Burden of schizophrenia in recently diagnosed patients: healthcare utilisation and cost perspective

Abstract

Background:

Inpatient care to manage relapse of patients with schizophrenia contributes greatly to the overall financial burden of treatment. The present study explores to what extent this is influenced by duration of illness.

Methods:

Medical and pharmaceutical claims data for patients diagnosed with schizophrenia (ICD-9 295.xx) were obtained from the PharMetrics Integrated Database, a large, regionally representative US insurance claims database, for the period 1998–2007. Recently diagnosed (n = 970) and chronic patients (n = 2996) were distinguished based on ICD-9 295.xx classification, age and claims history relative to the first year (recently diagnosed) and the third year onwards (chronic) after the first index schizophrenia event.

Results:

The medical resource use and costs during the year following the index schizophrenia event differed significantly between cohorts. A higher proportion of recently diagnosed patients were hospitalised compared with chronic patients (22.3% vs 12.4%; p < 0.0001), spending a greater mean number of days in hospital (5.1 days vs 3.0 days; p = 0.0065) as well as making more frequent use of emergency room (ER) resources during this time. The mean annual healthcare costs of recently diagnosed patients were also greater ($20,654 vs $15,489; p < 0.0001) with inpatient costs making up a higher proportion of total costs (62.9%) compared with chronic patients (38.5%).

Conclusions:

There is a considerably higher overall economic burden in the year following their first schizophrenia event in the treatment of recently diagnosed schizophrenia patients compared with chronic patients. Since hospitalisations and ER visits are the most significant components contributing to this finding, efforts that focus on measures to reduce the risk of relapse, particularly amongst recently diagnosed patients, such as improved adherence programs, may lead to better clinical and economic outcomes in the management of schizophrenia.

Limitations:

Only commercially insured patients and direct medical costs were included, therefore, results may underestimate the economic burden of schizophrenia.

Key words:

• Burden of illness
• Costs
• Early illness
• Hospitalisation
• Relapse
• Schizophrenia

Transparency

Declaration of funding

This research was supported by Johnson & Johnson Pharmaceutical Services, LLC.

Declaration of financial/other support

D.N., K.S.A., J.D. and J.S. have disclosed that they are employees of, and own stock in, Johnson & Johnson.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgements

The authors thank Iain McDonald of ScopeMedical Ltd for providing medical writing assistance in the preparation of this manuscript, funded by Johnson & Johnson. No other non-author assistance was used in the preparation of this manuscript.

The authors were responsible for the methodological decisions, analysis and interpretation of results.