OBJECTIVES : To describe antipsychotics utilization and direct medical costs associated with schizophrenia in Chinese urban employed and resident patients.

METHODS : We used data collected from medical institutions and screened patients who had complete records from Jan 1^st to Dec 31^st in 2017. SAS 9.3 was used to describe drugs utilization and direct medical expense.

RESULTS : A total of 2133 patients with schizophrenia who had a 1-year complete follow-up were included in the study. During the one-year observation period, 960 patients had outpatient visit and 1,182 patients had inpatient visit, 9 of them had both of outpatient and inpatient visit. The inpatients were more likely to be male (OR=4.84, P<0.001) and resident (OR=4.81, P<0.001). The percentage of second-generation antipsychotics prescription was 91.04% in outpatients and 84.33% in inpatients, respectively. The annual total outpatient costs were about $750.35 per patient, of which 72.06% were antipsychotic drug costs. The annual total inpatient costs were about $33,272.28 per patients, of which 9.50% were antipsychotic drugs costs. The average first and second generation antipsychotic drugs costs per patient per prescription for outpatients were $3.29 and $33.19, compared with $0.25 and $3.00 for inpatients, respectively.

CONCLUSIONS : Second-generation antipsychotics were widely used in Chinese urban patients with schizophrenia. The antipsychotics costs were the majority of outpatient costs, but they remained tiny in inpatient costs. The total direct medical costs related to inpatient visit were much higher than outpatient visit. Appropriate usage of antipsychotic drugs and integrated schizophrenia management are necessary to prevent hospitalization rate and may reduce the economic burden of patients with schizophrenia in China.