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The Societal Cost of Schizophrenia: An Updated Systematic Review of Cost-of-Illness Studies

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Abstract

Background

Schizophrenia imposes a substantial economic burden on society. This updated systematic review aims to collate the latest societal cost of schizophrenia across countries by reviewing recent cost-of-illness (COI) studies.

Methods

An electronic search was conducted across several databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Health Management Information Consortium, and System for Information on Grey Literature) to identify COI studies published from 2016 to 2022. Two independent reviewers selected studies for inclusion. The cost components and estimates reported by included studies were descriptively summarised. All costs were converted to US dollars (2022 values). Study quality was assessed using a checklist adapted from Larg & Moss.

Results

Twenty-four studies were included (5 from the update review and 19 from the original review), of which only two were conducted for low- and middle-income countries (LMICs). Widespread methodological heterogeneity among included studies was observed. The annual societal cost per person varied from US$819 in Nigeria to US$94,587 in Norway. Productivity losses accounted for 32–83% of the overall societal cost, whilst direct healthcare cost made up 11–87%. The reporting quality of included studies varied.

Conclusion

This review highlights the substantial economic burden of schizophrenia and a lack of COI studies for LMICs. Recommendations on future research, and good practices on improving the methodological and reporting quality of COI research for schizophrenia are provided.

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Authors and Affiliations

  1. King’s Health Economics (KHE), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, The David Goldberg Centre, Box 024, London, SE5 8AF, UK

    Claire Lin, Xiaoyu Zhang & Huajie Jin

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  1. Claire Lin
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Corresponding author

Correspondence to Huajie Jin.

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Author contributions

HJ conceived the idea of this review. CL and XZ performed the first round (title and abstract) screening and second round (full-text) sifting, data extraction and quality assessment. HJ advised on the overall plan and implementation of the systematic review. CL and HJ wrote the first draft of the paper, which was subsequently edited by all authors who have approved the final version. CL will serve as a guarantor for the overall content of the manuscript.

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Data availability statement

All data generated or analysed during this study are included in this published article.

Funding

No funding was received for the preparation of this study.

Conflict of interest

CL, XZ and HJ declare no conflicts of interest.

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Lin, C., Zhang, X. & Jin, H. The Societal Cost of Schizophrenia: An Updated Systematic Review of Cost-of-Illness Studies. PharmacoEconomics 41, 139–153 (2023). https://doi.org/10.1007/s40273-022-01217-8

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