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Clinical research was funded by Shire Pharmaceuticals Iberica Ltd (Spain). Editorial assistance was funded by Shire International GmbH. Although employees of Shire were involved in the design, collection, analysis, interpretation, and fact checking of information, the content of this manuscript, the ultimate interpretation, and the decision to submit it for publication in BMC Psychiatry was made by the authors independently. Alain Joseph from Shire reviewed and edited the manuscript for scientific accuracy.

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Health care and societal costs of the management of children and adolescents with attention-deficit/hyperactivity disorder in Spain: a descriptive analysis

Publicated to:Bmc Psychiatry. 18 (40): 40- - 2018-02-08 18(40), DOI: 10.1186/s12888-017-1581-y

Authors: Quintero, J; Ramos-Quiroga, JA; Sebastian, JS; Montanes, F; Fernandez-Jaen, A; Martinez-Raga, J; Giral, MG; Graell, M; Mardomingo, MJ; Soutullo, C; Eiris, J; Tellez, M; Pamias, M; Correas, J; Sabate, J; Garcia-Orti, L; Alda, JA

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Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood (5.3% to 7.1% worldwide prevalence), with substantial overall financial burden to children/adolescents, their families, and society. The aims of this study were to describe the clinical characteristics of children and adolescents with ADHD in Spain, estimate the associated direct/indirect costs of the disorder, and assess whether the characteristics and financial costs differed between children/adolescents adequately responding to currently available pharmacotherapies compared with children/adolescents for whom pharmacotherapies failed. Methods: This was a multicenter, cross-sectional, descriptive analysis conducted in 15 health units representative of the overall Spanish population. Data on demographic characteristics, socio-occupational status, social relationships, clinical variables of the disease, and pharmacological and non-pharmacological treatments received were collected in 321 children and adolescents with ADHD. Direct and indirect costs were estimated over one year from both a health care system and a societal perspective. Results: The estimated average cost of ADHD per year per child/adolescent was (sic)5733 in 2012 prices; direct costs accounted for 60.2% of the total costs ((sic)3450). Support from a psychologist/educational psychologist represented 45.2% of direct costs and 27.2% of total costs. Pharmacotherapy accounted for 25.8% of direct costs and 15.5% of total costs. Among indirect costs ((sic)2283), 65.2% was due to caregiver expenses. The total annual costs were significantly higher for children/adolescents who responded poorly to pharmacological treatment ((sic)7654 versus (sic)5517; P = 0.024), the difference being mainly due to significantly higher direct costs, particularly with larger expenses for non-pharmacological treatment (P = 0.012). Conclusions: ADHD has a significant personal, familial, and financial impact on the Spanish health system and society. Successful pharmacological intervention was associated with lower overall expenses in the management of the disorder.

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