title: [Age- and Gender-specific Costs as Well as Drug Therapies of ADHD Patients].
abstract: Backround and Objectives: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental disorders in children and adolescents. The rate of persistence into adulthood varies up to 60% and shows the importance of the disease. Here we present age-stratified cost information on adult patients, as well as data on occupational therapy, medication and multimodal treatment. Furthermore, we also investigated retrospectively if methylphenidate was prescribed for adults already before its approval in 2011.
  
  
  METHODS
  Claims data of a major German insurance fund (Techniker Krankenkasse) was available. Inclusion criteria were patients with ADHD diagnosis, either hospitalized or treated on an outpatient basis in 2006, 2007 and 2008 and insured over this period. This enabled identifying this disease as chronic. The data were analyzed as part of a control group design (1:3). Cost differences were examined as also the odds ratios for the burden of comorbidities and use of atomoxetine and methylphenidate.
  
  
  RESULTS
  77.9% of the identified ADHD patients were male (mean age: 16.5 years ±11.1). The mean total costs of patient treatment were € 2,032 (±4,112). The odds ratio was highest for the indication developmental disorders of scholastic skills (15.4) and differed between the sexes (female: 24.0 vs. male: 14.2). Drug prescription was higher in male than in female patients (atomoxetine: 7.2 vs. 5.9% and methylphenidate 59.1 vs. 48.4%).
  
  
  CONCLUSIONS
  This study provides important insights into the importance of the adult ADHD collective. There were increasing resource consumption identified in adult ADHD patients. In addition, methylphenidate was used off-label for treating adults already before 2011 and its approval in 2011 provided increased certainty for physicians regarding prescription of this drug.
authors.affiliation: Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover.
authors.forename: M
authors.initials: M
authors.lastname: Klora
authors.affiliation: Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover.
authors.forename: J
authors.initials: J
authors.lastname: Zeidler
authors.affiliation: Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover.
authors.forename: D
authors.initials: D
authors.lastname: Lublow
authors.affiliation: Techniker Krankenkasse, WINEG, Hamburg.
authors.forename: R
authors.initials: R
authors.lastname: Linder
authors.affiliation: Techniker Krankenkasse, WINEG, Hamburg.
authors.forename: F
authors.initials: F
authors.lastname: Verheyen
authors.affiliation: Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover.
authors.forename: J-M G
authors.initials: JM
authors.lastname: von der Schulenburg
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000191:economics*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants