The prevalence and incidence, resource use and financial costs of treating people with attention deficit/hyperactivity disorder (ADHD) in the United Kingdom (1998 to 2010)

Abstract

Background: Attention deficit/hyperactivity disorder (ADHD) is a common disorder that often presents in childhood and is associated with increased healthcare resource use. The aims of this study were to characterise the epidemiology of diagnosed ADHD in the UK and determine the resource use and financial costs of care.

Methods: For this retrospective, observational cohort study, patients newly diagnosed with ADHD between 1998 and 2010 were identified from the UK Clinical Practice Research Datalink (CPRD) and matched to a randomly drawn control group without a diagnosis of ADHD. The prevalence and incidence of diagnosed ADHD were calculated. Resource utilisation and corresponding financial costs post-diagnosis were estimated for general practice contacts, investigations, prescriptions, outpatient appointments, and inpatient admissions.

Results: Incidence of diagnosed ADHD (and percentage change using 1998 as a reference) increased from 6.9 per 100,000 population in 1998 to 12.2 per 100,000 (78%) in 2007 and then fell to 9.9 per 100,000 (44%) by 2009. The corresponding prevalence figures were 30.5, 88.9 (192%) and 81.5 (167%) per 100,000. Incidence and prevalence were higher in males than females. Mean annual total healthcare costs were higher for ADHD cases than controls (£1,327 versus £328 for year 1, £1,196 vs. £337 for year 2, £1,148 vs. £316 for year 3, £1,126 vs. £325 for year 4, and £1,112 vs. £361 for year 5).

Conclusions: The prevalence of diagnosed ADHD in routine practice in the UK was notably lower than in previous reports, and both prevalence and incidence of diagnosed ADHD in primary care have fallen since 2007. Financial costs were more than four times higher in those with ADHD than in those without ADHD.

Figure 1

Incidence of ADHD (per 100,000 person-years) in the UK between 1998 and 2010 a) by age group, b) for patients aged 6–17 years by gender and c) Patients aged ≥18 years by gender.

Figure 2

Incidence of first prescription for ADHD medication (per 100,00 person-years) by age group between 1998 and 2010.

Figure 3

Prevalence of ADHD (per 100,000) in the UK between 1998 and 2009 a) by age group, b) for patients aged 6–17 years at index date by gender and c) for patients aged ≥18 years at index date.

Figure 4

Distribution of healthcare costs in the first year following index date.

Figure 5

Breakdown of average annual costs (all ages) in the first year following index date.