{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:09:21Z","timestamp":1779368961707,"version":"3.53.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["PharmacoEconomics Open"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1007\/s41669-026-00647-w","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T17:23:21Z","timestamp":1774891401000},"page":"567-575","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Healthcare Costs of Metabolic Disorders Among Individuals with Schizophrenia Following Initiation of Oral Antipsychotic Therapy"],"prefix":"10.1007","volume":"10","author":[{"given":"Joseph","family":"Tkacz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Cajigal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Sidovar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Pennington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Okunev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-2878","authenticated-orcid":false,"given":"Kristin","family":"Gillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"647_CR1","unstructured":"National Institute of Mental Health. Schizophrenia. 2024. https:\/\/www.nimh.nih.gov\/health\/statistics\/schizophrenia."},{"issue":"12","key":"647_CR2","doi-asserted-by":"publisher","first-page":"5319","DOI":"10.1038\/s41380-023-02138-4","volume":"28","author":"M Solmi","year":"2023","unstructured":"Solmi M, Seitidis G, Mavridis D, Correll CU, Dragioti E, Guimond S, et al. Incidence, prevalence, and global burden of schizophrenia\u2014data, with critical appraisal, from the Global Burden of Disease (GBD) 2019. Mol Psychiatry. 2023;28(12):5319\u201327.","journal-title":"Mol Psychiatry"},{"issue":"10","key":"647_CR3","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1080\/03007995.2021.1954894","volume":"37","author":"D Pilon","year":"2021","unstructured":"Pilon D, Patel C, Lafeuille MH, Zhdanava M, Lin D, C\u00f4t\u00e9-Sergent A, et al. Prevalence, incidence and economic burden of schizophrenia among Medicaid beneficiaries. Curr Med Res Opin. 2021;37(10):1811\u20139.","journal-title":"Curr Med Res Opin"},{"issue":"1","key":"647_CR4","doi-asserted-by":"publisher","DOI":"10.1038\/s41537-024-00490-0","volume":"10","author":"MT Finnerty","year":"2024","unstructured":"Finnerty MT, Khan A, You K, Wang R, Gu G, Layman D, et al. Prevalence and incidence measures for schizophrenia among commercial health insurance and Medicaid enrollees. Schizophrenia. 2024;10(1):68.","journal-title":"Schizophrenia"},{"issue":"1","key":"647_CR5","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1080\/13696998.2023.2189859","volume":"26","author":"P Li","year":"2023","unstructured":"Li P, Benson C, Geng Z, Seo S, Patel C, Doshi JA. Antipsychotic utilization, healthcare resource use and costs, and quality of care among fee-for-service Medicare beneficiaries with schizophrenia in the United States. J Med Econ. 2023;26(1):525\u201336.","journal-title":"J Med Econ"},{"key":"647_CR6","doi-asserted-by":"crossref","unstructured":"Kadakia A, Catillon M, Fan Q, Williams GR, Marden JR, Anderson A, et al. The economic burden of schizophrenia in the United States. J Clin Psychiatry. 2022;83(6).","DOI":"10.4088\/JCP.22m14458"},{"key":"647_CR7","unstructured":"COBENFY (xanomeline and trospium chloride). Prescribing information. Bristol-Myers Squibb; 2024."},{"key":"647_CR8","doi-asserted-by":"publisher","first-page":"757","DOI":"10.2147\/TCRM.S117321","volume":"13","author":"M Solmi","year":"2017","unstructured":"Solmi M, Murru A, Pacchiarotti I, Undurraga J, Veronese N, Fornaro M, et al. Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review. Ther Clin Risk Manag. 2017;13:757\u201377.","journal-title":"Ther Clin Risk Manag"},{"key":"647_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-13-246","volume":"13","author":"M Markowitz","year":"2013","unstructured":"Markowitz M, Karve S, Panish J, Candrilli SD, Alphs L. Antipsychotic adherence patterns and health care utilization and costs among patients discharged after a schizophrenia-related hospitalization. BMC Psychiatry. 2013;13:246.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"647_CR10","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/jphs.12004","volume":"4","author":"J Panish","year":"2013","unstructured":"Panish J, Karve S, Candrilli SD, Dirani R. Association between adherence to and persistence with atypical antipsychotics and psychiatric relapse among US Medicaid-enrolled patients with schizophrenia. J Pharm Health Serv Res. 2013;4(1):29\u201339.","journal-title":"J Pharm Health Serv Res"},{"issue":"5","key":"647_CR11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.5498\/wjp.v2.i5.74","volume":"2","author":"FJ Acosta","year":"2012","unstructured":"Acosta FJ, Hernandez JL, Pereira J, Herrera J, Rodriguez CJ. Medication adherence in schizophrenia. World J Psychiatry. 2012;2(5):74\u201382.","journal-title":"World J Psychiatry"},{"key":"647_CR12","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11010130","author":"MU Shad","year":"2023","unstructured":"Shad MU. Seventy years of antipsychotic development: a critical review. Biomedicines. 2023. https:\/\/doi.org\/10.3390\/biomedicines11010130.","journal-title":"Biomedicines"},{"issue":"12","key":"647_CR13","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-021-01298-w","volume":"23","author":"M Pahwa","year":"2021","unstructured":"Pahwa M, Sleem A, Elsayed OH, Good ME, El-Mallakh RS. New antipsychotic medications in the last decade. Curr Psychiatry Rep. 2021;23(12):87.","journal-title":"Curr Psychiatry Rep"},{"issue":"4","key":"647_CR14","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/14656566.2023.2181073","volume":"24","author":"PM Haddad","year":"2023","unstructured":"Haddad PM, Correll CU. Long-acting antipsychotics in the treatment of schizophrenia: opportunities and challenges. Expert Opin Pharmacother. 2023;24(4):473\u201393.","journal-title":"Expert Opin Pharmacother"},{"key":"647_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2025.116378","volume":"345","author":"MC Lohman","year":"2025","unstructured":"Lohman MC, Scott V, Verma M, Jones P, Fields E. Distribution and correlates of long-acting injectable antipsychotic use among community mental health center patients. Psychiatry Res. 2025;345:116378.","journal-title":"Psychiatry Res"},{"issue":"6","key":"647_CR16","first-page":"549","volume":"30","author":"C Cai","year":"2024","unstructured":"Cai C, Kozma C, Patel C, Benson C, Yunusa I, Zhao P, et al. Adherence, health care utilization, and costs between long-acting injectable and oral antipsychotic medications in South Carolina Medicaid beneficiaries with schizophrenia. J Manag Care Spec Pharm. 2024;30(6):549\u201359.","journal-title":"J Manag Care Spec Pharm"},{"issue":"4","key":"647_CR17","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1080\/03007995.2021.1882977","volume":"37","author":"C Patel","year":"2021","unstructured":"Patel C, Emond B, Morrison L, Lafeuille M-H, Lefebvre P, Lin D, et al. Risk of subsequent relapses and corresponding healthcare costs among recently-relapsed Medicaid patients with schizophrenia: a real-world retrospective cohort study. Curr Med Res Opin. 2021;37(4):665\u201374.","journal-title":"Curr Med Res Opin"},{"key":"647_CR18","unstructured":"Swarup S, Ahmed I, Grigorova Y, Zeltser R. Metabolic syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright \u00a9 2025, StatPearls Publishing LLC.; 2025."},{"issue":"5","key":"647_CR19","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1093\/ijnp\/pyaa097","volume":"24","author":"Y Mizuki","year":"2021","unstructured":"Mizuki Y, Sakamoto S, Okahisa Y, Yada Y, Hashimoto N, Takaki M, et al. Mechanisms underlying the comorbidity of schizophrenia and type 2 diabetes mellitus. Int J Neuropsychopharmacol. 2021;24(5):367\u201382.","journal-title":"Int J Neuropsychopharmacol"},{"issue":"3","key":"647_CR20","doi-asserted-by":"publisher","first-page":"176","DOI":"10.4103\/0976-500X.114596","volume":"4","author":"RK Chadda","year":"2013","unstructured":"Chadda RK, Ramshankar P, Deb KS, Sood M. Metabolic syndrome in schizophrenia: differences between antipsychotic-na\u00efve and treated patients. J Pharmacol Pharmacother. 2013;4(3):176\u201386.","journal-title":"J Pharmacol Pharmacother"},{"key":"647_CR21","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17186700","author":"MJ Sun","year":"2020","unstructured":"Sun MJ, Jang MH. Risk factors of metabolic syndrome in community-dwelling people with schizophrenia. Int J Environ Res Public Health. 2020. https:\/\/doi.org\/10.3390\/ijerph17186700.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"647_CR22","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s40263-023-01057-w","volume":"38","author":"C Zhuo","year":"2024","unstructured":"Zhuo C, Zhang Q, Wang L, Ma X, Li R, Ping J, et al. Insulin resistance\/diabetes and schizophrenia: potential shared genetic factors and implications for better management of patients with schizophrenia. CNS Drugs. 2024;38(1):33\u201344.","journal-title":"CNS Drugs"},{"issue":"Suppl 2","key":"647_CR23","first-page":"8","volume":"6","author":"JA Lieberman 3rd","year":"2004","unstructured":"Lieberman JA 3rd. Metabolic changes associated with antipsychotic use. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 2):8\u201313.","journal-title":"Prim Care Companion J Clin Psychiatry"},{"key":"647_CR24","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2017.00432","volume":"11","author":"Z Freyberg","year":"2017","unstructured":"Freyberg Z, Aslanoglou D, Shah R, Ballon JS. Intrinsic and antipsychotic drug-induced metabolic dysfunction in schizophrenia. Front Neurosci. 2017;11:432.","journal-title":"Front Neurosci"},{"key":"647_CR25","unstructured":"U.S. Bureau of Labor Statistics. Consumer Price Index: Medical Care. https:\/\/www.bls.gov\/cpi\/factsheets\/medical-care.htm."},{"issue":"6","key":"647_CR26","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1089\/met.2023.0003","volume":"21","author":"PS Akinola","year":"2023","unstructured":"Akinola PS, Tardif I, Leclerc J. Antipsychotic-induced metabolic syndrome: a review. Metab Syndr Relat Disord. 2023;21(6):294\u2013305.","journal-title":"Metab Syndr Relat Disord"},{"key":"647_CR27","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1257460","author":"KRH Mortimer","year":"2023","unstructured":"Mortimer KRH, Katshu MZUH, Chakrabarti L. Second-generation antipsychotics and metabolic syndrome: a role for mitochondria. Front Psychiatry. 2023. https:\/\/doi.org\/10.3389\/fpsyt.2023.1257460.","journal-title":"Front Psychiatry"},{"issue":"6","key":"647_CR28","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1038\/s41366-023-01291-8","volume":"47","author":"W Ye","year":"2023","unstructured":"Ye W, Xing J, Yu Z, Hu X, Zhao Y. Mechanism and treatments of antipsychotic-induced weight gain. Int J Obes. 2023;47(6):423\u201333.","journal-title":"Int J Obes"},{"issue":"12","key":"647_CR29","doi-asserted-by":"publisher","DOI":"10.1111\/jne.13347","volume":"35","author":"M Fonseca","year":"2023","unstructured":"Fonseca M, Carmo F, Martel F. Metabolic effects of atypical antipsychotics: molecular targets. J Neuroendocrinol. 2023;35(12):e13347.","journal-title":"J Neuroendocrinol"},{"key":"647_CR30","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201100328","author":"RA Hansen","year":"2012","unstructured":"Hansen RA, Maciejewski M, Yu-Isenberg K, Farley JF. Adherence to antipsychotics and cardiometabolic medication: association with health care utilization and costs. Psychiatr Serv. 2012. https:\/\/doi.org\/10.1176\/appi.ps.201100328.","journal-title":"Psychiatr Serv"},{"key":"647_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-017-0133-7","author":"CU Correll","year":"2017","unstructured":"Correll CU, Ng-Mak DS, Stafkey-Mailey D, Farrelly E, Rajagopalan K, Loebel A. Cardiometabolic comorbidities, readmission, and costs in schizophrenia and bipolar disorder: a real-world analysis. Ann Gen Psychiatry. 2017. https:\/\/doi.org\/10.1186\/s12991-017-0133-7.","journal-title":"Ann Gen Psychiatry"},{"issue":"6","key":"647_CR32","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1007\/s10935-024-00798-8","volume":"45","author":"N Salari","year":"2024","unstructured":"Salari N, Maghami N, Ammari T, Mosafer H, Abdullahi R, Rasoulpoor S, et al. Global prevalence of metabolic syndrome in schizophrenia patients: a systematic review and meta-analysis. J Prev (2022). 2024;45(6):973\u201386.","journal-title":"J Prev. (2022)"},{"key":"647_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1395771","volume":"15","author":"K Dong","year":"2024","unstructured":"Dong K, Wang S, Qu C, Zheng K, Sun P. Schizophrenia and type 2 diabetes risk: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1395771.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"647_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.769309","volume":"12","author":"M Afzal","year":"2021","unstructured":"Afzal M, Siddiqi N, Ahmad B, Afsheen N, Aslam F, Ali A, et al. Prevalence of overweight and obesity in people with severe mental illness: systematic review and meta-analysis. Front Endocrinol (Lausanne). 2021;12:769309.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"2\u20133","key":"647_CR35","first-page":"490","volume":"152","author":"RS Shim","year":"2015","unstructured":"Shim RS, Druss BG, Zhang S, Kim G, Oderinde A, Shoyinka S, et al. Emergency department utilization among Medicaid beneficiaries with schizophrenia and diabetes: the consequences of increasing medical complexity. Schizophr Res. 2015;152(2\u20133):490\u20137.","journal-title":"Schizophr Res"}],"container-title":["PharmacoEconomics - Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41669-026-00647-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41669-026-00647-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41669-026-00647-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:57:24Z","timestamp":1779368244000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41669-026-00647-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["647"],"URL":"https:\/\/doi.org\/10.1007\/s41669-026-00647-w","relation":{},"ISSN":["2509-4262","2509-4254"],"issn-type":[{"value":"2509-4262","type":"print"},{"value":"2509-4254","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"assertion":[{"value":"24 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"KW, EP, and IO are employees of Inovalon, which received funding from Karuna Therapeutics, a Bristol Myers Squibb company, to conduct this study. KG is an employee of Karuna Therapeutics, a Bristol Myers Squibb company. At the time the research was conducted, JT was an employee of Inovalon and AC and MS were employees of Karuna Therapeutics, a Bristol Myers Squibb company.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article has no associated data that will be made available, due to restrictions outlined by data usage agreements with select data contributors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and materials"}},{"value":"This administrative claims analysis utilized de-identified data in compliance with the confidentiality requirements in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Thus, this study was exempt from institutional review board review and approval.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"This administrative claims analysis utilized de-identified data in compliance with the confidentiality requirements in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Thus, this study was exempt from patient consent procedures.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The codes used for this study can be shared upon reasonable request to the corresponding author.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}},{"value":"All authors had access to the data, had a role in writing this manuscript, including critically reviewing the manuscript, and made significant contributions to this work. All authors agreed on the journal submission choice, have agreed on all revisions, gave final approval for the version to be published, and agreed to be accountable for all aspects of the work.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}