Table 1 |
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Studies of the Direct Costs of ADHD |
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| Citation |
Sample |
Data Sources (Time Period) |
Findings1 |
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| Birnbaum et al. 2005 |
Treated ADHD patients aged 7–44 (N = 1219) and their family members under age 65 (N
= 3692); controls without ADHD matched to both patients (N = 1219) and family members
(N = 3692) on age, gender, employment status, geographical location age, gender, state
of residence, and employment status) |
Claims data from large Fortune 100 company (1996–1998) |
This study estimated total excess costs for the US population, defined as the difference
between ADHD patients/family members and controls. Annual mean direct ADHD treatment
costs (2004 US $) were $674/$745 for girls/boys with ADHD (excess costs = $0.53/$1.06
billion) and $412/$529 for female/male adults with ADHD (excess costs = $0.13/$0.40
billion). Annual other direct treatment costs (2004 US $) were $865/$990 for girls/boys
(excess costs = $0.80/$2.0 billion) and $2609/$3022 for female/male adults with ADHD
(excess costs = $0.67/$1.46 billion). |
| Burd et al. 2003a |
Children aged 0–21 years with ADHD (N = 3,872) and non-matched controls (N = 95,119)
without ADHD |
North Dakota Health Claims Database (1996–1997) |
Annual, mean direct treatment costs (2004 US $) were $870 for ADHD patients versus
$663 for controls; 1.9% of total annual health expenditures in North Dakota attributable
to ADHD. |
| Chan et al. 2002 |
Children aged 5–20 years with ADHD (N = 165), asthma (N = 322) or neither diagnosis
(N = 4,952) |
Nationally representative household survey data (1996) |
Annual, incremental direct treatment costs (2004 US $) were $661 for children with
ADHD (P < 0.001) and $603 for children with asthma (P < 0.01) (relative to costs for children with neither diagnosis) |
| Guevara et al. 2001 |
Children aged 3–17 years with ADHD (N = 2992) and matched (on age and sex) controls
(N = 11,968) without ADHD |
Health maintenance organization in western Washington State (1997) |
Annual, incremental direct treatment costs (2004 US $) were $503 (95% CI: $450–552)
for children with ADHD alone and $1088 (95% CI: $899–$1,304) for children with ADHD
plus coexisting mental health disorders (relative to costs for children with no ADHD) |
| Kelleher et al. 2001 |
Children aged 7–20 years with ADHD (N = 1,602) and with asthma (N = 1,411) |
Medicaid claims data for patients in Pittsburgh, PA and surrounding counties (1994–1995) |
Annual, mean (± SD) direct treatment costs (2004 US $) were $2,567 ± $2,959 for the
ADHD group versus $2,382 ± $2,664 for the asthma group (difference not statistically
significant) |
| Leibson et al. 2001 |
Children aged 5–19 years with ADHD (N = 309) and non-matched controls (N = 3,810)
without ADHD |
Rochester, Minnesota medical facility-linked billing data system (1987–1995) |
Long-term (9 year), median direct treatment costs (2004 US $) for ADHD patients compared
with those without ADHD were more than double ($6,158 vs. $2,780; P < 0.001), even for the subset with no hospital or emergency room admissions ($183
vs. $93; P < 0.001) |
| Leslie et al. 2001 |
Children aged ≤ 17 years with use of mental health services, including patients with
hyperactivity (N~10,000) |
Health care claims for privately insured population (MarketScan®) (1993–1996) |
Annual inpatient costs (2004 US $) per treated hyperactive patient declined from $26,550
in 1993 to $8,644 in 1996 (P < 0.001); there was also a significant decline in outpatient treatment costs ($931
and $659, respectively, P < 0.001) |
| Mandell et al. 2003 |
Children aged 3–15 years with ADHD (N = 4,306) and with no psychiatric disorder (N
= 60,975) |
Medicaid claims data for patients in Philadelphia, PA (1993–1996) |
Long-term (3 year), mean direct treatment costs (2004 US $) were $4,891 for ADHD patients
versus $221 for patients with no psychiatric disorder |
| Marchetti et al. 2001 |
Hypothetical cohort of school-aged children with ADHD |
Literature review, managed care survey, clinical experts (2000–2001) |
Average, total annual expected cost (2001 US $) per treated patient was $1,710 for
Metadate CD, $1876 for Concerta, $2,061 for methylphenidate immediate-release/extended
release (MPH IR/ER), $2,122 for MPH IR, $2,392 for Ritalin, and $2,567 for Adderall. |
| Secnik et al. 2005b |
Adults aged 18–64 with ADHD (N = 2,252) and matched controls without ADHD (N = 2252;
matched on age, gender, metropolitan statistical area, and type of insurance coverage) |
Health care claims for privately insured population (MarketScan®) (1999–2001) |
Controlling for the impact of comorbidities, adults diagnosed with ADHD had significantly
(P < 0.0001) higher outpatient costs ($3,009 vs. $1.491), inpatient costs ($1,259 vs.
$514), prescription drug costs ($1,673 vs. $1,008) and total annual medical costs
($5,651 vs. $2,771) compared with matched controls without ADHD |
| Swensen et al. 2003 |
Children aged 0–18 years with ADHD (N = 1,086) and matched (on age, gender, and state
of residence) controls (N = 1,086) without ADHD |
Claims data from large Fortune 100 company (1996–1998) |
Annual, mean (± SD) direct treatment costs (2004 US $) were $2,046 ± $3,474 for the
ADHD group versus $703 ± $2,215 for matched controls without ADHD (P < 0.0001). |
| Swensen et al. 2004 |
Individuals aged 0–64 with ADHD (N = 1,308) and matched (on age, gender, state of
residence, and employment status) controls (N = 1,308) without ADHD |
Claims data from large Fortune 100 company (1996–1998) |
Annual, mean direct treatment costs (2004 US $) were $1,797 for children with ADHD
versus $577 for matched controls without ADHD (P < 0.05); $2,230 for adolescents with ADHD versus $783 for matched controls without
ADHD (P < 0.05); and $4,929 for adults with ADHD versus $1,473 for matched controls without
ADHD (P < 0.05). |
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1All costs updated to Year 2004 US $ using the Medical Services component of the Consumer Price Index (for US-based studies). For non-US studies, all country-specific costs first updated to Year 2004 currency values based on country-specific inflators; and then converted to Year 2004 US$ based on currency exchange rates. MPH = methylphenidate IR = immediate release ER = extended release |
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Matza et al. Cost Effectiveness and Resource Allocation 2005 3:5 doi:10.1186/1478-7547-3-5 |
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