Objective: Schizophrenia is associated with increased morbidity and mortality compared to the general population, largely resulting from increased incidence of cardiovascular disease and diabetes. Some atypical antipsychotics are associated with adverse metabolic symptoms, such as weight gain, dyslipidaemia and glucose dysregulation, which may further increase the risk of coronary heart disease (CHD) and diabetes. This study aimed to assess the impact of these symptoms on cost of treating patients' physical health. Methods: Data from the Schizophrenia Trial for Aripiprazole (STAR) study showed that metabolic side effects of aripiprazole treatment are less than those experienced by patients receiving standard-of-care (SOC) treatment (physicians' selection of olanzapine/quetiapine/risperidone). In a post-hoc analysis, projected risks for diabetes/coronary heart disease (CHD) were calculated using the Stern and Framingham models. These risks were used to estimate the difference in direct and indirect cost consequences of diabetes and CHD in schizophrenia patients treated with aripiprazole or SOC over a 10-year period, assuming risk of diabetes onset/CHD events remained linear. Diabetes costs were estimated from UKPDS and UK T2ARDIS studies, respectively, and CHD costs were estimated using prevalence data from the Health Survey of England and published literature. All costs were inflated to 2007 costs using the UK government's Pay and Prices Index inflation rates. Results: The number of avoided diabetes cases (23.4 cases/1000 treated patients) in patients treated with aripiprazole compared with SOC was associated with estimated total (direct and indirect) cost savings of £37,261,293 over ten years for the UK population. Similarly, the number of avoided CHD events (3.9 events/1000 treated patients) was associated with estimated total cost savings of £7,506,770 over ten years. Conclusion: Compared with SOC, the favourable metabolic profile of aripiprazole treatment may provide reductions in health and economic burden to schizophrenia patients and psychiatric health care services in the UK.