OBJECTIVE: How the introduction of new pharmaceuticals affects spending for treatment of children with attention-deficit hyperactivity disorder (ADHD) is unknown. This study examined trends in use of pharmaceuticals and their costs among children with ADHD from 1996 to 2005. METHODS: This observational study used annual cohorts of children ages three to 17 with ADHD (N=107,486 unique individuals during the study period) from Florida Medicaid claims to examine ten-year trends in the predicted probability for medication use for children with ADHD with and without psychiatric comorbidities as well as mental health spending and its components. Additional outcome measures included average price per day and average number of days filled for medication classes. RESULTS: Overall, the percentage of children with ADHD treated with ADHD drugs increased from 60% to 63%, and the percentage taking antipsychotics more than doubled, from 8% to 18%. In contrast, rates of antidepressant use declined from 21% to 15%, and alpha agonist use was constant, at 15%. Mental health spending increased 61%, with pharmaceutical spending representing the fastest-rising component (up 192%). Stimulant spending increased 157%, mostly because of increases in price per prescription. Antipsychotic spending increased 588% because of increases in both price and quantity (number of days used). By 2005, long-acting ADHD drugs accounted for over 90% of stimulant spending. CONCLUSIONS: Long-acting ADHD drugs have rapidly replaced short-acting stimulant use among children with ADHD. The use of antipsychotics as a second-tier agent in treating ADHD has overtaken traditional agents such as antidepressants or alpha agonists, suggesting a need for research into the efficacy and side effects of second-generation antipsychotics among children with ADHD.
OBJECTIVE: How the introduction of new pharmaceuticals affects spending for treatment of children with attention-deficit hyperactivity disorder (ADHD) is unknown. This study examined trends in use of pharmaceuticals and their costs among children with ADHD from 1996 to 2005. METHODS: This observational study used annual cohorts of children ages three to 17 with ADHD (N=107,486 unique individuals during the study period) from Florida Medicaid claims to examine ten-year trends in the predicted probability for medication use for children with ADHD with and without psychiatric comorbidities as well as mental health spending and its components. Additional outcome measures included average price per day and average number of days filled for medication classes. RESULTS: Overall, the percentage of children with ADHD treated with ADHD drugs increased from 60% to 63%, and the percentage taking antipsychotics more than doubled, from 8% to 18%. In contrast, rates of antidepressant use declined from 21% to 15%, and alpha agonist use was constant, at 15%. Mental health spending increased 61%, with pharmaceutical spending representing the fastest-rising component (up 192%). Stimulant spending increased 157%, mostly because of increases in price per prescription. Antipsychotic spending increased 588% because of increases in both price and quantity (number of days used). By 2005, long-acting ADHD drugs accounted for over 90% of stimulant spending. CONCLUSIONS: Long-acting ADHD drugs have rapidly replaced short-acting stimulant use among children with ADHD. The use of antipsychotics as a second-tier agent in treating ADHD has overtaken traditional agents such as antidepressants or alpha agonists, suggesting a need for research into the efficacy and side effects of second-generation antipsychotics among children with ADHD.
Authors: Andrew S Rowland; David M Umbach; Lil Stallone; A Jack Naftel; E Michael Bohlig; Dale P Sandler Journal: Am J Public Health Date: 2002-02 Impact factor: 9.308
Authors: James T McCracken; James McGough; Bhavik Shah; Pegeen Cronin; Daniel Hong; Michael G Aman; L Eugene Arnold; Ronald Lindsay; Patricia Nash; Jill Hollway; Christopher J McDougle; David Posey; Naomi Swiezy; Arlene Kohn; Lawrence Scahill; Andres Martin; Kathleen Koenig; Fred Volkmar; Deirdre Carroll; Allison Lancor; Elaine Tierney; Jaswinder Ghuman; Nilda M Gonzalez; Marco Grados; Benedetto Vitiello; Louise Ritz; Mark Davies; James Robinson; Don McMahon Journal: N Engl J Med Date: 2002-08-01 Impact factor: 91.245
Authors: Thomas G McGuire; Joseph P Newhouse; Sharon-Lise Normand; Julie Shi; Samuel Zuvekas Journal: J Health Econ Date: 2014-02-17 Impact factor: 3.883
Authors: Michael L Birnbaum; Ema Saito; Tobias Gerhard; Almut Winterstein; Mark Olfson; John M Kane; Christoph U Correll Journal: Curr Psychiatry Rep Date: 2013-08 Impact factor: 5.285
Authors: Dominic Hodgkin; Constance M Horgan; Amity E Quinn; Elizabeth L Merrick; Maureen T Stewart; Laurel K Leslie Journal: Clin Ther Date: 2014-11-14 Impact factor: 3.393
Authors: Kimberly E Hoagwood; Kelly Kelleher; Bonnie T Zima; James M Perrin; Scott Bilder; Stephen Crystal Journal: Health Aff (Millwood) Date: 2016-07-01 Impact factor: 6.301