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The Cost of Relapse in Schizophrenia

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Abstract

Introduction

Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia.

Objectives

We aimed to undertake a comprehensive search of the available literature on the cost of relapse.

Methods

We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars.

Results

We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033–$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12–15 months. European studies report excess costs of $8665–$18,676 (2015 PPP$) over periods of 6–12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions.

Conclusions

Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

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Acknowledgements

This study was funded by Janssen-Cilag Ltd. It was not part of a specific programme. Representatives from Janssen have commented on a draft but the authors retained sole control over the design, implementation and reporting of the results.

PM was responsible for the conception of the project and editing of the manuscript. MP undertook the literature searching, extraction of data, regression analysis and drafting of the manuscript .

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  1. King’s Health Economics, PO24 David Goldberg Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF, UK

    Mark Pennington & Paul McCrone

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Pennington, M., McCrone, P. The Cost of Relapse in Schizophrenia. PharmacoEconomics 35, 921–936 (2017). https://doi.org/10.1007/s40273-017-0515-3

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