Healthcare Costs Associated With Adverse Events During Treatment Episodes for Pediatric Attention-Deficit/Hyperactivity Disorder
Author(s)
Jeff Schein, DrPH, MPH1, Maryaline Catillon, PhD2, Anaïs Lemyre, PhD3, Alice Qu, BA2, Frédéric Kinkead, MA3, Marjolaine Gauthier-Loiselle, PhD3, Martin Cloutier, MSc3, Ann Childress, MD4;
1Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA, 2Analysis Group, Inc., New York, NY, USA, 3Analysis Group, Inc., Montréal, QC, Canada, 4Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USA
1Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA, 2Analysis Group, Inc., New York, NY, USA, 3Analysis Group, Inc., Montréal, QC, Canada, 4Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USA
Presentation Documents
OBJECTIVES: Although adverse events (AEs) are common in pediatric patients treated for attention-deficit/hyperactivity disorder (ADHD), there is limited real-world evidence on their costs from a payer’s perspective. Therefore, this study assessed the healthcare costs associated with selected AEs among pediatric patients treated for ADHD in the United States (US).
METHODS: This retrospective cohort study identified patients aged 6-17 years, who received pharmacologic treatment for ADHD from a large US claims database (10/1/2015─9/30/2023). Studied AEs were selected based on statistically significant risk differences from a matching-adjusted indirect comparison of ADHD treatments. Patients were categorized into AE and AE-free cohorts based on the presence of ICD-10-CM codes for the given AE in medical claims. Cohorts were reweighted using entropy balancing such that they have similar characteristics. AE-specific costs were identified from claims with ICD-10-CM codes for a given AE and total excess healthcare costs were assessed by comparing costs per-patient-per-month (PPPM) across balanced cohorts.
RESULTS: A total of 393,919 patients met the eligibility criteria (mean age: 12.5 years; male: 65.4%; stimulant monotherapy: 71.8%). Overall, 13.6% had ≥1 studied AE during their treatment episode, with upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%) being the most common AEs. All studied AEs were associated with statistically significant AE-specific costs PPPM (asthenia: $196; somnolence: $171; insomnia: $169; vomiting: $106; dizziness: $92; upper abdominal pain: $91; irritability: $75; decreased weight: $46) and total excess healthcare costs PPPM (asthenia: $1,178; somnolence: $821; vomiting: $427; insomnia: $404; dizziness: $380; upper abdominal pain: $336; irritability: $231; decreased weight: $219; all p<0.01).
CONCLUSIONS: AEs were common during ADHD treatment episodes in pediatric patients and were associated with significant healthcare costs. Findings highlight the importance of ADHD treatments with a favorable safety profile to help reduce the considerable burden of AEs experienced by patients and corresponding healthcare costs.
METHODS: This retrospective cohort study identified patients aged 6-17 years, who received pharmacologic treatment for ADHD from a large US claims database (10/1/2015─9/30/2023). Studied AEs were selected based on statistically significant risk differences from a matching-adjusted indirect comparison of ADHD treatments. Patients were categorized into AE and AE-free cohorts based on the presence of ICD-10-CM codes for the given AE in medical claims. Cohorts were reweighted using entropy balancing such that they have similar characteristics. AE-specific costs were identified from claims with ICD-10-CM codes for a given AE and total excess healthcare costs were assessed by comparing costs per-patient-per-month (PPPM) across balanced cohorts.
RESULTS: A total of 393,919 patients met the eligibility criteria (mean age: 12.5 years; male: 65.4%; stimulant monotherapy: 71.8%). Overall, 13.6% had ≥1 studied AE during their treatment episode, with upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%) being the most common AEs. All studied AEs were associated with statistically significant AE-specific costs PPPM (asthenia: $196; somnolence: $171; insomnia: $169; vomiting: $106; dizziness: $92; upper abdominal pain: $91; irritability: $75; decreased weight: $46) and total excess healthcare costs PPPM (asthenia: $1,178; somnolence: $821; vomiting: $427; insomnia: $404; dizziness: $380; upper abdominal pain: $336; irritability: $231; decreased weight: $219; all p<0.01).
CONCLUSIONS: AEs were common during ADHD treatment episodes in pediatric patients and were associated with significant healthcare costs. Findings highlight the importance of ADHD treatments with a favorable safety profile to help reduce the considerable burden of AEs experienced by patients and corresponding healthcare costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE150
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Neurological Disorders, SDC: Pediatrics