Cost of Illness and Comorbidities in Adults Diagnosed With Attention-Deficit/Hyperactivity Disorder

Autor: Paul Hodgkins, Rahul Sasane, LB Montejano, Dan Huse
Rok vydání: 2011
Předmět:
Zdroj: The Primary Care Companion For CNS Disorders.
ISSN: 2155-7780
DOI: 10.4088/pcc.10m01030
Popis: Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral condition characterized by core symptoms of inattentiveness, hyperactivity, and impulsivity that can manifest as disruptions in the academic, social, and home settings.1 Although once considered to be a childhood disorder, there is a growing recognition of the persistence of ADHD into adulthood and the need for treatment.2–10 The 12-month prevalence of adults with ADHD in the United States has been estimated to be 4.4%,11 making it one of the most common psychiatric disorders of adulthood. A recent meta-analysis of studies of ADHD among adults from a number of countries reported a pooled prevalence of 2.5%.12 In the workplace, ADHD places a potentially large economic burden on employers, who incur direct and indirect health care costs associated with ADHD and comorbid illnesses, resulting in significant loss in productivity.13,14 Accordingly, a 2006 study estimated the loss of ADHD-related economic productivity to be between $67 billion and $116 billion.14 In comparison, the economic burden of asthma has been estimated to be $20 billion.15 In a 2005 study of ADHD in an employed population,16 individuals with ADHD had more comorbidities (including anxiety, bipolar disorder, depression, drug or alcohol abuse, antisocial disorder, and oppositional defiant disorder), lost more work time, and utilized more health care resources than those who sought professional care for other medical problems. The same study showed that total medical costs for adults with ADHD were almost twice those of individuals without ADHD ($5,651 vs $2,771, respectively). Another study showed that each year employees with ADHD have a mean excess of 8.4 days of absence from work, 21.7 days with reduced work quantity, and 13.6 days with reduced work quality compared with employees without the condition.17 These workplace-related performance issues associated with ADHD accounted for an estimated 143.8 million days of lost productivity in the 10 countries studied.17 In the United States in 2000, work loss accounted for 12% of the estimated $31.6 billion cost of adults with ADHD or $3.7 billion.18 The objective of this study was to determine the burden of adults with ADHD in an employed population by measuring the prevalence of comorbidities and the cost of illness associated with health care utilization and workplace productivity loss comparisons in 2 groups (non-ADHD control and depression). To compare the health care utilization and annual cost of ADHD, the present study used depression as a benchmark, as depression is one of the most prevalent psychiatric conditions. It is a leading cause of social and economic burdens, costing an estimated $26.1 billion annually in medical care and up to $51.5 billion in lost productivity.19,20 Clinical Points ♦In adults with attention-deficit/hyperactivity disorder (ADHD), medical and psychiatric comorbidities are the primary drivers of health care utilization and cost. Specifically, depression, anxiety, asthma, and bipolar disorder are more highly prevalent in ADHD patients than in those without the illness. ♦Total costs of ADHD are doubled when indirect costs of lost productivity are considered. ♦Current evidence of the greater costs and clinical burden of ADHD is important to insurers and policy makers.
Databáze: OpenAIRE
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