Economic impact of schizophrenia on health systems [Pitch presentation]

Background Schizophrenia represents an important public health issue. An assessment of its costs would be useful to provide recommendations for policy and decision-making strategies. The aims of our study were to carry out a systematic review to assess the economic burden of schizophrenia in terms of direct and indirect costs and to perform a quality appraisal of the analysed studies. Methods A literature search was carried out on PubMed, Scopus and Cochrane Library to retrieve cost-of-illness (COI) analyses focused on schizophrenia and published up to December 2015. COI analyses that considered direct and indirect costs were included. Each included manuscript was independently appraised by three researchers on the basis of the British Medical Journal Drummond’s checklist. Results 2724 articles were initially retrieved, and 84 were included in the current review. The included studies showed a medium– high-quality level. The available studies seemed to be heterogeneous both in terms of methodology and results reporting. Extrapyramidal symptoms in patients with schizophrenia seemed to be associated with increased healthcare resource utilization and higher medical costs. Indirect costs were evaluated in 32 studies from a societal perspective and, in almost all these studies, their estimation exceed those provided for direct costs. High social costs of schizophrenia were also described for caregivers of schizophrenia patients. Conclusions The review confirmed that schizophrenia absorbs a huge amount of health-care resources. Further research is therefore needed to better understand the economic impact and to identify and promote public health strategies to tackle obesity