EPIDEMIOLOGY AND TREATMENT PATHWAYS OF SCHIZOPHRENIA IN ENGLAND
Author(s)
Ravinder Claire, PhD1, Miriam King, BA2, Christopher F. Brewer, MBioch MBBS MRCS MFPM2, Sophia Ho, MPharm2, Reya Sharma, MSc2.
1Senior Manager, Bristol Myers Squibb, Uxbridge, United Kingdom, 2Bristol Myers Squibb, Uxbridge, United Kingdom.
1Senior Manager, Bristol Myers Squibb, Uxbridge, United Kingdom, 2Bristol Myers Squibb, Uxbridge, United Kingdom.
OBJECTIVES: To estimate the prevalence and incidence of schizophrenia in England and characterise treatment pathways and lines of therapy using real-world data.
METHODS: This retrospective observational study used routinely collected electronic health records from CPRD Aurum, linked to Hospital Episode Statistics and deprivation data. Adults (≥18 years) with a recorded diagnosis of schizophrenia between January 2010 and October 2025 were included. Annual prevalence and incidence rates were estimated using repeated cross-sectional analyses. Incident cases were defined by the first recorded diagnosis with ≥12 months prior registration. Treatment pathways were constructed by identifying sequential lines of antipsychotic therapy among incident patients.
RESULTS: A total of 118,595 patients with schizophrenia were identified, with 59,548 meeting eligibility criteria for analyses requiring ≥12 months prior registration. The cohort had a median age at diagnosis of 48 years, and 59% were male. In 2024, the recorded prevalence was approximately 0.36%, with relatively stable trends over time. Incidence declined from approximately 19 per 100,000 person-years in 2010 to approximately 15 per 100,000 person-years in 2024; however, rates remained higher in younger adults, with 22 per 100,000 in those aged 18-24 and 23 per 100,000 in those aged 25-34 in 2024. Among incident patients initiating antipsychotic treatment (69%), treatment pathways demonstrated substantial switching. Approximately 44% of patients progressed to a second line of therapy, and 36% of those receiving a second line progressed to a third line. Second-generation antipsychotics dominated first-line treatment (~82%), with olanzapine (27%), aripiprazole (17.8%), risperidone (16.3%), and quetiapine (13.2%) being the most prescribed agents.
CONCLUSIONS: Schizophrenia in England is characterised by stable prevalence, a decline in overall incidence over time, with persistently higher incidence in younger adults. Treatment pathways show frequent switching and progression to later lines. These findings highlight ongoing unmet need, particularly in achieving sustained disease control early in the disease course.
METHODS: This retrospective observational study used routinely collected electronic health records from CPRD Aurum, linked to Hospital Episode Statistics and deprivation data. Adults (≥18 years) with a recorded diagnosis of schizophrenia between January 2010 and October 2025 were included. Annual prevalence and incidence rates were estimated using repeated cross-sectional analyses. Incident cases were defined by the first recorded diagnosis with ≥12 months prior registration. Treatment pathways were constructed by identifying sequential lines of antipsychotic therapy among incident patients.
RESULTS: A total of 118,595 patients with schizophrenia were identified, with 59,548 meeting eligibility criteria for analyses requiring ≥12 months prior registration. The cohort had a median age at diagnosis of 48 years, and 59% were male. In 2024, the recorded prevalence was approximately 0.36%, with relatively stable trends over time. Incidence declined from approximately 19 per 100,000 person-years in 2010 to approximately 15 per 100,000 person-years in 2024; however, rates remained higher in younger adults, with 22 per 100,000 in those aged 18-24 and 23 per 100,000 in those aged 25-34 in 2024. Among incident patients initiating antipsychotic treatment (69%), treatment pathways demonstrated substantial switching. Approximately 44% of patients progressed to a second line of therapy, and 36% of those receiving a second line progressed to a third line. Second-generation antipsychotics dominated first-line treatment (~82%), with olanzapine (27%), aripiprazole (17.8%), risperidone (16.3%), and quetiapine (13.2%) being the most prescribed agents.
CONCLUSIONS: Schizophrenia in England is characterised by stable prevalence, a decline in overall incidence over time, with persistently higher incidence in younger adults. Treatment pathways show frequent switching and progression to later lines. These findings highlight ongoing unmet need, particularly in achieving sustained disease control early in the disease course.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH230
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Mental Health (including addiction), Neurological Disorders