Relationship between costs and symptoms in schizophrenia patients treated with antipsychotic medication: a review

BACKGROUND: The purpose of this review is to understand how changes in costs of illness are related to the effects of antipsychotic medications on symptoms in schizophrenia patients. METHOD: A search of the MEDLINE database was performed using the keywords costs, symptoms, and schizophrenia. Studies published between 1965 and 2003 in English, French, German, or Spanish that assessed costs, symptoms, and relationships between costs and symptoms were reviewed. RESULTS: Twenty studies were identified. Most of the reviewed clinical trials of antipsychotic medications reported a decrease in mean costs of illness and an improvement in symptoms. However, many of the studies did not examine the relationship between changes in costs and symptoms. CONCLUSION: There is little evidence that changes in costs of illness are directly related to the effects of antipsychotic medications on symptoms. This review emphasizes the need for standardizing the assessment of costs and clinical outcomes, looking more specifically at the relationship between types of costs and specific aspects of psychopathology and developing new statistical models relating changes in costs and clinical outcomes.