Lin Claire, Zhang Xiaoyu, Jin Huajie
King's Health Economics (KHE), Institute of Psychiatry, Psychology and Neuroscience, King's College London, The David Goldberg Centre, Box 024, London, SE5 8AF, UK.
Pharmacoeconomics. 2023 Feb;41(2):139-153. doi: 10.1007/s40273-022-01217-8. Epub 2022 Nov 21.
Schizophrenia imposes a substantial economic burden on society. This updated systematic review aims to collate the latest societal cost of schizophrenia across countries by reviewing recent cost-of-illness (COI) studies.
An electronic search was conducted across several databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Health Management Information Consortium, and System for Information on Grey Literature) to identify COI studies published from 2016 to 2022. Two independent reviewers selected studies for inclusion. The cost components and estimates reported by included studies were descriptively summarised. All costs were converted to US dollars (2022 values). Study quality was assessed using a checklist adapted from Larg & Moss.
Twenty-four studies were included (5 from the update review and 19 from the original review), of which only two were conducted for low- and middle-income countries (LMICs). Widespread methodological heterogeneity among included studies was observed. The annual societal cost per person varied from US$819 in Nigeria to US$94,587 in Norway. Productivity losses accounted for 32-83% of the overall societal cost, whilst direct healthcare cost made up 11-87%. The reporting quality of included studies varied.
This review highlights the substantial economic burden of schizophrenia and a lack of COI studies for LMICs. Recommendations on future research, and good practices on improving the methodological and reporting quality of COI research for schizophrenia are provided.
精神分裂症给社会带来了巨大的经济负担。这项更新的系统评价旨在通过回顾近期的疾病成本（COI）研究，整理各国精神分裂症的最新社会成本。
在多个数据库（MEDLINE、Embase、PsycINFO、Cochrane系统评价数据库、卫生管理信息联盟和灰色文献信息系统）中进行电子检索，以识别2016年至2022年发表的COI研究。两名独立评审员选择纳入研究。对纳入研究报告的成本组成部分和估计值进行描述性总结。所有成本均换算为美元（2022年价值）。使用改编自Larg和Moss的清单评估研究质量。
纳入了24项研究（5项来自更新评价，19项来自原始评价），其中只有两项是针对低收入和中等收入国家（LMICs）进行的。观察到纳入研究之间存在广泛的方法学异质性。人均年度社会成本从尼日利亚的819美元到挪威的94,587美元不等。生产力损失占总体社会成本的32%-83%，而直接医疗成本占11%-87%。纳入研究的报告质量各不相同。
本评价强调了精神分裂症的巨大经济负担以及LMICs缺乏COI研究。提供了关于未来研究的建议，以及提高精神分裂症COI研究方法和报告质量的良好实践。
