Economic burden of schizophrenia: the European situation. A scientific literature review. [Comunicazione breve]

Schizophrenic disorders represent one of the most common public health issues in psychiatry. An estimated 4 million people in Europe suffer from schizophrenia. The European Burden of Disease Report quotes a point prevalence of 0.25- 0.56% for schizophrenia. This disorder has been demonstrated to have important social and economic consequences, so it is necessary to assess its economic burden. The aim of this study was to analyze the costs related to schizophrenia in the European continent. Methods A literature search on the economic burden of schizophrenia in Europe was performed by using specific key words and MeSH terms. To this purpose, the main electronic databases (PubMed, Cochrane Library and Embase) were accessed and studies estimating direct or indirect costs attributable to healthcare management of schizophrenia were included. Results The search resulted in 359 publications, of which 43 were included by reviewing titles. Among them, only 9 articles (regarding 12 European Countries) were respondent to inclusion criteria. The annual mean cost of schizophrenia for each person was estimated being 23,241 E (30% direct costs) in UK, 7,506 E (88% direct costs) in Italy and 6,028 E (53% direct costs) in Spain. In particular there are many differences in the cost of outpatient visits (94.34 E in UK, 32.85 E in France, 14.50 E in Germany) and in the cost of treatment (from 2,958 E in Spain up to 36,978 E in Switzerland). The cost proportions of direct medical costs differed between countries, with prevalent outpatient costs in Sweden, medication costs in Spain and accommodation costs in Switzerland. Conclusions This study confirms the significant economic burden of schizophrenia. The amount of medical and nonmedical costs shows the dimension of the problem in Europe as well as the need to focus on this issue. A great heterogeneity of costs emerges between the European countries underlining the necessity to join more efficient governance tools and processes while pursuing healthcare quality and adopt common Public Health choices in the management of this mental illness. Key message Schizophrenia represents a serious problem for all European countries. Itsmanagement requires ahomogenizationofhealthcare practice in order to improve quality and reduce costs.