Burden of schizophrenia on selected comorbidity costs

Abstract

Patients suffering from schizophrenia tend to have high rates of medical comorbidities and mortality.This study evaluated the healthcare costs of patients with schizophrenia and specific comorbidities relative to patients without schizophrenia with the same comorbidities, using Medicaid insurance claims databases from five states (from 2001–2010). The most common comorbidities were hypertension (48.8%), substance abuse (39.1%) and diabetes (28.4%). Patients with schizophrenia incurred greater all-cause monthly healthcare costs (cost difference [95% CI]: US$978 [933; 1024]) and comorbidity-related costs (cost difference [95% CI]: US$288 [269; 307]). Schizophrenia was also associated with significantly higher comorbidity-related costs in each comorbidity subgroup (among the three most common comorbidities: 99% higher in hypertension, 293% in substance abuse, and 105% in diabetes). The results suggest that patients with schizophrenia and comorbidities common in patients with schizophrenia had higher all-cause and comorbidity-related healthcare costs compared with patients without schizophrenia with the same comorbidities.

Keywords::

• comorbidities
• costs
• Medicaid
• resource utilization
• schizophrenia

Financial & competing interest disclosure

This research was funded by Janssen Scientific Affairs, LLC, Titusville. M-H Lafeuille, J Dean, MS Duh and P Lefebvre are employees of Analysis Group, Inc., a consulting company that has received research grants from Janssen Scientific Affairs, LLC. J Fastenau and W Olson are employees of Janssen Scientific Affairs, LLC and Johnson & Johnson stockholders. J Panish was an employee of Janssen Scientific Affairs at the time of this analysis and is currently employed by Ethicon, Inc. M Markowitz was an employee of Janssen Scientific Affairs, LLC at the time of this analysis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors wish to thank M Grzywacz and AM Grittner for providing editorial and technical assistance with this manuscript.

Key issues

• Patients suffering from schizophrenia and other mental illnesses tend to have high rates of medical comorbidities and mortality. Some studies have suggested that comorbidities are underdetected in people with mental illness.

• Medical comorbidity can affect the quality of life as well as the delivery of psychiatric and medical services, cause or exacerbate the psychotic illness and contribute to prolonged schizophrenia-related hospitalizations and treatment failure.

• This study used Medicaid insurance claims databases from five states to evaluate healthcare costs of patients with schizophrenia and specific comorbidities relative to patients without schizophrenia with the same comorbidities.

• The most common comorbidities were hypertension (48.8%), substance abuse (39.1%) and diabetes (28.4%).

• Schizophrenia was associated with significantly higher healthcare costs including costs related to hypertension, substance abuse and diabetes that were, respectively, 99, 293 and 105% higher in schizophrenia patients compared with nonschizophrenia patients with the same comorbidities.

• These results suggest that effective treatment of schizophrenia may have cost-savings potential going beyond psychiatric-related costs and encompassing comorbidity-related healthcare costs.

Notes