The economic burden of schizophrenia in Germany:a population-based retrospective cohort study using genetic matching

OBJECTIVE: Prior studies to determine the economic consequences of schizophrenia have largely been undertaken in clinical settings with a small number of cases and have been unable to analyze effects across different age cohorts. The aim of this study is to investigate the burden of schizophrenia in Germany.

METHODS: Costs, service utilization, and premature mortality attributable to schizophrenia were estimated for the year 2008 using a retrospective matched cohort design. Therefore, 26,977 control subjects as well as 9411 individuals with a confirmed diagnosis of schizophrenia were drawn from a sickness fund claims database. To reduce conditional bias, the non-parametric genetic matching method was employed.

RESULTS: The final study population comprised 8224 matched pairs. The annual cost attributable to schizophrenia was €11,304 per patient from the payers' perspective and €20,609 from the societal perspective with substantial variations among age groups: direct medical expenses were highest among patients aged>65 years, whereas younger individuals (<25 years) incurred the greatest non-medical costs. The annual burden of schizophrenia from the perspective of German society ranges between €9.63 billion and €13.52 billion.

CONCLUSION: There are considerable differences in the distribution of costs and service utilization for schizophrenia. Because schizophrenia is characterized by an early age of onset and a long duration, research efforts should be targeted at particular populations to obtain the most beneficial outcomes, both clinically and economically.