title: Economic impact of childhood/adolescent ADHD in a European setting: the Netherlands as a reference case.
abstract: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent psychiatric disorder in children/adolescents. This study reviews available European-based studies of ADHD-related costs and applies the findings to the Netherlands to estimate annual national costs for children/adolescents from a societal perspective. A systematic literature search was conducted for primary studies in Europe, published January 1, 1990 through April 23, 2013. Per-person cost estimates were converted to 2012 Euros and used to estimate annual national ADHD-related costs based on the Dutch 2011 census, ADHD prevalence rates, family composition, and employment rates. Seven studies met the inclusion criteria. The average total ADHD-related costs ranged from €9,860 to 14,483 per patient and annual national costs were between €1,041 and €1,529 million (M). The largest cost category was education (€648 M), representing 62 and 42 % of the low- and high-value overall national estimates, respectively. By comparison, ADHD patient healthcare costs ranged between €84 M (8 %) and €377 M (25 %), and social services costs were €4.3 M (0.3-0.4 %). While the majority of the costs were incurred by ADHD patients themselves, €161 M (11-15 %) was healthcare costs to family members that were attributable to having an ADHD child/adolescent. In addition, productivity losses of family members were €143-€339 M (14-22 %). Despite uncertainties because of the small number of studies identified and the wide range in the national cost estimates, our results suggest that ADHD imposes a significant economic burden on multiple public sectors in Europe. The limited number of European-based studies examining the economic burden of ADHD highlights the need for more research in this area.
authors.affiliation: PharmacoEpidemiology & PharmacoEconomics, University of Groningen, Antonius Deusinglaan 1, 9713, Groningen, The Netherlands, h.h.le@rug.nl.
authors.forename: Hoa H
authors.initials: HH
authors.lastname: Le
authors.forename: Paul
authors.initials: P
authors.lastname: Hodgkins
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kahle
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
authors.forename: Juliana
authors.initials: J
authors.lastname: Setyawan
authors.forename: M Haim
authors.initials: MH
authors.lastname: Erder
authors.forename: Jalpa A
authors.initials: JA
authors.lastname: Doshi
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000191:economics* / Q000453:epidemiology; D002648:Child; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence