title: The Economic Burden of Schizophrenia in the United States in 2013.
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.
authors.affiliation: Analysis Group, Montreal, Quebec, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Cloutier
authors.affiliation: Otsuka America Pharmaceutical, 508 Carnegie Center, Princeton, NJ 08540. myrlene.sanon@otsuka-us.com.|Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Myrlene Sanon
authors.initials: MS
authors.lastname: Aigbogun
authors.affiliation: Analysis Group, Montreal, Quebec, Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Guerin
authors.affiliation: Analysis Group, Montreal, Quebec, Canada.
authors.forename: Roy
authors.initials: R
authors.lastname: Nitulescu
authors.affiliation: Analysis Group, Montreal, Quebec, Canada.
authors.forename: Agnihotram V
authors.initials: AV
authors.lastname: Ramanakumar
authors.affiliation: Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Siddhesh A
authors.initials: SA
authors.lastname: Kamat
authors.affiliation: Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: DeLucia
authors.affiliation: Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Duffy
authors.affiliation: Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Susan N
authors.initials: SN
authors.lastname: Legacy
authors.affiliation: Otsuka America Pharmaceutical, Princeton, New Jersey, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Henderson
authors.affiliation: Lundbeck LLC, Deerfield, Illinois, USA.
authors.forename: Clement
authors.initials: C
authors.lastname: Francois
authors.affiliation: Analysis Group, Boston, Massachusetts, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000191:economics* / Q000453:epidemiology