title: The Brazilian policy of withholding treatment for ADHD is probably increasing health and social costs.
abstract: OBJECTIVE
  To estimate the economic consequences of the current Brazilian government policy for attention-deficit/hyperactivity disorder (ADHD) treatment and how much the country would save if treatment with immediate-release methylphenidate (MPH-IR), as suggested by the World Health Organization (WHO), was offered to patients with ADHD.
  
  
  METHODS
  Based on conservative previous analyses, we assumed that 257,662 patients aged 5 to 19 years are not receiving ADHD treatment in Brazil. We estimated the direct costs and savings of treating and not treating ADHD on the basis of the following data: a) spending on ADHD patients directly attributable to grade retention and emergency department visits; and b) savings due to impact of ADHD treatment on these outcomes.
  
  
  RESULTS
  Considering outcomes for which data on the impact of MPH-IR treatment are available, Brazil is probably wasting approximately R$ 1.841 billion/year on the direct consequences of not treating ADHD in this age range alone. On the other hand, treating ADHD in accordance with WHO recommendations would save approximately R$ 1.163 billion/year.
  
  
  CONCLUSIONS
  By increasing investments on MPH-IR treatment for ADHD to around R$ 377 million/year, the country would save approximately 3.1 times more than is currently spent on the consequences of not treating ADHD in patients aged 5 to 19 years.
authors: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors: Carlos R
authors: CR
authors: Maia
authors: Instituto de Avaliação de Tecnologia em Saúde (IATS), Porto Alegre, RS, Brazil.
authors: Steffan F
authors: SF
authors: Stella
authors: Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
authors: Paulo
authors: P
authors: Mattos
authors: Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors: Guilherme V
authors: GV
authors: Polanczyk
authors: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors: Carisi A
authors: CA
authors: Polanczyk
authors: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors: Luis A
authors: LA
authors: Rohde
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000191:economics*; D001938:Brazil; D000697:Central Nervous System Stimulants / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D017281:Cost of Illness; D016527:Drug Costs; D005260:Female; D033161:Government Regulation; D006291:Health Policy / Q000191:economics; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000191:economics* / Q000627:therapeutic use; D028761:Withholding Treatment / Q000191:economics; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate