Presentation (CTI)

OBJECTIVES: Metabolic syndrome (MetS), a cluster of metabolic abnormalities including central adiposity, insulin resistance, hypertension, and atherogenic dyslipidemia, affects about a third of people with schizophrenia. Although MetS-related disorders are known to contribute to increased morbidity and mortality in people with schizophrenia, there is limited evidence quantifying economic burden. This study aimed to assess the impact of one or more MetS-related disorders on medical costs in people with schizophrenia in the United States using claims data.
METHODS: A retrospective cohort study was conducted using the STATinMED Real World Data Insights database covering the period from 2018 to 2024. Adults (≥18 years of age) with schizophrenia were identified and grouped into cohorts with one or more MetS-related disorders (obesity, hyperlipidemia, hypercholesterolemia, diabetes, and/or hypertension) and controls (without these disorders). Propensity score matching was applied to balance baseline characteristics. The primary outcome was all-cause medical costs, during a 12-month follow-up, adjusted for insurance status and inflation.
RESULTS: The study included 71,570 adults and 50,678 controls. After matching, the numbers for MetS-related disorders and the people in each group were: 0, N=40,552; 1, n=15840; 2, n=11,833; 3, n=8119; 4, n=4074; 5, n=686. Total medical costs increased incrementally with the number of MetS-related disorders; those with all 5 MetS-related disorders incurred total medical costs of $34,441 per person per year, over 4 times higher than costs of $8396 for those without MetS-related disorders. Outpatient and inpatient costs were the primary contributors to this increase.
CONCLUSIONS: There is a substantial economic burden associated with MetS-related disorders in people with schizophrenia, primarily driven by outpatient and inpatient care. The findings underscore the importance of managing MetS in this population, which includes early risk assessments, lifestyle modification, and the selection of antipsychotic medications with fewer metabolic adverse effects.