OBJECTIVES: The primary objective of this umbrella review was to evaluate the direct and indirect economic burden of schizophrenia on society. Additionally, the study aimed to categorize and quantify the various types of costs associated with managing and treating schizophrenia. Here we present direct and indirect costs from the umbrella review, expressed in monetary terms.

METHODS: An umbrella review was conducted, incorporating systematic literature reviews and meta-analyses. Data sources included PubMed, EMBASE, APA PsycInfo, and the Cochrane Database of Systematic Reviews. Quality assessment of the reviews was performed using the AMSTAR II checklist. The data collection focused on extracting all primary data presented in the included reviews. For comparability, all costs were adjusted for inflation and converted to United States dollars.

RESULTS: The initial search yielded 2,155 studies for screening. After removing duplicates, 1,007 abstracts were screened. Full-text eligibility was assessed for 180 studies, of which 32 reviews were included in the data extraction. The findings revealed that the indirect costs of schizophrenia, such as lost productivity and caregiver expenses, were higher (median cost across all included primary studies: 19,244 USD per patient per year (PPPY) at 2010 prices) than the direct costs (12,018 USD PPPY), which include medical treatments and hospitalizations. Drug costs (median 2,266 USD PPPY), inpatient costs (median 2,177 USD PPPY) and outpatient costs (median 1,802 USD PPPY) showed similar trends across the included countries. The highest levels of total cost were found in studies from the United Kingdom (99,098 USD PPPY) and the United States (67,127 USD PPPY).

CONCLUSIONS: This study underscores the significant economic burden posed by schizophrenia, highlighting the predominance of indirect costs over direct costs. The cost analysis also revealed substantial variations across different countries, with the United Kingdom facing the highest expenses.