IDEAS home Printed from
   My bibliography  Save this article

The Cost of Relapse in Schizophrenia


  • Mark Pennington

    () (King’s College London)

  • Paul McCrone

    (King’s College London)


Introduction Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia. Objectives We aimed to undertake a comprehensive search of the available literature on the cost of relapse. Methods We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars. Results We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033–$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12–15 months. European studies report excess costs of $8665–$18,676 (2015 PPP$) over periods of 6–12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions. Conclusions Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

Suggested Citation

  • Mark Pennington & Paul McCrone, 2017. "The Cost of Relapse in Schizophrenia," PharmacoEconomics, Springer, vol. 35(9), pages 921-936, September.
  • Handle: RePEc:spr:pharme:v:35:y:2017:i:9:d:10.1007_s40273-017-0515-3
    DOI: 10.1007/s40273-017-0515-3

    Download full text from publisher

    File URL:
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Tarricone, Rosanna & Gerzeli, S. & Montanelli, R. & Frattura, Lucilla & Percudani, Mauro & Racagni, Giorgio, 2000. "Direct and indirect costs of schizophrenia in community psychiatric services in Italy: The GISIES study," Health Policy, Elsevier, vol. 51(1), pages 1-18, February.
    2. Simon Frey & Roland Linder & Georg Juckel & Tom Stargardt, 2014. "Cost-effectiveness of long-acting injectable risperidone versus flupentixol decanoate in the treatment of schizophrenia: a Markov model parameterized using administrative data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 133-142, March.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Olga Chivilgina & Tenzin Wangmo & Bernice Simone Elger & Thomas Heinrich & Fabrice Jotterand, 2020. "mHealth for schizophrenia spectrum disorders management: A systematic review," International Journal of Social Psychiatry, , vol. 66(7), pages 642-665, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Massimiliano Agovino & Maria Ferrara, 2017. "Can civilian disability pensions overcome the poverty issue? A DSGE analysis for Italian data," Quality & Quantity: International Journal of Methodology, Springer, vol. 51(4), pages 1469-1491, July.
    2. Tarricone, Rosanna, 2006. "Cost-of-illness analysis: What room in health economics?," Health Policy, Elsevier, vol. 77(1), pages 51-63, June.
    3. Jan Zeidler & Jörg Mahlich & Wolfgang Greiner & Stephan Heres, 2013. "Cost Effectiveness of Paliperidone Palmitate for the Treatment of Schizophrenia in Germany," Applied Health Economics and Health Policy, Springer, vol. 11(5), pages 509-521, October.
    4. Agovino, Massimiliano & Ferrara, Maria, 2015. "Disabilità e povertà: il ruolo delle pensioni di invalidità civile. Un'analisi DSGE per i dati italiani [Disability and poverty: the role of civilian disability pensions. A DSGE analysis for Italia," MPRA Paper 65616, University Library of Munich, Germany.

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:35:y:2017:i:9:d:10.1007_s40273-017-0515-3. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla) or (Springer Nature Abstracting and Indexing). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.