Objectives
To comprehensively assess the economic burden associated with ADHD among children and adolescents in the US in 2018.
Methods
Excess costs (in 2018 US dollars) incurred by children and adolescents with ADHD were evaluated from a societal perspective. Direct healthcare costs were estimated using data from the Truven Health Analytics MarketScan® database (01/01/2013-12/31/2018). Direct healthcare costs, non-direct healthcare costs (i.e., research and training, education, substance use [adolescent only], and road traffic accidents [adolescents only]), and indirect costs (i.e., caregiving, unemployment [adolescent only], productivity loss [adolescent only], and premature mortality [adolescent only]) were assessed using academic and governmental publications.
Results
Based on an estimated ADHD prevalence of 10.0% among children (N=2.9 million) and 6.5% among adolescents (N=1.7 million), total excess costs incurred by children and adolescents with ADHD were estimated at $19.4 billion ($6,799 per individual) and $13.8 billion ($8,349 per individual), respectively. Among children, excess costs comprised $5.0 billion (25.9%) in direct healthcare costs, $11.7 billion (60.0%) in direct non-healthcare costs, and $2.7 billion (14.1%) in indirect costs (caregiving costs only). Among adolescents, excess costs comprised $4.0 billion (29.0%) in direct healthcare costs, $7.4 billion (53.5%) in direct non-healthcare costs, and $2.4 billion (17.5%) in indirect costs. Excess direct healthcare costs were mainly driven by pharmacy costs ($2.7 billion [54.3%] for children; $1.8 billion [44.9%] for adolescents). Excess direct non-healthcare costs were mainly driven by education costs ($11.6 billion [99.9%] for children; $6.7 billion [91.3%] for adolescents). Excess indirect costs were mainly driven by caregiving costs for adolescents ($1.6 billion [65.8%]).
Conclusions
The economic burden of ADHD is substantial among children and adolescents and was mainly driven by excess costs in education and caregiving. These data further emphasize the need for new approaches to reduce the high burden of ADHD in these populations.
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