OBJECTIVES: Since methylphenidate (MPH), an ADHD treatment, is highly likely to be misused or abused due to concentration enhancement, diet, or addiction, strict regulatory management is required. We aimed to confirm the national MPH regulatory status in Korea by analyzing all prescriptions unrelated to whether drug reimbursement, the number of discards, and prescription trends.

METHODS: NIMS Data is nationwide real-world data that includes both paid and unpaid prescriptions of narcotics built by the Korea Institute of Drug Safety & Risk Management. Using the 2020-2021 use-dataset, we analyzed the number of MPH net usage (MPH_NU) through the total number of MPH usage and MPH discards for two years, and the differences in use, prescription pattern, healthcare institution utilization of MPH by sex and age of patients prescribed MPH. Next, the data for each year and changes were analyzed in more detail.

RESULTS: The MPH_NU over the past two years was 81,992,244.4ea, and the discards were 7,241.4ea. Men were prescribed twice as many MPH as women (66.8% vs. 33.2%), and it was the most prescribed in clinics (70.0%) and 10s (36.7%). The use of teenage boys was high (42.4%), and women were in their teens and 20s. Under 10, ER-MPH was 2.2 times more prescribed than that of IR/OROS-MPH combined, and the prescribed ratio of IR/OROS-MPH to IR-MPH increased rapidly as the age increased. Compared to 2020, the MPH_NU increased (20.5%), and markedly, the discards increased by 797.9% in 2021. Additionally, prescriptions increased the most in clinics (88.3%), but the increase rate was the highest in public health centers (55.1%).

CONCLUSIONS: This study revealed that MPH usage was nationally well-regulated from prescription to disposal from the recent entire MPH usage data. Future research is needed from a long-term regulatory perspective by linking real-world medical data and NIMS data.