Descriptive comparison of drug treatment-persistent, -nonpersistent, and nondrug treatment patients with newly diagnosed attention deficit/hyperactivity disorder in Germany

Research output: Contribution to journalArticleResearchpeer review

Authors

  • Sebastian Braun
  • Leo Russo
  • Jan Zeidler
  • Roland Linder
  • Paul Hodgkins

External Research Organisations

  • Xcenda GmbH
  • The TK Scientific Institute of Value and Efficiency in Healthcare (WINEG)
  • Shire Pharmaceuticals
  • Shire
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Details

Original languageEnglish
Pages (from-to)673-685
Number of pages13
JournalClinical Therapeutics
Volume35
Issue number5
Early online date13 Apr 2013
Publication statusPublished - May 2013

Abstract

Background: Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous behavioral disorder commonly found in children, with serious lifetime health and social consequences for both children and their parents. Public awareness of ADHD in Germany has increased in the past decade, but little is known about the costs of treating newly diagnosed patients in clinical practice. Objective: This study aimed to describe the resource utilization and treatment costs of patients aged 6 to 17 years with newly diagnosed ADHD, using patient data from a German sickness fund, and to quantify resource utilization by drug treatment and treatment persistence. Methods: To identify patients with newly diagnosed ADHD, the second largest German sickness fund was utilized. Complete claims data of all de-identified patients meeting eligibility criteria for 2007 and 2008 were extracted. Patients were divided into 1 of 3 treatment groups: drug treatment-persistent, drug treatment-nonpersistent, and nondrug treatment. The differences in costs and resource utilization are reported in a descriptive manner, with paired and unpaired 2-sample Wilcoxon tests used. Results: Of 3407 newly diagnosed patients with ADHD, 1105 (32%) received an ADHD-specific drug following diagnosis; the remaining 2302 comprised the nondrug treatment group. Of the total number of drug-treated patients, 1-year observational data were available for only 786 methylphenidate users (71%). Of these, 503 patients (64%) comprised the drug treatment-persistent group (those having at least 1 prescription every 3 months during the 12 months following their first ADHD prescription) and 283 (36%) comprised the drug treatment-nonpersistent group. After excluding those patients with <12 months of follow-up, 1779 patients (52%) were included in the nondrug-treatment group. Outpatient visits and the number of drug prescriptions and associated costs were highest in the drug treatment-persistent group (. P = 0.05); however, the number of hospital admissions and days spent in-hospital were lowest in this group. Significant average savings of €187/y in overall costs (. P = 0.05) were noted for the drug treatment-persistent group compared with the drug treatment-nonpersistent group. These mean savings were €739/y and €552/y (drug treatment-persistent group and drug treatment-nonpersistent group, respectively) compared with nondrug-treated patients. Conclusions: There are potential cost-savings benefits when patients are treatment persistent. Therefore, future disease-management programs might consider treatment persistence as potentially reducing overall payer costs. Additionally, the clinical and psychosocial situations of patients and their families should be taken into account.

Keywords

    ADHD, Claims analysis, Costs, Germany, Persistence, Resource use

ASJC Scopus subject areas

Cite this

Descriptive comparison of drug treatment-persistent, -nonpersistent, and nondrug treatment patients with newly diagnosed attention deficit/hyperactivity disorder in Germany. / Braun, Sebastian; Russo, Leo; Zeidler, Jan et al.
In: Clinical Therapeutics, Vol. 35, No. 5, 05.2013, p. 673-685.

Research output: Contribution to journalArticleResearchpeer review

Braun S, Russo L, Zeidler J, Linder R, Hodgkins P. Descriptive comparison of drug treatment-persistent, -nonpersistent, and nondrug treatment patients with newly diagnosed attention deficit/hyperactivity disorder in Germany. Clinical Therapeutics. 2013 May;35(5):673-685. Epub 2013 Apr 13. doi: 10.1016/j.clinthera.2013.03.017
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title = "Descriptive comparison of drug treatment-persistent, -nonpersistent, and nondrug treatment patients with newly diagnosed attention deficit/hyperactivity disorder in Germany",
abstract = "Background: Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous behavioral disorder commonly found in children, with serious lifetime health and social consequences for both children and their parents. Public awareness of ADHD in Germany has increased in the past decade, but little is known about the costs of treating newly diagnosed patients in clinical practice. Objective: This study aimed to describe the resource utilization and treatment costs of patients aged 6 to 17 years with newly diagnosed ADHD, using patient data from a German sickness fund, and to quantify resource utilization by drug treatment and treatment persistence. Methods: To identify patients with newly diagnosed ADHD, the second largest German sickness fund was utilized. Complete claims data of all de-identified patients meeting eligibility criteria for 2007 and 2008 were extracted. Patients were divided into 1 of 3 treatment groups: drug treatment-persistent, drug treatment-nonpersistent, and nondrug treatment. The differences in costs and resource utilization are reported in a descriptive manner, with paired and unpaired 2-sample Wilcoxon tests used. Results: Of 3407 newly diagnosed patients with ADHD, 1105 (32%) received an ADHD-specific drug following diagnosis; the remaining 2302 comprised the nondrug treatment group. Of the total number of drug-treated patients, 1-year observational data were available for only 786 methylphenidate users (71%). Of these, 503 patients (64%) comprised the drug treatment-persistent group (those having at least 1 prescription every 3 months during the 12 months following their first ADHD prescription) and 283 (36%) comprised the drug treatment-nonpersistent group. After excluding those patients with <12 months of follow-up, 1779 patients (52%) were included in the nondrug-treatment group. Outpatient visits and the number of drug prescriptions and associated costs were highest in the drug treatment-persistent group (. P = 0.05); however, the number of hospital admissions and days spent in-hospital were lowest in this group. Significant average savings of €187/y in overall costs (. P = 0.05) were noted for the drug treatment-persistent group compared with the drug treatment-nonpersistent group. These mean savings were €739/y and €552/y (drug treatment-persistent group and drug treatment-nonpersistent group, respectively) compared with nondrug-treated patients. Conclusions: There are potential cost-savings benefits when patients are treatment persistent. Therefore, future disease-management programs might consider treatment persistence as potentially reducing overall payer costs. Additionally, the clinical and psychosocial situations of patients and their families should be taken into account.",
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T1 - Descriptive comparison of drug treatment-persistent, -nonpersistent, and nondrug treatment patients with newly diagnosed attention deficit/hyperactivity disorder in Germany

AU - Braun, Sebastian

AU - Russo, Leo

AU - Zeidler, Jan

AU - Linder, Roland

AU - Hodgkins, Paul

N1 - Funding Information: This study was supported by an unrestricted grant by Shire Development, LLC , which develops and manufactures treatments for psychiatric disorders including ADHD. Drs. Russo and Hodgkins are full-time employees of, and own stock/stock options in, Shire Development, LLC. Drs. Braun and Zeidler declare no conflicts of interest.

PY - 2013/5

Y1 - 2013/5

N2 - Background: Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous behavioral disorder commonly found in children, with serious lifetime health and social consequences for both children and their parents. Public awareness of ADHD in Germany has increased in the past decade, but little is known about the costs of treating newly diagnosed patients in clinical practice. Objective: This study aimed to describe the resource utilization and treatment costs of patients aged 6 to 17 years with newly diagnosed ADHD, using patient data from a German sickness fund, and to quantify resource utilization by drug treatment and treatment persistence. Methods: To identify patients with newly diagnosed ADHD, the second largest German sickness fund was utilized. Complete claims data of all de-identified patients meeting eligibility criteria for 2007 and 2008 were extracted. Patients were divided into 1 of 3 treatment groups: drug treatment-persistent, drug treatment-nonpersistent, and nondrug treatment. The differences in costs and resource utilization are reported in a descriptive manner, with paired and unpaired 2-sample Wilcoxon tests used. Results: Of 3407 newly diagnosed patients with ADHD, 1105 (32%) received an ADHD-specific drug following diagnosis; the remaining 2302 comprised the nondrug treatment group. Of the total number of drug-treated patients, 1-year observational data were available for only 786 methylphenidate users (71%). Of these, 503 patients (64%) comprised the drug treatment-persistent group (those having at least 1 prescription every 3 months during the 12 months following their first ADHD prescription) and 283 (36%) comprised the drug treatment-nonpersistent group. After excluding those patients with <12 months of follow-up, 1779 patients (52%) were included in the nondrug-treatment group. Outpatient visits and the number of drug prescriptions and associated costs were highest in the drug treatment-persistent group (. P = 0.05); however, the number of hospital admissions and days spent in-hospital were lowest in this group. Significant average savings of €187/y in overall costs (. P = 0.05) were noted for the drug treatment-persistent group compared with the drug treatment-nonpersistent group. These mean savings were €739/y and €552/y (drug treatment-persistent group and drug treatment-nonpersistent group, respectively) compared with nondrug-treated patients. Conclusions: There are potential cost-savings benefits when patients are treatment persistent. Therefore, future disease-management programs might consider treatment persistence as potentially reducing overall payer costs. Additionally, the clinical and psychosocial situations of patients and their families should be taken into account.

AB - Background: Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous behavioral disorder commonly found in children, with serious lifetime health and social consequences for both children and their parents. Public awareness of ADHD in Germany has increased in the past decade, but little is known about the costs of treating newly diagnosed patients in clinical practice. Objective: This study aimed to describe the resource utilization and treatment costs of patients aged 6 to 17 years with newly diagnosed ADHD, using patient data from a German sickness fund, and to quantify resource utilization by drug treatment and treatment persistence. Methods: To identify patients with newly diagnosed ADHD, the second largest German sickness fund was utilized. Complete claims data of all de-identified patients meeting eligibility criteria for 2007 and 2008 were extracted. Patients were divided into 1 of 3 treatment groups: drug treatment-persistent, drug treatment-nonpersistent, and nondrug treatment. The differences in costs and resource utilization are reported in a descriptive manner, with paired and unpaired 2-sample Wilcoxon tests used. Results: Of 3407 newly diagnosed patients with ADHD, 1105 (32%) received an ADHD-specific drug following diagnosis; the remaining 2302 comprised the nondrug treatment group. Of the total number of drug-treated patients, 1-year observational data were available for only 786 methylphenidate users (71%). Of these, 503 patients (64%) comprised the drug treatment-persistent group (those having at least 1 prescription every 3 months during the 12 months following their first ADHD prescription) and 283 (36%) comprised the drug treatment-nonpersistent group. After excluding those patients with <12 months of follow-up, 1779 patients (52%) were included in the nondrug-treatment group. Outpatient visits and the number of drug prescriptions and associated costs were highest in the drug treatment-persistent group (. P = 0.05); however, the number of hospital admissions and days spent in-hospital were lowest in this group. Significant average savings of €187/y in overall costs (. P = 0.05) were noted for the drug treatment-persistent group compared with the drug treatment-nonpersistent group. These mean savings were €739/y and €552/y (drug treatment-persistent group and drug treatment-nonpersistent group, respectively) compared with nondrug-treated patients. Conclusions: There are potential cost-savings benefits when patients are treatment persistent. Therefore, future disease-management programs might consider treatment persistence as potentially reducing overall payer costs. Additionally, the clinical and psychosocial situations of patients and their families should be taken into account.

KW - ADHD

KW - Claims analysis

KW - Costs

KW - Germany

KW - Persistence

KW - Resource use

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U2 - 10.1016/j.clinthera.2013.03.017

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