Teoh Siew Li, Chong Huey Yi, Abdul Aziz Salina, Chemi Norliza, Othman Abdul Razak, Md Zaki Nurzuriana, Vanichkulpitak Possatorn, Chaiyakunapruk Nathorn
School of Pharmacy, Monash University Malaysia, Selangor.
Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Neuropsychiatr Dis Treat. 2017 Jul 28;13:1979-1987. doi: 10.2147/NDT.S137140. eCollection 2017.
Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.
A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.
The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M.
This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.
精神分裂症（SCZ）尽管发病率较低，但却是一种极具致残性的疾病。与精神分裂症相关的经济负担巨大，主要归因于生产力损失。为了更好地了解低收入和中等收入国家地区精神分裂症的经济负担，我们旨在确定马来西亚精神分裂症的经济负担。
采用基于患病率的方法，从社会角度在马来西亚进行了一项回顾性研究，研究时间段为2013年起的1年。我们使用自下而上的微观成本核算技术，包括直接医疗成本、直接非医疗成本和间接成本。主要数据来源是在吉隆坡医院（HKL）进行的病历审查。通过将在国家心理健康精神分裂症登记处注册的患者唯一识别号码与2013年HKL的患者名单进行匹配，以电子方式识别病历。其他数据来源包括政府文件、文献和当地网站。为确保结果的稳健性，进行了概率敏感性分析。
2015年马来西亚接受治疗的精神分裂症病例总数估计为15,104例，总经济负担为1亿美元（M），相当于国内生产总值的0.04%。平均而言，每位患者的平均成本为6,594美元。在精神分裂症的总经济负担中，72%归因于间接成本，为7200万美元，其次是直接医疗成本（26%），为2600万美元，直接非医疗成本（2%），为170万美元。
本研究突出了精神分裂症经济负担的规模，并告知政策制定者对精神分裂症患者的支持不足。应分配更多资源以改善精神分裂症患者的状况并减轻经济负担。
