Neurol Ther. 2026 Jun 16. doi: 10.1007/s40120-026-00973-5. Online ahead of print.
ABSTRACT
INTRODUCTION: Metabolic comorbidities, including central adiposity, dyslipidemia, insulin resistance, and hypertension, are common in individuals with schizophrenia and contribute to an increased risk of cardiovascular disease and related mortality. There is limited evidence quantifying the economic burden of metabolic comorbidities in schizophrenia. This study aimed to assess the impact of cumulative metabolic comorbidity burden on medical costs in individuals with schizophrenia using claims data.
METHODS: A retrospective cohort study was conducted using the STATinMED Real World Data Insights database covering the period 2018-2024 in the United States (US). Adults with schizophrenia were grouped by number of metabolic comorbidities (obesity, hyperlipidemia, hypercholesterolemia, diabetes, and/or hypertension). Propensity score matching was applied to balance selected baseline characteristics in individuals with and without metabolic comorbidities. The primary outcome was all-cause medical costs, during a 12-month follow-up, adjusted for insurance status and inflation.
RESULTS: Overall, 122,248 individuals were eligible. After matching, the numbers for metabolic comorbidities and individuals in each group were: 0, n = 40,552; 1, n = 15,840; 2, n = 11,833; 3, n = 8119; 4, n = 4074; and 5, n = 686. Estimated total medical costs increased with the number of metabolic comorbidities; individuals with five metabolic comorbidities incurred mean costs of US$34,441 per person per year, over 4 times higher than the $8396 cost for individuals with none. A similar pattern was observed for estimated outpatient, inpatient, and stay-related costs, with 3.5-, 2.3- and 1.7-fold increases, respectively.
CONCLUSION: There is a substantial economic burden associated with cumulative metabolic comorbidities in individuals with schizophrenia. Prevention and management of metabolic comorbidities in this population includes early risk assessments, lifestyle modification, and the selection of antipsychotic medications with few metabolic adverse effects. Addressing metabolic comorbidities should be a key component of multidisciplinary care to reduce health-related and economic impacts in schizophrenia.
PMID:42301550 | DOI:10.1007/s40120-026-00973-5