OBJECTIVES: Schizophrenia is a debilitating chronic psychiatric illness with a considerable impact on the patient and the patient's environment, in terms of morbidity, mortality, human suffering and societal costs. Currently, little is known of the exact cost of relapse in schizophrenia. Our objective is to estimate cost of relapse based on resource utilization data collected alongside a clinical trial. METHODS: "Constatre" is a multicenter, open-label, randomized, active-control, long-term study comparing risperidone long acting injectable treatment with oral quetiapine, conducted from October 2004 to November 2007 at 124 sites in 25 countries (ClinicalTrials.gov identifier: NCT00216476). Information regarding Medical Resource Utilization (MRU) during the three months following relapse was collected for a subset of patients. To estimate the associated relapse related costs, average purchase power parity adjusted country resource unit costs (2010 Euro) were applied. RESULTS: Detailed MRU data were available for 63 patients spread across Europe. The overall mean MRU cost per patient in the three months following the relapse was 7592, of which 79% was related to psychiatric hospitalisation. 68% of the relapsed patients were hospitalized, for on average 38.8 days, representing a total cost of 9117 (range 277 - 20,868) per hospitalised patient. 5% of the patients were in day-clinic, on average for 41.3 days, representing a cost of 5829 per patient. The majority (60%) of the relapsed patients had outpatient visits, representing a mean cost per patient of 1834, mainly to psychiatrists (57% of patients, average = 14.5 visits) and nurses (10% of patients, average = 105.9 visits). CONCLUSIONS: Costs related to relapse of schizophrenic patients are considerable, and mainly driven by psychiatric hospitalisation. Antipsychotic treatment that prevents or reduces relapse and psychiatric hospitalisation can have a major impact on the total schizophrenia related treatment cost.
Hemels, M., Diels, J., González, B., & Jensen, R. (2011). PMH19 Cost of Relapse in Schizophrenia in Europe: The Constatre Study. Value in Health, 14(7), A290. https://doi.org/10.1016/j.jval.2011.08.321