Rising drug expenditures for ADHD

The NHS is likely to face a 10-fold increase in the cost of drugs prescribed to children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in the decade to 2012.

The research, published in the online open access journal Child and Adolescent Psychiatry and Mental Health, modelled various scenarios to determine possible costs to the National Health Service in England and the statutory health insurance providers in Germany.

Michael Schlander of the University of Heidelberg in Germany created a model based on demographic and epidemiological data, past spending trends, and an assessment of which drugs may soon be available for prescriptions. He calculated a range of the possible costs by varying the assumptions made for factors such as the likelihood of diagnosis and treatment, the level of treatment and the costs of drugs.

The cost of ADHD prescriptions to the NHS in England was £7 million in 2002 and the study predicted that this will rise to somewhere between £49 and £101 million per year by 2012. Prof Schlander stated: "The scenarios developed here strongly suggest that the trend of rising drug expenditures for ADHD may not abate in the near future."

At the same time Schlander emphasized that caution should be exercised when interpreting this data: "The mere focus of the present analysis is budgetary impact," and thus the data "illuminate just one half of the health economic equation; they do not provide information on 'value for money'."

The main characteristics of ADHD are inattention, hyperactivity and impulsivity. In the USA the percentage of children being treated for ADHD has been estimated at between 2.9 and 4.8%. The ADHD drugs bill in the USA is expected to top $4 billion by 2010 (for adults as well as children). In the UK it is thought that ADHD used to be under-diagnosed. The number of prescriptions is now rising sharply. One new drug that may become available in 2008 in the UK is Vyvanse(r), which is thought to have a lower potential for abuse and overdose than existing ADHD drugs.