Cost of schizophrenia to UK society - An incidence-based cost-of-illness model for the first 5 years following diagnosis

Objective: This study estimated the cost to UK society of an annual cohort of newly diagnosed patients with schizophrenia over the first 5 years follo wing diagnosis, using an incidence-based cost-of-illness framework. Design and setting: A discrete event model of the course of schizophrenia w as constructed, based on a literature review and interviews among a panel o f healthcare professionals (n = 7). Seven discrete disease states were defi ned within the model. Patients' movements between these disease states enab led 10 disease courses to be identified. In each disease state, the model e stimated resource use and corresponding costs borne by the National Health Service (NHS), Local Authorities, the Home Office and society as a result o f lost productivity. Patients and participants: The model simulated patients? movements between disease states over the first 5 years following diagnosis. Since there are 7500 new cases of schizophrenia per year in the UK, the model was run for 7 500 patient simulations. Main outcome measures and results: The total discounted cost to society att ributable to an annual cohort of newly-diagnosed patients with schizophreni a over the first 5 pears following diagnosis was estimated at pound 862 mil lion (range: pound 788 million to pound 926 million in sensitivity analysis ). The discounted mean 5-year cost was estimated to be approximately pound 115 000 (range: pound 105 000 to pound 124 000) per patient or approximatel y pound 23 000 (range: pound 21 000 to pound 25 000) per patient per year. The NHS accounted for 38% of the total cost, Local Authorities for 12% and the Home Office for 1%. Indirect costs due to lost productivity accounted f or 49%. Of the NHS costs, hospital admissions accounted for 69% and hospita l visits (outpatient, day ward and day centre attendances) for a further 26 %. Drugs (antipsychotics and adjunctive medications) accounted for 2%. Conclusions: NHS expenditure and lost productivity costs predominated, irre spective of disease course. This indicates that treatments that reduce hosp italisation and potentially enable patients to return to active employment could significantly reduce the societal burden of schizophrenia.