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Background/Objective <p>Metabolic disorders are prevalent among the schizophrenia population due to relatively poor access to healthcare, lifestyle factors, genetics, and metabolic side effects associated with antipsychotic treatment. This study evaluated the rate, timing, and costs associated with the onset of metabolic disorders among individuals with schizophrenia newly initiating oral antipsychotics (OAPs) from the perspective of United States (US) healthcare payers.</p> Methods <p>Those eligible for inclusion in this retrospective administrative claims analysis met the following criteria between 1/1/2016 and 9/30/2023: (1) schizophrenia diagnosis, (2) ≥&#xa0;12 months of continuous enrollment preceding diagnosis, (3) an absence of OAPs during the 12 months preceding diagnosis, (4) at least two claims for OAPs during the 12 months following diagnosis, and (5) absence of diabetes, obesity, hyperlipidemia, or metabolic syndrome any time preceding initiation of OAPs. During the variable-length post-schizophrenia diagnosis period, onset of metabolic disorders was assessed using Kaplan-Meier analyses. Individuals with metabolic disorders were then matched to non-metabolic disorder controls, and healthcare costs were evaluated during the 12 months following the first evidence of metabolic disorders or proxy index date.</p> Results <p>A total of 45,528 individuals with schizophrenia qualified for the study, and 34.7% developed metabolic disorders within 6 years after initiating OAPs. Compared to a matched cohort of individuals without metabolic disorders, individuals with a metabolic disorder incurred significantly greater all-cause annual healthcare costs (mean [standard deviation] in 2023 US dollars, $27,520 [$44,200] vs. $19,044 [$34,352]; <i>p</i> &lt;&#xa0;0.0001) during the 12-month post-index period.</p> Conclusion <p>This analysis demonstrated that new onset of a metabolic disorder following OAP initiation was associated with higher healthcare costs from the perspective of US healthcare payers. Reduction of metabolic disorders may be key in reducing the economic burden of schizophrenia.</p>

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Prevalence and Healthcare Costs of Metabolic Disorders Among Individuals with Schizophrenia Following Initiation of Oral Antipsychotic Therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月30日

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  • Joseph Tkacz,
  • Alejandro Cajigal,
  • Matthew Sidovar,
  • Kathleen Wilson,
  • Emma Pennington,
  • Ilya Okunev,
  • Kristin Gillard

摘要

Background/Objective

Metabolic disorders are prevalent among the schizophrenia population due to relatively poor access to healthcare, lifestyle factors, genetics, and metabolic side effects associated with antipsychotic treatment. This study evaluated the rate, timing, and costs associated with the onset of metabolic disorders among individuals with schizophrenia newly initiating oral antipsychotics (OAPs) from the perspective of United States (US) healthcare payers.

Methods

Those eligible for inclusion in this retrospective administrative claims analysis met the following criteria between 1/1/2016 and 9/30/2023: (1) schizophrenia diagnosis, (2) ≥ 12 months of continuous enrollment preceding diagnosis, (3) an absence of OAPs during the 12 months preceding diagnosis, (4) at least two claims for OAPs during the 12 months following diagnosis, and (5) absence of diabetes, obesity, hyperlipidemia, or metabolic syndrome any time preceding initiation of OAPs. During the variable-length post-schizophrenia diagnosis period, onset of metabolic disorders was assessed using Kaplan-Meier analyses. Individuals with metabolic disorders were then matched to non-metabolic disorder controls, and healthcare costs were evaluated during the 12 months following the first evidence of metabolic disorders or proxy index date.

Results

A total of 45,528 individuals with schizophrenia qualified for the study, and 34.7% developed metabolic disorders within 6 years after initiating OAPs. Compared to a matched cohort of individuals without metabolic disorders, individuals with a metabolic disorder incurred significantly greater all-cause annual healthcare costs (mean [standard deviation] in 2023 US dollars, $27,520 [$44,200] vs. $19,044 [$34,352]; p < 0.0001) during the 12-month post-index period.

Conclusion

This analysis demonstrated that new onset of a metabolic disorder following OAP initiation was associated with higher healthcare costs from the perspective of US healthcare payers. Reduction of metabolic disorders may be key in reducing the economic burden of schizophrenia.