OBJECTIVES: There is a significant amount of disability among people living with schizophrenia, especially those with cognitive deficits since these symptoms are often overlooked, and are not generally responsive to therapies. A targeted literature review was performed in order to identify the current economic burden of cognitive impairment associated with schizophrenia (CIAS) and identify potential evidence gaps.

METHODS: Literature published between January 2007 and September 2017 was identified by searching MEDLINE, Embase, EconLit (Ovid SP®), and NHS Economic Evaluations Database. Supplemental searches for relevant conference proceedings from 2015-2016 was also performed.

RESULTS: A total of 5,509 records were screened for inclusion resulting in 23 relevant primary full text articles (n=27 total; n=4 secondary articles) identified for inclusion among which three primary publications (n=5 total; n=2 secondary) reporting the economic burden of CIAS patients specifically. There was a high observed rate of resource use among a CIAS patient population with a crude hospitalization rate of 6.24 per patient per year and an average length of hospital stay of 21.12 days for specialist care. Direct healthcare costs ranged from £8,271 to £13,426 in the UK and $10,665-$56,394 among older cognitively impaired individuals in the US. Only one study reported indirect costs with an average social security cost of £2,243.43 and an average of 40 days missed from work.

CONCLUSIONS: This review uncovered a paucity of data relating to the economic burden incurred by patients with CIAS that could be attributed to cognitive impairment exclusive of other direct or indirect costs associated with schizophrenia. This review found that there are high costs and resource use associated with schizophrenia patients in general; however, there is no current evidence estimating the proportion of patients with schizophrenia that have cognitive impairment and how these symptoms effect the costs for treating schizophrenia overall.