Treatment costs of attention deficit hyperactivity disorder in Germany.

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 euro 3,888, and the incremental costs were euro 2,902. The largest proportions of incremental costs were due to therapeutic devices and remedies like occupational therapy amounting to euro 1,270. Proportionate costs of euro 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.