Francesco Saverio Mennini1,2, Andrea Marcellusi3,4, Simone Gazzillo5, Claudia Nardone5, Paolo Sciattella5, Raffaele Migliorini6, Marco Trabucco Aurilio7, Mario Amore8, Roberto Brugnoli9. 1. Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy. f.mennini@uniroma2.it. 2. Department of Accounting Finance and Informatics, Kingston University, London, UK. f.mennini@uniroma2.it. 3. Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy. andrea.marcellusi@uniroma2.it. 4. Department of Accounting Finance and Informatics, Kingston University, London, UK. andrea.marcellusi@uniroma2.it. 5. Economic Evaluation and HTA (EEHTA), CEIS, Facoltà di Economia, Università di Roma "Tor Vergata", Via Columbia 2, 00133, Rome, Italy. 6. Ufficio di Coordinamento Medico Legale, Istituto Nazionale Previdenza Sociale (INPS), Rome, Italy. 7. Dipartimento di Medicina e Scienze della Salute, Università degli Studi del Molise, Campobasso, Italy. 8. Università di Genova, Genoa, Italy. 9. Università degli Studi di ROMA "La Sapienza", Rome, Italy.
Abstract
BACKGROUND: Schizophrenia is one of the mental disorders with the highest economic and social costs, with an important burden on patients, caregivers, and society. OBJECTIVE: The objective of this study was to estimate the direct and social security costs of schizophrenia in Italy. As far as direct costs are concerned, those related to hospitalizations and pharmaceutical expenditure have been analyzed, while disability benefits (DBs) and incapacity pensions (IPs) have been considered for the social security costs. METHODS: In order to provide annual economic burden of schizophrenia using the real-world data, we analyzed the main regional and national databases related to hospitalizations and pharmaceuticals. Hospitalizations have been analyzed considering the Hospital Information System, which collects all the information regarding hospital discharges from all public and private hospitals (psychiatric wards or residential facilities have not been considered). Hospitalizations with a discharge date between 2009 and 2016, and with a primary or secondary diagnosis of schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 295.xx) were selected. Hospital costs have been estimated considering the national tariffs associated with each selected hospitalization. In addition, using the same inclusion criteria, the average DBs (for workers with reduced working capacity) and IPs (for workers without working capacity) provided each year have been analyzed from the social security benefit applications database. The estimate of pharmaceutical expenditure was prepared based on the OsMed 2018 Report (Italian Medicines Agency, latest issue 18 July 2019). A one-way deterministic sensitivity analysis was conducted to examine the robustness of the results. RESULTS: In Italy from 2009 to 2016, schizophrenia had an important economic impact from a social perspective. On average, 13,800 patients were hospitalized, with an average of 2.98 hospitalizations per patient. From a National Health Service (NHS) perspective and with specific reference to hospitalizations, the annual economic burden was €101.4 million, with an average cost per patient of €7338. On the other hand, pharmaceutical expenditure amounts to over €147 million each year, while residential, semi-residential, and specialist facilities amount to approximately €1 billion. Again, schizophrenia led to approximately 15,000 recipients of social security benefits (DBs and IPs) yearly from 2009 to 2015, with an average annual expenditure of €160.1 million (average cost per patient = €10,675). CONCLUSIONS: Our study estimates an economic burden of schizophrenia of €1250 million per year in direct costs, of which 20% is related to hospitalizations and pharmaceutical expenditure. With regard to social security benefits, an average annual expenditure of €160.1 million was calculated (average cost per patient = €10,675).
BACKGROUND:Schizophrenia is one of the mental disorders with the highest economic and social costs, with an important burden on patients, caregivers, and society. OBJECTIVE: The objective of this study was to estimate the direct and social security costs of schizophrenia in Italy. As far as direct costs are concerned, those related to hospitalizations and pharmaceutical expenditure have been analyzed, while disability benefits (DBs) and incapacity pensions (IPs) have been considered for the social security costs. METHODS: In order to provide annual economic burden of schizophrenia using the real-world data, we analyzed the main regional and national databases related to hospitalizations and pharmaceuticals. Hospitalizations have been analyzed considering the Hospital Information System, which collects all the information regarding hospital discharges from all public and private hospitals (psychiatric wards or residential facilities have not been considered). Hospitalizations with a discharge date between 2009 and 2016, and with a primary or secondary diagnosis of schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 295.xx) were selected. Hospital costs have been estimated considering the national tariffs associated with each selected hospitalization. In addition, using the same inclusion criteria, the average DBs (for workers with reduced working capacity) and IPs (for workers without working capacity) provided each year have been analyzed from the social security benefit applications database. The estimate of pharmaceutical expenditure was prepared based on the OsMed 2018 Report (Italian Medicines Agency, latest issue 18 July 2019). A one-way deterministic sensitivity analysis was conducted to examine the robustness of the results. RESULTS: In Italy from 2009 to 2016, schizophrenia had an important economic impact from a social perspective. On average, 13,800 patients were hospitalized, with an average of 2.98 hospitalizations per patient. From a National Health Service (NHS) perspective and with specific reference to hospitalizations, the annual economic burden was €101.4 million, with an average cost per patient of €7338. On the other hand, pharmaceutical expenditure amounts to over €147 million each year, while residential, semi-residential, and specialist facilities amount to approximately €1 billion. Again, schizophrenia led to approximately 15,000 recipients of social security benefits (DBs and IPs) yearly from 2009 to 2015, with an average annual expenditure of €160.1 million (average cost per patient = €10,675). CONCLUSIONS: Our study estimates an economic burden of schizophrenia of €1250 million per year in direct costs, of which 20% is related to hospitalizations and pharmaceutical expenditure. With regard to social security benefits, an average annual expenditure of €160.1 million was calculated (average cost per patient = €10,675).
Authors: G Fond; J Dubreucq; P L Sunhary de Verville; O Godin; C Andrieu-Haller; F Berna; B Aouizerate; D Capdevielle; I Chereau; J Clauss-Kobayashi; N Coulon; J M Dorey; C Dubertret; J Mallet; D Misdrahi; C Passerieux; R Rey; B Pignon; F Schürhoff; M Urbach; P M Llorca; C Lançon; L Boyer Journal: Eur Arch Psychiatry Clin Neurosci Date: 2022-03-25 Impact factor: 5.760