title: Association between societal costs and treatment response in children and adolescents with ADHD and their parents. A cross-sectional study in the Netherlands.
abstract: Attention Deficit Hyperactivity Disorder (ADHD) is associated with considerable burden of illness at a patient, family and societal level. Although pharmacological treatment is recommended by authoritative guidelines, evidence on its influence on the broader burden of illness is limited. As treatment induces costs, proper healthcare decision making requires evidence on the associated societal costs or benefits and particularly the difference that response to treatment can make. Data on ADHD related resource use of patients 8-18 years and parents were collected by means of a cross-sectional, online survey amongst members of the Dutch parent association. Children were stratified to responders and non-responders to treatment according to pre-defined expert definitions. Analyses were performed on 618 questionnaires (428 responders; 190 non-responders to treatment). Children were 11.8 years on average and mainly boys (82 %). Total monthly costs for children were €578 and €839 for responders and non-responders, respectively (p = 0.021), with a breakdown to direct medical costs (€322 vs. €512; p = 0.068), direct non-medical costs (€222 vs. €296; p = 0.090), and indirect non-medical costs (€34 vs. €57; p < 0.001). For parents, total costs were €246 vs. €399 for the responding and non-responding children, respectively (p = 0.006), with a breakdown to direct medical costs (€130 vs. €211; p = 0.010) and indirect non-medical costs (€116 vs. €181; p = 0.092). Total monthly costs of children and their parents together were €824 and €1228 for responders and non-responders to treatment, respectively (p = 0.002). These results stress the importance of a focus on response to treatment, not only beneficial for patients and their family, but also resulting in considerable societal benefits.
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, P.O. Box 9010, 6500 GL Nijmegen, the Netherlands ; Janssen-Cilag BV, P.O. Box 90240, 5000 LT Tilburg, the Netherlands.
authors.forename: Annemarie
authors.initials: A
authors.lastname: van der Kolk
authors.affiliation: Institute for Medical Technology Assessment (iMTA), P.O. Box 1738, 3000, DR Rotterdam, the Netherlands.
authors.forename: Clazien Am
authors.initials: CA
authors.lastname: Bouwmans
authors.affiliation: Institute for Medical Technology Assessment (iMTA), P.O. Box 1738, 3000, DR Rotterdam, the Netherlands.
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Schawo
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, P.O. Box 9010, 6500 GL Nijmegen, the Netherlands ; Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, the Netherlands.
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.affiliation: Gilead Sciences B.V., Amsterdam, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: van Agthoven
authors.affiliation: Institute for Medical Technology Assessment (iMTA), P.O. Box 1738, 3000, DR Rotterdam, the Netherlands.
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
keywords: ADHD; Burden of illness; Cross-sectional; Societal costs; Treatment response