Treatment costs of attention deficit hyperactivity disorder in Germany
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ORIGINAL PAPER
Treatment costs of attention deficit hyperactivity disorder in Germany Sebastian Braun • Jan Zeidler • Roland Linder Susanne Engel • Frank Verheyen • Wolfgang Greiner
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Received: 10 April 2012 / Accepted: 29 October 2012 / Published online: 21 November 2012 Springer-Verlag Berlin Heidelberg 2012
Abstract Background Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioural disorders among children and adolescents. The number of patients as well as prescriptions to treat this disease has continuously increased over the past few years. The aim of the present study was to analyse the costs for treating ADHD patients from the perspective of a major German health insurance fund. Methodology Anonymised administrative claims data were available for the study. All services reimbursed by the health fund for the selected ADHD patients were recorded. Apart from the resource use attributed directly to ADHD, co-morbidities as well as incremental costs were described based on a control group design. Results A total of 30,264 ADHD patients were diagnosed in 2008. The total costs for these patients were €3,888, and the incremental costs were €2,902. The largest proportions of incremental costs were due to therapeutic devices and remedies like occupational therapy amounting to €1,270.
Proportionate costs of €263 have been settled for pharmacotherapy with Methylphenidate and Atomoxetine. However, 41 % of the patients were not treated with ADHD-related pharmaceuticals. Conclusions ADHD costs are relevant from health insurance perspective. The expenses for occupational therapy constitute the cost driver. Compared to the findings of studies from the United States and contrarily to the backdrop of public discussions about considerably increased prescriptions of ADHD-specific drugs, the significantly higher additional expenses for occupational therapy services are impressing. This kind of therapy is internationally rather unknown and is therefore not acknowledged as a therapeutic standard. Keywords ADHD Social health insurance fund Claims data Costs Germany JEL
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Background S. Braun (&) Herescon GmbH–Health Economic Research and Consulting, Ko¨nigsworther Straße 2, 30167 Hannover, Germany e-mail: [email protected] J. Zeidler Center for Health Economics, Leibniz University Hannover, Hannover, Germany R. Linder S. Engel F. Verheyen Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany W. Greiner Faculty of Health Sciences, University of Bielefeld, Bielefeld, Germany
Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioural disorders among children and adolescents. It is a chronic disorder with considerable restrictions for the affected patients. ADHD can be diagnosed in case of inattentive and impulsive behaviour in combination with or without obvious hyperactivity which does not depend on the patient’s age or stage of development and which leads to clear negative effects in social relationships as well as at school
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