Commonly, research to assess the value of medication therapy in schizophrenia includes the assumption that the most effective antipsychotic agent will invariably lead to a reduction in medical services, thereby reducing total direct costs within a system of care. OBJECTIVES: In this methods paper, we argue that quantifying decreases in certain medical costs (i.e., acute care) associated with medication treatment can be key in decisions to purchase, prescribe, or reimburse. We also propose that pharmacoeconomic researchers consider the complexities of interpreting outpatient service use for those with schizophrenia. METHODS: We discuss the notion that increased use of certain services may indicate that individuals are responding to medication, are engaged in their treatment plans, and are tending to previously-neglected routine health care needs. Additionally, we provide evidence that short-term increases in outpatient service use may be highly consistent with published standards for comprehensive maintenance treatment of schizophrenia. RESULTS: We present data illustrating the importance of disaggregating service types when attempting to understand the relationship between treatment response and costs. Analyses should also include both a short-term and a longer-term perspective, to determine the extent to which an initial "investment" in medication and perhaps other (outpatient) treatment is likely to "pay off" through reductions in subsequent ER and hospitalization costs, and in individuals more able to lead productive and enjoyable lives. CONCLUSIONS: Research and policy focused solely on decreases in total costs (i.e., fewer services received) can underestimate the complexity of both treatment and outcomes for those with schizophrenia.