(268) Economic impact of experiential negative symptoms among patients living with schizophrenia: Medical expenditure panel survey

Background: : Patients living with schizophrenia exhibit increased experiential negative symptoms (NS), such as avolition, asociality, and anhedonia, which adversely impact cognitive function, including verbal memory, processing speed, and emotional regulation, and quality of life and functioning.

Objective: : With limited information on the costs of experiential NS, this study examined the costs and healthcare resource use (HCRU) related to experiential NS in patients living with schizophrenia.

Methods: : This cross-sectional study of non-institutionalized adults aged ≥18 years diagnosed with schizophrenia utilized the US nationally representative Medical Expenditure Panel Survey data (1997-2022). Patients were considered to have experiential NS if any proxies for avolition, anhedonia, or asociality were reported. Avolition and anhedonia were assessed on lack of interest or pleasure in activities over the past two weeks, while asociality was identified through restricted social, recreational, or family engagements stemming from mental or physical health issues. Weighted descriptive and comparative analyses were stratified by experiential NS, using χ2 tests and t-tests, with costs adjusted to 2024 US dollars.

Results: : Of 1,804 (weighted n=616,530) adults living with schizophrenia (mean age: 47.5, 53.2% male), 71.3% reported experiential NS. Patients with experiential NS, compared to those without, had higher annual incidence of inpatient visits (24.5% vs. 14.5%, p< 0.01), ER visits (36.0% vs. 20.2%, p< 0.01), and 48.4% higher annual total healthcare costs ($20,038 vs. $13,502, p< 0.01). Indirect costs, measured as annual wage loss due to unemployment, were nearly 1.4 times higher for individuals with experiential NS compared to those without ($39,803.53 vs. $27,642.42).

Conclusions: : Experiential NS were reported in the majority of adults living with schizophrenia and were associated with significantly increased HCRU and costs. Limitations include reliance on self-reported data, potential recall bias, and the exclusion of institutionalized populations, potential incomplete assessment of the disease burden. These findings illustrate high burden and need for effective treatment strategies for experiential NS in schizophrenia.

Sponsorship:: Boehringer Ingelheim Pharmaceuticals, Inc.