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PharmacoEconomics

, Volume 23, Issue 1, pp 93–102 | Cite as

Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder

  • Kristina Secnik
  • Andrine Swensen
  • Maureen J. Lage
Original Research Article

Abstract

Introduction: The purpose of this retrospective study was to examine the prevalence of comorbidities, resource use, direct medical costs, and the costs associated with missed work for adults diagnosed with attention-deficit hyperactivity disorder (ADHD).

Study design: From a large claims database that captures inpatient, outpatient and prescription drug services, individuals diagnosed with ADHD between the years 1999 and 2001 were retrospectively identified. The ADHD cohort (n = 2252) were matched with a non-ADHD cohort (n = 2252) on a 1: 1 ratio, based upon age, gender, metropolitan statistical area and type of insurance coverage. The ADHD cohort was compared with the non-ADHD cohort for differences in comorbidities and direct medical costs (inpatient, outpatient and prescription drug costs) using year 2001 prices.

Using data from six Fortune 200 employers, time missed from work and costs associated with absenteeism, short-term disability and worker’s compensation was examined for a subsample (n = 354) of the employees diagnosed with ADHD.

Chi-square and t-statistics were used to compare the ADHD population with the control group with regards to comorbidites and service use. Analysis of covariance and multivariate regressions were used to examine differences in days missed from work, direct medical costs and costs associated with missed work.

Results: Adults diagnosed with ADHD were significantly more likely to have a comorbid diagnosis of asthma (p = 0.0014), anxiety (p < 0.0001), bipolar disorder (p < 0.0001), depression (p < 0.0001), drug or alcohol abuse (p < 0.0001), antisocial disorder (p = 0.0081) or oppositional disorder (p = 0.0022) compared with the control group. Controlling for the impact of comorbidities, adults diagnosed with ADHD had significantly higher outpatient costs ($US3009 vs $US1492; p < 0.0001), inpatient costs ($US1259 vs $US514; p < 0.0001), prescription drug costs ($US1673 vs $US1008; p < 0.0001), and total medical costs ($US5651 vs $US2771; p < 0.0001) compared with the non-ADHD cohort. Employees diagnosed with ADHD missed significantly more days due to ‘unofficial’ absences (4.33 days vs 1.13 days; p < 0.0001).

Conclusions: The results demonstrate that adults diagnosed with ADHD have a higher prevalence of comorbidities, higher medical costs and more absences than matched individuals without ADHD. These findings suggest that there may be an opportunity for the effective treatment of ADHD to lead to cost-offsets.

Keywords

Irritable Bowel Syndrome Direct Medical Cost Prescription Drug Cost Medical Claim Data Mental Illness Diagnosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

Funding for this project was provided by Eli Lilly and Company. Kristina Secnik and Andrine Swensen are salaried employees of Lilly Research Laboratories. Maureen J. Lage is a consultant to Eli Lilly and Company. The authors have no other potential conflicts of interest. All three authors contributed equally to study design and construction of the manuscript. MJL had primary responsibility for the analyses. We would like to thank the editor and five anonymous referees for helpful comments.

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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Kristina Secnik
    • 1
  • Andrine Swensen
    • 1
  • Maureen J. Lage
    • 2
    • 3
  1. 1.Lilly Research LaboratoriesIndianapolisUSA
  2. 2.Department of Health Administration, School of BusinessQuinnipiac UniversityHamdenUSA
  3. 3.HealthMetrics Outcomes ResearchGrotonUSA

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