OBJECTIVES: The objectives of this study are to estimate the prevalence of schizophrenia in Switzerland and to assess its burden on patients, caregivers and society as a whole. METHODS: A hospital registry was combined with a physician survey and health insurance claims data to capture all patients living in the northern part of the canton of Zurich. Total costs included direct medical and non-medical costs and lost production. All costs were calculated for the year 2012 from a societal perspective using a prevalence-based bottom-up approach. Intangible costs were expressed as quality adjusted life years (QALY) lost and were calculated from Swiss life tables, standardized mortality ratios and utility weights from the literature. Uncertainty and its sources were addressed in univariate and probabilistic sensitivity analysis. RESULTS: The point prevalence of schizophrenia in 2012 was estimated at 0.39% of the Swiss population. The average annual costs of schizophrenia amounted to EUR 39,408 per patient and consisted of direct medical costs of EUR 9,507 (24%), the costs of care by relatives and in residential homes of EUR 4,793 (12%) and lost production of EUR 25,108 (64%). Inpatient hospital care accounted for EUR 6,242 per year or 66% of direct medical costs. The estimated reduction in life expectancy of 10.46 years and the utility decrement of 22.05 percentage points lead to intangible costs of 19.02 QALY per incident chronic case. CONCLUSIONS: The results of this study show the high burden of schizophrenia on patients, caregivers and society as a whole. The high costs of inpatient hospital care demonstrate the benefits of an effective prevention of relapse associated with hospitalization. Programs for the reintegration of schizophrenic patients into the labor market have a high potential to reduce the costs of schizophrenia considering the high burden of lost production and the early onset of the disease.