Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

Wallace Breno Barbosa (), Juliana de Oliveira Costa (), Lívia Lovato Pires Lemos (), Rosângela Maria Gomes (), Helian Nunes Oliveira (), Cristina Mariano Ruas (), Francisco de Assis Acurcio (), Corrado Barbui (), Marion Bennie (), Brian Godman () and Augusto Afonso Guerra ()
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Wallace Breno Barbosa: Federal University of Minas Gerais
Juliana de Oliveira Costa: Federal University of Minas Gerais
Lívia Lovato Pires Lemos: Federal University of Minas Gerais
Rosângela Maria Gomes: Federal University of Minas Gerais
Helian Nunes Oliveira: Federal University of Minas Gerais
Cristina Mariano Ruas: Federal University of Minas Gerais
Francisco de Assis Acurcio: Federal University of Minas Gerais
Corrado Barbui: University of Verona
Marion Bennie: Strathclyde University
Brian Godman: Strathclyde University
Augusto Afonso Guerra: Federal University of Minas Gerais

Applied Health Economics and Health Policy, 2018, vol. 16, issue 5, No 10, 697-709

Abstract: Abstract Background Schizophrenia is associated with significant economic burden. In Brazil, antipsychotic drugs and outpatient and hospital services are provided by the Brazilian National Health System (SUS) for patients with schizophrenia. However, few studies capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective Our objective was to use real-world data to describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010. Methods We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. We assessed only direct medical costs and the study was conducted from a public-payer perspective. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results We identified 174,310 patients with schizophrenia, with mean ± standard deviation (SD) annual costs of $US1811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of total costs, with a mean annual cost per patient of $US1578.74 ± 240.40. Mean annual costs per patient were $US2482.90 ± 302.92 for psychiatric hospitalization and $US862.96 ± 160.18 for outpatient psychiatric care. Olanzapine was used by 47.7% of patients and represented 62.8% of the total costs of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient for outpatient psychiatric care and psychiatric hospitalization. Conclusions Atypical antipsychotics were responsible for the majority of the schizophrenia treatment costs, and psychiatric hospitalization costs were the highest mean annual cost per patient. Authorities should ensure efficient use of atypical antipsychotics and encourage outpatient psychiatric care over psychiatric hospitalization where possible.

Date: 2018
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DOI: 10.1007/s40258-018-0408-4

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