ARTICLES
Attention-Deficit/Hyperactivity Disorder: Increased Costs for Patients and Their Families

https://doi.org/10.1097/00004583-200312000-00008Get rights and content

ABSTRACT

Objective

To estimate the direct (medical and prescription drug) and indirect (work loss) costs of children treated for attention-deficit/hyperactivity disorder (ADHD) and their family members.

Method

The data source was an administrative database from a national, Fortune 100 manufacturer that included all medical, pharmaceutical, and disability claims for beneficiaries (n > 100,000). The analysis involved four samples. The ADHD patient sample included individuals age 18 or younger with at least one ADHD claim during the study period (1996–1998). Resource utilization of ADHD patients was contrasted with a matched control sample of patients who did not have claims for ADHD. The ADHD and non-ADHD family samples included non-ADHD family members of ADHD patients and their matched controls.

Results

The annual average expenditure (direct cost) per ADHD patient was $1,574, compared to $541 among matched controls. The annual average payment (direct plus indirect cost) per family member was $2,728 for non-ADHD family members of ADHD patients versus $1,440 for family members of matched controls. Both patient and family cost differences were significant at the 95% confidence level.

Conclusions

ADHD imposes a significant financial burden regarding the cost of medical care and work loss for patients and family members.

Section snippets

METHOD

The goal of this study was to assess the economic burden of childhood ADHD to employers. Specifically, we estimated the direct medical care costs of ADHD sufferers and family members, and indirect costs to family members. To determine the incremental burden of ADHD in terms of direct and indirect costs, we compared employer expenditures for children treated for ADHD relative to an age- and gender-matched population of those without ADHD who were beneficiaries of the same employer, as well as

Demographics.

Consistent with epidemiological estimates (American Academy of Child and Adolescent Psychiatry, 1997, American Academy of Child and Adolescent Psychiatry, 2000), the treated prevalence of ADHD in the patients of age 18 or younger was 4%. The average age of the ADHD cases and the matched control group was 12 years; 74% were male. The ADHD patient and matched control samples had the same demographics by construction (Table 1). While the demographic characteristics of both family samples were

Epidemiological and Economic Implications

The results reported here are consistent with relevant epidemiological studies. At a patient level, findings related to increased comorbidities among ADHD patients lend support to the well-recognized link between ADHD and other mental disorders. In addition, ADHD status is associated with an increase in patient's medical costs, as well as those of family members. Epidemiological patterns that ADHD is associated with greater stress in both parents and siblings are consistent with the results in

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      A study of a U.S. national Fortune 100 company’s database of over 100,000 beneficiaries compared healthcare costs for youths with ADHD with matched controls without ADHD. The annual average cost per family member was $2728 for non-ADHD family members of ADHD patients, almost double the $1440 for family members of matched controls (Swensen et al., 2003). German health insurance records, including over 25,000 patients with ADHD, indicate that patients with ADHD cost roughly €1500 more annually than those without ADHD.

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      Because children with ADHD are more accident-prone, they might miss school, sports, and other childhood activities. Consequently, parents of children with ADHD miss work to take care of their children or to accompany them during physician visits [8]. In 1998, the annual direct cost was $1574 per patient with ADHD as compared with $541 per matched control.

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    Research supported by an unconditional grant from Eli Lilly and Company.

    Portions of this manuscript were presented at the 48th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, October 2001.

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