Key Takeaways
Extended Takeaways
- Indirect costs dominated the 2019 burden at $251.9 billion, or 73.4% of the total, indicating that schizophrenia’s economic impact extends far beyond medical spending and should be considered in care planning and policy discussions.
- Caregiving alone was estimated at $112.3 billion ($28,761 per person with schizophrenia) and accounted for 32.7% of the total economic burden, underscoring how strongly patient functioning and treatment resistance can affect family and caregiver burden.
- Among direct medical categories, inpatient care was the largest component at $30.2 billion, exceeding pharmacy costs of $12.1 billion and outpatient costs of $12.9 billion, which suggests that preventing hospitalization may offer greater economic impact than focusing on medication costs alone.
- Mean excess health care costs differed by payer, with the highest excess among commercially insured patients at $19,293 versus $15,347 for Medicaid-insured patients and $11,963 for Medicare-insured patients; payer mix may therefore influence how health systems estimate local schizophrenia-related costs.
- Direct non–health care costs reached $35.0 billion, including $26.1 billion in law enforcement costs and $6.5 billion related to SSI and SSDI, highlighting the need for psychiatrists to recognize schizophrenia as a multisector burden that affects criminal justice and disability systems as well as health care.
- The sensitivity analysis still found a very large burden using a lower prevalence of 0.72%, with total excess costs of $215.1 billion, which suggests the overall conclusion is robust even when prevalence assumptions are more conservative.
