OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is the most diagnosed psychiatric disorder in children. The non-stimulant guanfacine hydrochloride (Intuniv®) was launched in Europe for second-line treatment of ADHD in patients 6 to 17 years of age from 2016 onwards. Objective of the study is to provide insights on utilization patterns, including off-label use, in European countries for this drug.

METHODS: This is a multi-country retrospective drug utilization study using different longitudinal patient-level data sources of 6 countries, Denmark, Germany, Norway, Spain, Sweden and UK complemented by a prescriber survey in 4 countries, Belgium, Finland, Ireland and The Netherlands conducted in 2021. The observational period in the databases is from 2016 (country specific launch date) up to 2020.

RESULTS: Results are based on 16,578 patients covered in the 6 databases and insights on 218 patients provided by 102 prescribers in the survey. Based on the databases the percentage of patients with an ADHD diagnosis ranged from 75% in Denmark to 94% in Germany. Based on the survey the result ranged from 93% in Ireland to 98% in Belgium. Comorbidities of interest, mostly anxiety disorders, were documented in 5% to 36% of patients across the countries. Off-label use due to an age <6 years was very low (≤1% in all countries), while off-label use in adults (≥18 years) ranged from 3% to 35%, with high percentages observed in Belgium (35%) and the Nordic countries (Denmark 34%, Finland and Sweden, both 24%). For 51% to 98% of the patients, psychostimulants prior to the first prescription of guanfacine hydrochloride were recorded in the databases in Denmark, Germany, Norway, Spain, Sweden and UK. According to the survey, results in Belgium, Ireland, Finland and The Netherlands ranged from 53% to 75%.

CONCLUSIONS: Findings indicate that, in most countries, guanfacine hydrochloride is prescribed mainly within the label.