Health care and societal costs of the management of children and adolescents with attention-deficit/hyperactivity disorder in Spain: a descriptive analysis

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Abstract

Background

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood (5.3% to 7.1% worldwide prevalence), with substantial overall financial burden to children/adolescents, their families, and society. The aims of this study were to describe the clinical characteristics of children and adolescents with ADHD in Spain, estimate the associated direct/indirect costs of the disorder, and assess whether the characteristics and financial costs differed between children/adolescents adequately responding to currently available pharmacotherapies compared with children/adolescents for whom pharmacotherapies failed.

Methods

This was a multicenter, cross-sectional, descriptive analysis conducted in 15 health units representative of the overall Spanish population. Data on demographic characteristics, socio-occupational status, social relationships, clinical variables of the disease, and pharmacological and non-pharmacological treatments received were collected in 321 children and adolescents with ADHD. Direct and indirect costs were estimated over one year from both a health care system and a societal perspective.

Results

The estimated average cost of ADHD per year per child/adolescent was €5733 in 2012 prices; direct costs accounted for 60.2% of the total costs (€3450). Support from a psychologist/educational psychologist represented 45.2% of direct costs and 27.2% of total costs. Pharmacotherapy accounted for 25.8% of direct costs and 15.5% of total costs. Among indirect costs (€2283), 65.2% was due to caregiver expenses. The total annual costs were significantly higher for children/adolescents who responded poorly to pharmacological treatment (€7654 versus €5517; P = 0.024), the difference being mainly due to significantly higher direct costs, particularly with larger expenses for non-pharmacological treatment ( P = 0.012).

Conclusions

ADHD has a significant personal, familial, and financial impact on the Spanish health system and society. Successful pharmacological intervention was associated with lower overall expenses in the management of the disorder.

Electronic supplementary material

The online version of this article (10.1186/s12888-017-1581-y) contains supplementary material, which is available to authorized users.

Related collections

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Margaret C Reilly, Arthur Zbrozek, Ellen Dukes (1993)

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Author and article information

Contributors

Javier Quintero: fjquinterog@yahoo.es

Josep A. Ramos-Quiroga: ramosquiroga@gmail.com

Javier San Sebastián: jsansebastiancabases@gmail.com

Francisco Montañés: fmontanes@fhalcorcon.es

Alberto Fernández-Jaén: AFERJAEN@telefonica.net

José Martínez-Raga: martinez_josrag@gva.es

Marta García Giral: mggiral@clinic.cat

Montserrat Graell: montserrat.graell@salud.madrid.org

María J. Mardomingo: mjmardomingo@aepnya.net

César Soutullo: csoutullo@unav.es

Jesús Eiris: eirisjm@yahoo.es

Montserrat Téllez: montsetellez22@gmail.com

Montserrat Pamias: mpamias@tauli.cat

Javier Correas: jclauffer@yahoo.es

Juncal Sabaté: jchueca-c@shire.com

Laura García-Orti: lgarciaorti@shire.com

José A. Alda: +34 93280400 , jalda@sjdhospitalbarcelona.org

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 8 February 2018

Publication date PMC-release: 8 February 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 40

Affiliations

[1 ]ISNI 0000 0001 2157 7667, GRID grid.4795.f, Psychiatry Department, Hospital Universitario Infanta Leonor and Psychiatry and Medical Psychology Department, , Complutense University, ; Madrid, Spain

[2 ]GRID grid.7080.f, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; and Department of Psychiatry and Legal Medicine, , Universitat Autònoma de Barcelona, ; Bellaterra, Spain

[3 ]ISNI 0000 0004 1937 0239, GRID grid.7159.a, Child and Adolescent Psychiatry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain and Psychiatry Department, , Universidad de Alcalá, ; Madrid, Spain

[4 ]ISNI 0000 0001 2206 5938, GRID grid.28479.30, Hospital Universitario Fundación de Alcorcón, Madrid, , Spain and Rey Juan Carlos I University, ; Madrid, Spain

[5 ]GRID grid.488466.0, Department of Neuropediatrics, , Hospital Universitario Quirón, ; Madrid, Spain

[6 ]ISNI 0000 0004 1770 9825, GRID grid.411289.7, UDPyPC, , Hospital Universitario Dr. Peset and University of Valencia and University CEU-UCH, ; Valencia, Spain

[7 ]ISNI 0000 0000 9635 9413, GRID grid.410458.c, Child and Adolescent Psychiatry and Psychology Department, , Institute of Neuroscience, Hospital Clinic, ; Barcelona, Spain

[8 ]ISNI 0000 0004 1767 5442, GRID grid.411107.2, Child and Adolescent Psychiatry and Psychology Department, , Hospital Infantil Universitario Niño Jesús and Biomedical Network Research Centre on Mental Health (CIBERSAM), ; Madrid, Spain

[9 ]ISNI 0000 0001 2157 7667, GRID grid.4795.f, Child and Adolescent Psychiatry Department, Hospital Gregorio Marañón, , Universidad Complutense, ; Madrid, Spain

[10 ]ISNI 0000 0001 2191 685X, GRID grid.411730.0, Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, , University of Navarra Clinic, ; Pamplona, Spain

[11 ]ISNI 0000 0000 8816 6945, GRID grid.411048.8, Neuropediatric Division, Pediatric Department, , Complejo Hospitalario Universitario Santiago De Compostela, ; Santiago de Compostela, Spain

[12 ]ISNI 0000 0001 0360 9602, GRID grid.84393.35, Department of Neuropediatrics, Hospital La Fe, ; Valencia, Spain

[13 ]Hospital Parc Taulí, Sabadell, Spain and Autonomous University of Barcelona, Bellaterra, Spain

[14 ]Psychiatry and Mental Health Department, Hospital Universitario del Henares, Francisco de Victoria University, Madrid, Spain

[15 ]Shire, Madrid, Spain

[16 ]ISNI 0000 0001 0663 8628, GRID grid.411160.3, Child and Adolescent Psychiatry and Psychology Department, , Hospital Sant Joan de Déu, Esplugues de Llobregat, ; 08950 Barcelona, Spain

Article

Publisher ID: 1581

DOI: 10.1186/s12888-017-1581-y

PMC ID: 5806309

PubMed ID: 29422022

SO-VID: eefa3356-9e10-40e8-b398-9c53329dc8b0

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.