Perspective and the measurement of costs and benefits for cost-effectiveness analysis in schizophrenia.

A valid and compelling cost-effectiveness analysis of psychopharmacologic treatment of schizophrenia requires the application of analytically rigorous methods. All cost-effectiveness analyses must consider the issue of perspective as the well as the appropriate measurement of benefits and costs. Many of these issues are particularly difficult to address in the case of schizophrenia. Since costs may be borne by a wide range of parties, the choice of perspective is of critical importance. The fact that treatments for schizophrenia can extend life and the complexities raised by taking a broad perspective on the benefits and costs of treating schizophrenia can create challenges in the measurement of both benefits and costs. The measurement of benefits through quality-adjusted life years is also crucial in demonstrating the cost-effectiveness of treatments for schizophrenia, but is challenging because of the difficulty of measuring quality of life in schizophrenic patients. Attention to these important methodological issues is essential if cost-effectiveness analyses are to be useful in shepherding scarce resources to worthwhile treatments for patients with schizophrenia.