Unveiling the actual cost of Schizophrenia: An Activity-Based Costing (ABC) approach

Background: Despite its relatively low lifetime prevalence, the health, social, and economic burden of Schizophrenia is very significant. In the last 10 years, several studies have analysed the economic burden of Schizophrenia, even if there is a lack of research that has considered the actual cost for the community as the result of each event in the patient's history.

Objective: The present study aims to cover this gap by proposing a novel model to evaluate better the cost of Schizophrenia with real data from medical records.

Methods: We applied (i) a 'real life' analysis of medical database to capture each event of the clinical history and healthcare that could have an economic impact; and (ii) a novel Activity-Based Costing model to quantify the overall annual economic burden of a patient with Schizophrenia treated by public mental health services. We carried out the study with 523 patients with a diagnosis of Schizophrenia in the Department of Mental Health of Bari, in the South of Italy.

Results: Our results reveal an overall cost of €41.290 per patient with Schizophrenia per year. Almost half of the cost is due to rehabilitation. The second most important factor is instead related to disability and loss of productivity.

Conclusions: We believe that the present approach represents the most effective method to properly estimate actual costs when real-life data are available compared with other studies mainly based on prevalence-based approaches.