Healthcare Costs Associated with Adverse Events in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder
Jeff Schein1, Maryaline Catillon2, Anaïs Lemyre3
1Global Value & Real World Evidence, Otsuka Pharmaceutical Development & Commercialization, Inc., 508 Carnegie Center, Princeton, NJ, 08540, USA.
Insights
Adverse events (AEs) during attention-deficit/hyperactivity disorder (ADHD) treatment in children are common and costly. Optimizing ADHD treatments for safety can reduce the economic burden of these AEs.
Area of Science:
- Pediatric pharmacology
- Health economics
- Clinical research
Background:
- Adverse events (AEs) are frequent in pediatric patients undergoing treatment for attention-deficit/hyperactivity disorder (ADHD).
- Real-world data on the economic impact of AEs from a payer's perspective are limited.
- This study addresses the gap by examining healthcare costs linked to specific AEs in pediatric ADHD treatment.
Purpose of the Study:
- To quantify the healthcare costs associated with selected adverse events (AEs) in pediatric patients receiving attention-deficit/hyperactivity disorder (ADHD) treatment.
- To provide a payer's perspective on the economic burden of AEs in this population.
- To identify specific AEs contributing significantly to healthcare expenditures.
Main Methods:
- Retrospective cohort study utilizing US claims data from October 1, 2015, to September 30, 2023.
- Inclusion of pediatric patients aged 6-17 years receiving pharmacologic ADHD treatment.
- Use of entropy balancing to create comparable AE and AE-free cohorts for cost analysis (per patient per month).
Main Results:
- Over 393,000 pediatric patients were analyzed; 13.6% experienced at least one studied AE.
- The most common AEs included upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%).
- All studied AEs incurred significant costs, with asthenia showing the highest AE-specific ($196) and total excess costs ($1178) per patient per month.
Conclusions:
- Adverse events are prevalent during ADHD treatment in pediatric patients and impose substantial healthcare costs.
- The economic burden associated with AEs highlights the importance of considering safety profiles in ADHD treatment selection.
- Developing ADHD therapies with improved safety could mitigate the financial impact of adverse events.
Introduction:
Adverse events (AEs) are common in pediatric patients receiving attention-deficit/hyperactivity disorder (ADHD) treatment; however, real-world studies on their costs from a payer's perspective are lacking. Therefore, this study investigated the healthcare costs associated with selected AEs among pediatric patients receiving ADHD treatment in the United States.
Methods:
Using a retrospective cohort design, patients aged 6-17 years who received pharmacologic treatment for ADHD were identified from US claims data (October 1, 2015-September 30, 2023) and were categorized into AE and AE-free cohorts, separately for each studied AE. The eight selected AEs had statistically significant risk differences in a matching-adjusted indirect comparison of ADHD treatments and were identifiable from claims with ICD-10-CM codes. Entropy balancing was used to create cohorts with similar characteristics. Total excess healthcare costs and costs associated with AE-specific claims per patient per month (PPPM) were compared across balanced cohorts with vs. without a given AE.
Results:
Overall, 393,919 patients (mean age: 12.5 years; male: 65.4%; stimulant monotherapy: 71.8%) were included, among whom 13.6% had ≥ 1 studied AE that resulted in a medical encounter during their treatment episode. The most prevalent AEs were upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%). All AEs were associated with substantial AE-specific costs PPPM (asthenia: $196; somnolence: $171; insomnia: $169; vomiting: $106; dizziness: $92; upper abdominal pain: $91; irritability: $75; decreased weight: $46) and total excess healthcare costs PPPM (asthenia: $1178; somnolence: $821; vomiting: $427; insomnia: $404; dizziness: $380; upper abdominal pain: $336; irritability: $231; decreased weight: $219; all p < 0.01).
Conclusions:
AEs were common during ADHD treatment episodes in pediatric patients and were associated with significant healthcare costs. ADHD treatments with a favorable safety profile could help alleviate the economic burden of AEs.
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