OBJECTIVES: The study aimed to conduct a systematic review (SR) on the economic burden of schizophrenia and role of LAIs in reducing healthcare resource utilization cost in Asia including China, Japan, Indonesia, Philippines, and Thailand.

METHODS: A systematic literature search was conducted using PubMed and major psychiatric conferences until November 2021 to identify the studies evaluating schizophrenics treated with LAI antipsychotics. The search strategy utilized search terms (alone or in combination) related to LAI antipsychotics, budget impact analysis, cost benefit analysis, schizophrenia, psychiatric disorders etc. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

RESULTS: Out of 1,351 citations identified from PubMed search, and 56 from psychiatric conferences and cross referencing, 25 articles met the inclusion criteria and selected for final analysis. The studies involving cost of schizophrenia show variations in methodology and hence the cost results may vary consequently. In China and Indonesia, reported average annual treatment per patient costs for schizophrenia were $6,853 and $236, while Japan and Thailand estimated annual costs per patient (including direct and indirect costs) were $30,000 and $2,600 respectively. In Philippines, the annual per patient (private) costs were $335-$5,386 for in-patient and $377-$25,681 in out-patient setting. The results were consistent across studies that suggest use of LAIs reduces length of hospital stay, decreases hospitalization rate, and improves drug adherence rate. The economic evaluation of LAI in five included studies indicates that the increasing use of LAI anti-psychotics is a cost-effective treatment option to ease the economic burden of schizophrenia.

CONCLUSIONS: This study highlights potential advantages of LAIs to reduce the economic burden of schizophrenia. Despite the advantages, usage of LAI in clinical settings is limited in Asian countries. Hence, effective resource allocation and utilization is necessary to improve the access of LAIs to reduce the economic burden.