OBJECTIVE: To discuss the costs associated with mental illnesses that constitute a significant percentage of the total direct health care costs, currently estimated at $1605 per person per year (9% of the gross national product). The cost of all mental illness in the US has been estimated at US$103.7 billion (1985 dollars), of which schizophrenia alone accounts for US$22.7 billion. METHOD: A number of studies that have attempted to evaluate the cost of therapies in schizophrenia are examined. RESULTS: While schizophrenia affects only 1% of the population, it accounts for 2.5% of total health care expenditures in the US. For first-admission patients suffering from schizophrenia, it would appear to cost less to provide the most clinically-effective treatments than to provide a good level of milieu care with special treatment. CONCLUSION: Community-based care can be less costly than conventional hospital-based programs and can improve patient quality of life. Inhospital programs that reduce length of stay with the use of medication clinics or day hospital care may achieve significant cost savings. A special challenge is the subgroup of patients suffering from schizophrenia that is neuroleptic-resistant. New drugs, such as the atypical neuroleptics, clozapine and risperidone, may prove to be highly cost-effective in treating schizophrenia by preventing relapse and reducing hospital lengths of stay.
OBJECTIVE: To discuss the costs associated with mental illnesses that constitute a significant percentage of the total direct health care costs, currently estimated at $1605 per person per year (9% of the gross national product). The cost of all mental illness in the US has been estimated at US$103.7 billion (1985 dollars), of which schizophrenia alone accounts for US$22.7 billion. METHOD: A number of studies that have attempted to evaluate the cost of therapies in schizophrenia are examined. RESULTS: While schizophrenia affects only 1% of the population, it accounts for 2.5% of total health care expenditures in the US. For first-admission patients suffering from schizophrenia, it would appear to cost less to provide the most clinically-effective treatments than to provide a good level of milieu care with special treatment. CONCLUSION: Community-based care can be less costly than conventional hospital-based programs and can improve patient quality of life. Inhospital programs that reduce length of stay with the use of medication clinics or day hospital care may achieve significant cost savings. A special challenge is the subgroup of patients suffering from schizophrenia that is neuroleptic-resistant. New drugs, such as the atypical neuroleptics, clozapine and risperidone, may prove to be highly cost-effective in treating schizophrenia by preventing relapse and reducing hospital lengths of stay.