OBJECTIVES: Schizophrenia is associated with considerable disability and a high healthcare burden. This study evaluated marginal healthcare expenditure among schizophrenia patients in the US using the Medical Expenditure Panel Survey (MEPS).

METHODS: A cross-sectional study was conducted using the 2012-2019 MEPS, a nationally representative survey of noninstitutionalized individuals in the US. The study sample included (≥ 18 years), with (using ICD-9-CM codes: 295.xx and 298.xx, and ICD-10-CM code: F20.xx). The annual health expenditures involving various healthcare components were compared for patients with and without schizophrenia. Generalized Linear Model (GLM) with gamma distribution, log link, and Inverse Probability of Treatment Weighting (IPTW) was employed to compare the annual healthcare expenditures among the study groups.

RESULTS: The study identified 463 patients, representing 0.47 million schizophrenia patients in the US with an overall prevalence of 1.82%. Most of these patients were 18-34 years old (31.62%), male (59%), non-Hispanic whites (66%), never married (50%), non-smokers (58%), and belonged to the low-income category (67%). The mean Charlson Comorbidity Index (CCI) score was 0.79 (SE=0.07). The total annualized expenditure among the schizophrenia cohort was estimated to be $9.23 billion. The adjusted annual mean total costs among patients with schizophrenia ($19,539 [SE=$1,592]) were significantly higher than those without schizophrenia ($9,925 [SE=$ 179]) with incidence rate ratio (IRR) of 1.97 (95% CI:(1.68,2.31); p-value < 0.001). Prescribed medicines were the largest drivers of the total annual expenditures among patients with schizophrenia (Mean: $6,580 [SE=$551]) compared to non- schizophrenia patients (Mean: $2,816 [SE=$76]).

CONCLUSIONS: This study highlighted a considerable economic burden among patients with schizophrenia, especially prescription costs. Given the high prescription burden, future therapeutic approaches are needed to address the economic burden of schizophrenia.