Work

The global economic burden of schizophrenia: an umbrella review of systematic reviews and meta-analyses with reconstructed primary-study cost data

Year: 2026

Type: review

Abstract: BACKGROUND: Existing studies on the economic impact of schizophrenia are fragmented and vary in methodology, hindering an ample understanding of the total economic burden. AIMS: To quantify the global economic burden of schizophrenia by synthesizing findings from systematic reviews and meta-analyses, and to assess variations by cost category, world region and income level. METHOD: We conducted a protocol-driven umbrella review registered on PROSPERO (CRD42024504092). A systematic search of MEDLINE, EMBASE, Cochrane Library, and APA PsycINFO identified reviews reporting annual per-patient monetary cost estimates for schizophrenia. Monetary values were adjusted for inflation and converted to 2024 US dollars. RESULTS: Twenty-six systematic reviews involving 152 primary studies were included. The median annual per-patient total cost of schizophrenia across included primary studies was $33,236 (mean $47,872), with direct costs accounting for $23,126 (medical: $19,543; ancillary: $1,152) and indirect costs for $21,333. Costs were varied by income level: in high-income countries, the median total cost was $34,175, compared to $3,345 in upper-middle-income and $3,452 in lower-middle-income countries. Regional disparities were substantial, with Europe & Central Asia reporting the highest median costs among high-income settings. Data from low- and middle-income regions were limited or absent. Methodological heterogeneity, lack of standardization in cost reporting, and underrepresentation of low-resource settings limit generalizability. CONCLUSIONS: The included cost-of-illness estimates indicate that schizophrenia is associated with substantial annual per-patient costs, with hospitalization, long-term care, and productivity losses frequently among the largest reported components. However, the evidence base is heavily weighted toward high-income countries, and limited data from lower-resource settings constrain cross-country comparability. Future research should adopt standardized costing frameworks and expand data collection in underrepresented regions to improve the consistency, transparency, and geographic coverage of economic burden estimates.

Source: Health Economics Review

DOI: 10.1186/s13561-026-00766-4