Attention Deficit Hyperactivity Disorder Medication Consumption in 64 Countries from 2015 to 2019: A Longitudinal Study

Saturday, August 27, 2022

1:15 PM – 1:30 PM CEST

Location: C1M0

Publication Number: 170

Background: Timely recognition and appropriate treatment of attention deficit hyperactivity disorder (ADHD) are essential to enhance long-term outcomes of individuals with ADHD.

Objectives: To evaluate the multinational trends and patterns of ADHD medication consumption.

Methods: In this longitudinal trend study, we used pharmaceutical sales data of ADHD medication from the IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS) between 2015 and 2019, covering 64 countries across the world. ADHD medication included amphetamines, methylphenidate, atomoxetine, clonidine, and guanfacine. Consumption rates of ADHD medications were expressed as defined daily dose per 1000 child and adolescent inhabitants (aged 5-19) per day (DDD/TID). Linear mixed models were used to estimate the multinational, regional, and income level trend changes. We further explored the relationship between ADHD medication consumption and country's income, ADHD prevalence, and geographical location in multivariable linear regression analyses.

Results: The results showed that multinational ADHD medication consumption increased by +9.74% (95%CI, +6.28%, +13.33%) per year, from 1.20 DDD/TID in 2015 to 1.45 DDD/TID in 2019 across the 64 countries within thirteen geographical regions with marked differences between countries and regions. When stratified by countries' income levels, increases in ADHD medication consumption was only observed in high income countries but not in lower income countries. The greatest multinational increase over time was seen for amphetamine salts and guanfacine, with an average increase per year of +30.21% and +58.91% respectively. In 2019, the pooled consumption rates of ADHD medication were 6.49 DDD/TID (95%CI, 4.48, 9.42) in high-income countries, 0.36 DDD/TID (95%CI, 0.23, 0.58) in upper-middle-income countries and 0.02 DDD/TID (95%CI, 0.01, 0.05) in lower-middle-income countries. Multinational ADHD medication consumption was positively associated with gross domestic product per capita (P < 0.001) but not associated with ADHD prevalence (P = 0.21) and geographical region (P = 0.35).

Conclusions: Given that the global prevalence estimates of ADHD are much higher than the ADHD medication consumption in most lower income countries, there is an urgent need to evaluate the diagnostic situations of ADHD and potential barriers to ADHD medication access in these countries to minimise the risk of negative outcomes in individuals with ADHD.

Presenting Author(s)

AC

Adrienne YL Chan

The University of Hong Kong
Hong Kong SAR, Hong Kong

Slides

Co-Author(s)

TM

Tian-Tian Ma

Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong, Hong Kong
WL

Wallis Lau

Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom, United Kingdom
PI

Patrick Ip

Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
DC

David Coghill

Departments of Paediatrics and Psychiatry, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia, Australia
Le GAO

University of Hong Kong
Hong Kong, Hong Kong
YJ

Yogini Jani, PhD

Honorary Associate Professor
University College London (UCL), England, United Kingdom
YH

Yingfen Hsia

School of Pharmacy, Queen's University, Belfast, United Kingdom, United Kingdom
LW

Li Wei

Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom, United Kingdom
Katja Taxis, MD, PhD, FISPE

University of Groningen
Groningen, Groningen, Netherlands
ES

Emily Simonoff

Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom, United Kingdom
DT

David Taylor

South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, United Kingdom, United Kingdom
TL

Terry Y. Lum

Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong
Kenneth Man, PhD

Lecturer in Pharmacoepidemiology and Medication Safety
University of Hong Kong
London, United Kingdom
IW

Ian Wong

Professor
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China, Hong Kong