The Burden of Attention-Deficit/Hyperactivity Disorder in Adults: A Real-World Linked Data Study

Area of Science:

• Psychiatry
• Health Economics
• Pharmacology

Background:

• Attention-deficit/hyperactivity disorder (ADHD) poses significant humanistic and economic burdens on adult patients.
• Treatment strategies for adult ADHD vary, including immediate-release (IR) only, extended-release (ER) only, combined ER+IR stimulant formulations, and no medication.

Purpose of the Study:

• To assess the humanistic and economic burden of adult ADHD across different stimulant treatment regimens.
• To compare health-related quality of life (HRQoL), work productivity, activity impairment, healthcare resource utilization (HRU), and costs among ADHD patients on IR, ER, ER+IR, or unmedicated.

Main Methods:

• Linked data from the National Health and Wellness Survey and claims databases were analyzed.
• Patient characteristics and outcomes were compared across four groups: IR only, ER only, ER+IR stimulants, and unmedicated ADHD patients.
• Bivariate and multivariable analyses were employed to determine significant differences.

Main Results:

• The unmedicated group exhibited significantly lower physical component summary scores and higher HRU and costs compared to the ER+IR group.
• Multivariable analysis indicated the unmedicated group had double the outpatient visits and higher total annual direct costs than the ER+IR group.
• Mental health comorbidities were associated with poorer HRQoL mental component summary scores and increased activity impairment.

Conclusions:

• Adult ADHD patients treated with longer duration of effect (DoE) stimulant formulations, particularly ER+IR, demonstrate improved economic outcomes and potential cost savings.
• The management of adult ADHD should consider the impact of mental health comorbidities on patient outcomes.
• Longer DoE stimulant formulations may offer a more effective and cost-efficient treatment approach for adult ADHD.