title: The economic burden of schizophrenia in the United States in 2002.
abstract: OBJECTIVE
  This study quantifies excess annual costs associated with schizophrenia patients in the United States in 2002 from a societal perspective.
  
  
  METHODS
  Annual direct medical costs associated with schizophrenia were estimated separately for privately (N = 1090) and publicly (Medicaid; N = 14,074) insured patients based on administrative claims data, including a large private claims database and the California Medicaid program (MediCal) database, and compared separately to demographically/geographically matched control samples (1 case:3 controls). Medicare costs of patients over age 65 years were imputed using the Medicare/MediCal dual-eligible patients (N = 1491) and published statistics. Excess annual direct non-health care costs were estimated for law enforcement, homeless shelters, and research/training related to schizophrenia. Excess annual indirect costs were estimated for 4 components of productivity loss: unemployment, reduced workplace productivity, premature mortality from suicide, and family caregiving using a human capital approach based on market wages. All costs were adjusted to 2002 dollars using the Medical Care Consumer Price Index and were based on the reported prevalence in the National Comorbidity Survey Replication.
  
  
  RESULTS
  The overall U.S. 2002 cost of schizophrenia was estimated to be $62.7 billion, with $22.7 billion excess direct health care cost ($7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatient, $8.0 billion long-term care). The total direct non-health care excess costs, including living cost offsets, were estimated to be $7.6 billion. The total indirect excess costs were estimated to be $32.4 billion.
  
  
  CONCLUSIONS
  Schizophrenia is a debilitating illness resulting in significant costs. The indirect excess cost due to unemployment is the largest component of overall schizophrenia excess annual costs.
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA. ewu@analysisgroup.com
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Lizheng
authors.initials: L
authors.lastname: Shi
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ball
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Matthew
authors.initials: M
authors.lastname: Moulis
authors.forename: Jyoti
authors.initials: J
authors.lastname: Aggarwal
mesh_terms: D000041:Absenteeism; D000368:Aged; D002140:California / Q000453:epidemiology; D017281:Cost of Illness; D017049:Employer Health Costs / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D008605:Mental Health Services / Q000191:economics; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012559:Schizophrenia / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology