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The economic cost of schizophrenia in Ireland: a cost of illness study

Published online by Cambridge University Press:  13 June 2014

Caragh Behan ,
Brendan Kennelly  and
Eadbhard O'Callaghan
Caragh Behan
Affiliation:
DETECT Early Intervention Service for Psychosis, Dublin, Ireland
Brendan Kennelly
Affiliation:
Department of Economics, NUI Galway, Galway, Ireland
Eadbhard O'Callaghan*
Affiliation:
DETECT, Department of Psychiatry, UCD and Hospitaller Order of St John of God
*
Correspondence Block 5, Blackrock Business Park, Carysfort Avenue, Blackrock, Co Dublin, Ireland. Tel: 353-1-2791700, Fax: 353-1-2791799, E-mail: eadbhard@gmail.com
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Abstract

Objectives: Although there are many published reports about the human cost of schizophrenia, there are far fewer estimates of its economic cost, particularly in Ireland. The aim of this study was to provide a prevalence-based estimate of the costs associated with schizophrenia in Ireland during 2006.

Method: Using standard Cost of Illness (COI) procedures we compiled data from many sources including the Health Research Board, the Department of Health and Children and other government publications. Costs relating to health and social care, informal care, lost productivity, premature mortality and other public expenditures were included. Where national data were unavailable, we used bottom-up data from a geographically defined catchment area study and, in some instances, costs from two catchment areas were averaged. We did not measure human or intangible costs.

Results: The estimated total cost of schizophrenia was €460.6 million in 2006. The direct cost of care was €117.5 million and the burden of indirect costs was €343 million. The cost of lost productivity due to unemployment, absence from work and premature mortality was €277 million. Within indirect costs, the expenditure on informal care borne by families was €43.8 million.

Conclusions: Schizophrenia is not a very common condition but is an expensive one. This is attributable to its young age at onset, relatively low mortality rate and high severity particularly in terms of its impact on future employment. Measures to improve outcomes coupled with measures to improve employment such as supported employment strategies may impact significantly on the cost of schizophrenia. The study is limited because the national unit costs of many variables are not directly available and these Irish data are likely to be an underestimate. However, the results are comparable with a 2005 cost of illness study UK study.

Keywords

SchizophreniaEmploymentCost of illnessMental health economics
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 25 , Issue 3 , September 2008 , pp. 80 - 87
Copyright
Copyright © Cambridge University Press 2008

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References

1.Leal, J, Luengo-Fernandez, R, Gray, A, Petersen, S, Rayner, M. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J 2006; 2: 1610–1619 doi:10.1093/eurheartj/ehi733.CrossRefGoogle Scholar
2.Nolan, JJ, O'Halloran, D, McKenna, TJ, Firth, R, Richmond, S. The cost of treating Type 2 diabetes (CODEIRE) Ir Med J 2006; 99(10): 307–10.Google ScholarPubMed
3.Fry, J, Finley, W. The prevalence and costs of obesity in the EU. Proceedings of the Nutrition Society 2005; 64(3): 359–362CrossRefGoogle ScholarPubMed
4.Heerey, A, McGowan, B, Ryan, M, Walsh, M, Feely, J, Barry, M. Cost of treating acute myocardial infarction in an Irish teaching hospital. Ir Med J 2001; 94(5): 144–146.Google Scholar
5.Hodgson, TA, Meiners, MR. Cost of Illness Methodology: A Guide to Current Practices and Procedures. Milbank Memorial Fund Quarterly 1982; 60(3): 429–462.CrossRefGoogle ScholarPubMed
6.Jablensky, A, Sartorius, N, Ernberg, G, Anker, M, Korten, A, Cooper, JEet al.Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 1992; 20: 1–97.CrossRefGoogle ScholarPubMed
7.Nl Nualláin, M, O'Hare, A, Walsh, D. The Prevalence of Schizophrenia in Three Counties in Ireland. Acta Psychiatrica Scandinavic, 1990; 82(4): 136–140.CrossRefGoogle Scholar
8.Saha, S, Chant, D, Welham, J, McGrath, J. A Systematic review of the prevalence of Schizophrenia. PLoS Medicine 2(5), e141 DOI: 10.1371/jounal.pmed.0020141.CrossRefGoogle Scholar
9.Daly, A, Ward, M, Moran, R, Walsh, D. Activities of Irish Psychiatric Units and Hospitals 2006. Health Research Board Annual reports, Dublin 2006.Google Scholar
10. Economic and Social Research Institute. Activity in Acute Public Hospitals in Ireland 2004, Annual report 2007.Google Scholar
11.Mangalore, R, Knapp, M. Cost of schizophrenia in England. J Mental Health Policy Economics 2007 Mar; 10(1): 23–41.Google ScholarPubMed
12.Mental Health Commission 2006 Community Mental Health Services in Ireland: Activity and catchment area characteristics 2004, Annual report.Google Scholar
13.Tedstone Doherty, D, Walsh, D, Moran, R, Bannon, F. High Support Community Residences Census 2006. Health Research Board: Dublin 2007.Google Scholar
14.Tedstone Doherty, D, Walsh, D, Moran, R. Happy living here… A survey and evaluation of community mental health services in Ireland 2006, Mental Health Commission 2007.Google Scholar
15.Gavin, B, Cullen, W, O'Donoghue, B, Ascencio-Lane, JC, Bury, G, O'Callaghan, E.Schizophrenia in General Practice: a national survey of general practitioners in Ireland. Ir J of Med Sci 2005; 174(3): 38–42.CrossRefGoogle ScholarPubMed
16.Behan, C, McGlade, N, Haq, F, Kinsella, A, Gill, M, Corvin, A, O'Callaghan, E. Physical health and attendance at primary care in people with schizophrenia. Presented at the Irish College of Psychiatrists Winter Meeting November 2007.Google Scholar
17. Primary Care Reimbursement Service. Statistical Analysis of Claims and Payments 2006. Published by the Health Service Executive, 2007. http://www.hse.ie/eng/eng/PCRS/Primary_Care_Reimbursement_Service_Financial_and_statistical_Analysis_2006.pdfGoogle Scholar
18.Gilmer, TP, Dolder, CR, Lacro, JP, Folsom, DP, Lindamer, L, Garcia, Pet al.Adherence to treatment with antipsychotic medication and health care costs among medicaid beneficiaries with schizophrenia. Am J Psychiatry 2004; (161) 692–699.CrossRefGoogle ScholarPubMed
19. Disability, Carers and Voluntary Activities. Census 2006; 11, Central Statistics Office. The Stationary Office: Dublin 2006.Google Scholar
20.Clarke, M, Browne, S, McTighue, O, Gervin, M, Kinsella, A, Waddington, JL, Larkin, Cet al.Determinants of duration of untreated psychosis in an Irish catchment area sample. Ir J Psych Med 2007; 24 (2): 50–54.CrossRefGoogle Scholar
21. Industrial earnings and hours worked 2006. Central Statistics Office October 2006 Ref 186/2006.Google Scholar
22.Marwaha, S, Johnson, S. Schizophrenia and Employment: A review. Soc Psychiatry Psychiatr Epidemiol 2004; 39: 337–349.CrossRefGoogle ScholarPubMed
23.Crowther, R, Marshall, M, Bond, GR and Huxley, P. Vocational rehabilitation for people with severe mental illness. Cochrane database of Systematic Reviews 2001, Issue 2. Art. No: CD003080. DOI:10.1002/14651858.CD003080CrossRefGoogle Scholar
24.Almond, S, Healey, A. Mental health and absence from work: New evidence from the U Quarterly Labour Force Survey. Work Employment and Society 2003; 17(4): 731–742. DOI: 10.1177/0950017003174007.CrossRefGoogle Scholar
25. Statistical Yearbook in Ireland 2006, Central Statistics Office, 2007 www.cso.ie/releasespublications/statistical_yearbook_ireland_2007.htmGoogle Scholar
26.Harris, EC, Barraclough, B. Excess mortality of mental disorder. Br J Psychiatry 1998;173:11–53.CrossRefGoogle ScholarPubMed
27. Department for Transport Highways Economics Note No. 1: 2005 valuation of the benefits of prevention of road traffic accidents and casualties, 2007. www.dft.gov.uk/pgr/roadsafety/ea/pdfeconnote105, accessed 28/12/2007Google Scholar
28. Consumer Price Index Central Statistics Office 2006. www.cso.ie/statistics/consumpriceindex.htmGoogle Scholar
29. Census 2006, Central Statistics Office 2007. www.cso.ie/census/cen8us2006_volume_1.htmGoogle Scholar
30. Department of the Environment, Heritage and Local Government www.environ.ie/en/Publications/StatisticsandRegularPublications/HousingStatistics/ accessed 28th January 2008.Google Scholar
31.Folsem, D, Jeste, DV. Schizophrenia in homeless persons: a systematic review of the literature. Acta Psychiatr Scand 2002; 105; 404–413.CrossRefGoogle Scholar
32.Wright, B, Duffy, D, Curtin, K, Linehan, S, Monks, S, Kennedy, H. Psychiatric morbidity amongst women prisoners newly committed and amongst remanded and sentenced in the Irish prison system Ir J Psych Med 2006; 53(2): 47–53.CrossRefGoogle Scholar
33.Smith, C, O'Neill, H, Tobin, J, Walsh, D, Dooley, E. Mental disorders detected in an Irish prison sample. Crim Behav Ment Health 1996: 6: 177–183.CrossRefGoogle Scholar
34. Irish Prison Service Annual Report 2006, Irish Prison Services, 2007 http://www.irishprisons.ie/publications-Annual_Reports.htmGoogle Scholar
35.Keogh, F, Walsh, D. The cost of depression in Ireland Ir J Psych, 1995; 16(7166): 10–16.Google Scholar
36.O'Shea, E, O'Reilly, SThe economic and social cost of dementia in Ireland. Int J Geriatr Psychiatry 2000; 15: 208–21840.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
37. Health in Ireland, Key trends 2007. Published by the Department of Health and Children http://www.dohc.ie/publications/health_in_ireland2007.html Ref 44 National Centre for Pharmacoeconomics http://www.ncpe.ie/document.php?cid=30&sid=79&docid=107 accessed 21 st February 2006.Google Scholar
38.Petersen, S, Peto, V, Rafner, M, Leal, J, Luengo-Fernandez, R, Gray, A. Eurpean Cardiovascular Disease Statistics 2005 Edition, accessed on 30th April 2008 www.ehnheart.org/files/statistics%202005-092711A.pdfGoogle Scholar
39.Tarricone, R. Cost-of-illness analysis. What room in health economics? Health Policy 2006; 77(1): 51–63.CrossRefGoogle ScholarPubMed
40.Hu, T. An International Review of the Economic Costs of Mental Illness, 1990-2003. J Mental Health Policy Economics 2006; 9(1): 3–13.Google ScholarPubMed
41.Kelly, A, Teljeur, C. A new national deprivation index for Health and Health Services Research. Short Report. Small Area Health research Unit, Department of Public Health and Primary Care, Trinity College, Dublin 2004.Google Scholar
42.O'Keane, V, Walsh, D, Barry, S. ‘The Black Hole’ The funding allocated to the mental health services: where is it actually going? Irish Psychiatric Association June 2005.Google Scholar
43.Curtis, L, Netten, A. Unit Costs of Health and Social Care 2006. Personal Social Services Research Unit, University of Kent, Canterbury, 2006.Google Scholar
44. National Centre for Pharmacoeconomics. Accessed 21st February 2006. www.ncpe.ie/document.php?cid=30_sid-79&docid=107Google Scholar
45.Williams, R, Walsh, D, Dalby, JT. Services to schizophrenic patients: epidemiological and cost-effectiveness issues. Ir J Psychol Med 1992; 9: 83–89.CrossRefGoogle Scholar