Presentation (CTI)

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition, which typically presents in childhood. However, ADHD is increasingly recognised across the lifespan, resulting in growing demand for diagnostic and treatment services. This study examined national trends in ADHD medicines utilisation and expenditure in Ireland between 2021 and 2025 using Primary Care Reimbursement Service (PCRS) paid claims data.
METHODS: This was a repeated cross-sectional study based on paid pharmacy claims data in the community setting in Ireland. Data were obtained from the Irish Community Drug Schemes (CDS) pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS). The CDS database contains basic demographic information (age and gender) and details on reimbursed medicines coded using the WHO’s Anatomical Therapeutic Chemical (ATC) classification system for each individual with eligibility for the schemes. ADHD medications were identified using ATC codes for atomoxetine, guanfacine, lisdexamfetamine and methylphenidate.
RESULTS: ADHD medication utilisation increased substantially between 2021 and 2025; in January 2021 there were over 6,000 paid claims on the CDS, increasing to almost 23,000 paid claims in December 2025. Methylphenidate remained the most frequently prescribed ADHD medication, followed by lisdexamfetamine. Overall expenditure associated with ADHD pharmacotherapy increased from €4.4 million in 2021 to €13.4 million in 2025. In 2021, females accounted for 30% of paid claims for ADHD medicines on the General Medical Services scheme, increasing to 42% in 2025. There has also been an increase in the use of ADHD medicines in the 5 to 11 years age group; from 1.2% of claims in 2021 to 11.2% of claims in 2025.
CONCLUSIONS: This national analysis demonstrates a marked increase in ADHD medicines utilisation and expenditure in Ireland from 2021 to 2025. The findings highlight evolving patterns of ADHD diagnosis and treatment and indicate increasing pressure on healthcare resources. Ongoing monitoring of prescribing trends is warranted.