Assessing the Economic Burden and Benefit-cost of Treating Attention-deficit Hyperactivity Disorder in Germany

Background: Attention-deficit hyperactivity disorder (ADHD) is a condition which has been consistently documented to impact educational outcomes. Children with ADHD are regularly found to have lower educational attainment and increased likelihood of dropping out of school compared to children without ADHD. Objectives: To project the long-term societal economic consequences of reduced educational attainment, as measured by total lifetime earnings, in an untreated cohort of individuals diagnosed with ADHD in childhood, in Germany. In addition, this research aims at illustrating a cost-benefit analysis framework which could be applied to economically appraise the rate of return from investments in hypothetical health interventions targeting ADHD. Methods: Observational ADHD evidence was collated with demographic and human capital economics methods to quantify ADHD's impact on educational attainment and long-term labour outcome in Germany. The theoretical benefits deriving from effective interventions targeting ADHD were also quantified. Results: It was estimated that the average per capita lifetime earning loss associated with ADHD was €92,000 suggesting a societal loss of €2.93 billion from a single cohort (n=31,864). The benefit-cost analysis suggested that reasonably effective intervention may justify considerable investment in ADHD targeted intervention. Conclusions: Considering the broad economic consequences of the condition might suggest that interventions which change the life course of individuals with ADHD could offer cost-savings and influence future economic outputs.