OBJECTIVES: A cost-consequence analysis was performed to assess the economic implications of changes in cardiometabolic parameters after six-week treatment with lurasidone vs. other selected atypical antipsychotics in patients with schizophrenia. METHODS: A model using discrete event simulation was developed to assess the economic impact from a US payer perspective over a two-year timeframe. It uses baseline patient-level profiles from lurasidone trials to simulate changes in cardiometabolic parameters (e.g., LDL, HDL, triglycerides, total cholesterol, fasting glucose (FG), and BMI) associated with each treatment over six-weeks using data from lurasidone clinical trials for lurasidone and olanzapine and from the literature for risperidone, quetiapine IR and XR. Based on the simulations, the model projects the number of cases requiring pharmacological treatment for hyperlipidemia (i.e., LDL≥130 mg/dL), hyperglycemia (i.e., FG 100-126 mg/DL), as well as diabetes and cardiovascular events (CVD) using risk equations from the Framingham Heart Study. Costs (in 2010 values) are accrued according to each patient’s specific experience with treatments and events over the course of the simulation. RESULTS: Per 1,000 treated patients, lurasidone is predicted to result in 47, 14, 16, and 2 fewer incident diabetes; 74, 56, 56, and 49 fewer hyperlipidemia cases; and 191, 82, 82, and 16 fewer hyperglycemia cases than olanzapine, risperidone, quetiapine IR, and quetiapine XR, respectively. CVD events are also fewer with lurasidone, but the differences among treatments are minimal. These clinical benefits would result in net savings of $857, $414, $431, and $147 per patient, respectively, and $5,803, $8,657, $9,753, and $7,647 per patient, respectively, if including the costs of antipsychotic treatment. CONCLUSIONS: Based on the results of these economic analyses, lurasidone represents a potentially cost-saving alternative for the treatment of patients with schizophrenia.