CNSPulse
W86

IMPACT OF NEGATIVE SYMPTOMS ON HEALTHCARE RESOURCE UTILIZATION AND COSTS IN SCHIZOPHRENIA: A REAL-WORLD DATA ANALYSIS

Nadia Lipunova — Joannas Yeow2, Laila Hadaya1, Emily O.C. Palmer1, Subina Surendran3, Kristin Gillard4, Christoph U. Correll5, Kristin Gillard4 1Holmusk Technologies Inc, 2Holmusk Technologies Inc, 3Holmusk Technologies Inc, 4Bristol Myers Squibb, 5Zucker Hillside Hospital; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; The Feinstein Institute for Medical Research; Charité Universitätsmedizin; German Center for Mental Health (DZPG)

2026 ASCP Annual Meeting

Introduction

Negative symptoms in schizophrenia are present in approximately 60% of individuals and are associated with adverse patient outcomes. Understanding healthcare resource utilization (HCRU) patterns and economic burden associated with negative symptoms may optimize intervention opportunities and resource allocation. This study examined HCRU and cost differences between adults with and without negative symptoms in schizophrenia using real-world data.

Methods

This retrospective cohort study analyzed electronic health records from NeuroBlu Data (V24R5) linked with a US-based, de-identified, longitudinal medical and pharmacy administrative claims database (1999-2024). Individuals aged ≥18 years diagnosed with schizophrenia were included if they had ≥1 record of a Mental Status Examination, Brief Negative Symptom Assessment, or Natural Language Processing label indicating negative symptom status linked to their schizophrenia diagnosis. Healthcare utilization and cost outcomes were reported as totals and stratified by setting (inpatient [IP], outpatient [OP], and emergency [ED]). Negative binomial regression models with inverse probability treatment weighting were used to calculate incidence rate ratios (IRRs) for healthcare utilization outcomes, adjusted for demographic and clinical characteristics, psychopharmacological treatments, and insurance type. Cost ratios (CRs) were estimated using gamma regression with zero-inflation models where needed, adjusting for the same covariates.

Results

The linked cohort included 2616 adults (1774 with negative symptoms), 4.4% of the NeuroBlu Data eligible sample. Total HCRU was similar between patients with and without negative symptoms (IRR: 1.05; 95% CI: 0.97-1.14; P=0.19), but analyses by setting showed increased utilization of acute services (IRR [IP]: 1.19; 95% CI: 1.03-1.37; P=0.02); IRR [ED]: 1.43; 95% CI: 1.24-1.66; P < 0.001). Total healthcare cost was higher among patients with negative symptoms than controls (CR: 1.20; 95% CI: 1.05-1.37; P=0.01), which was driven by observed cost increase of OP services (CR: 1.16; 95% CI: 1.01-1.32; P=0.03). No statistically significant cost differences were observed for acute services (IP/ED), albeit the estimates suggested a trend toward increased IP costs for patients with negative symptoms (CR [IP]: 1.17;