Cost of illness studies on psychotic disorders in the U.S. reveal that patients with schizophrenia consume a disproportionate percentage of national healthcare dollars. It has been reported that although schizophrenia occurs in only 1% of the general population, patients with the disorder consume approximately 2.5% of total U.S. healthcare dollars and 22% of the costs of all mental illness.50,51,81Furthermore, patients with schizophrenia consume 10% of Social Security benefits, occupy up to 25% of all hospital beds, and account for 40% of long-term care days.51
Rupp & Keith estimated the total cost of schizophrenia in 1990 to be $33 billion.81 Of this amount, $17 billion was attributable to direct medical costs while $12 billion were attributable to indirect costs.82 Wyatt et al. estimated the indirect cost of schizophrenia to be much higher by using a "productive person-years" method.83 These researchers estimated the total costs of schizophrenia in the U.S. in 1991 to be $65 billion ($19 billion in direct costs and $46 billion in indirect costs).82 It is important to note that these cost of illness studies were conducted before the introduction of many of the antipsychotic agents discussed in this report. Since the early 1990s, atypical agents such as risperidone, clozapine and olanzapine may have contributed to a reduction in total costs or the proportion of U.S. health care dollars consumed by patients with schizophrenia.