost of hospitalization was ¥10,765 for schizophrenia, with ¥834 for psychiatric medications and ¥719 for nonpsychiatric medication 29.…”