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Introduction <p>Adverse events (AEs) are common in pediatric patients receiving attention-deficit/hyperactivity disorder (ADHD) treatment; however, real-world studies on their costs from a payer’s perspective are lacking. Therefore, this study investigated the healthcare costs associated with selected AEs among pediatric patients receiving ADHD treatment in the United States.</p> Methods <p>Using a retrospective cohort design, patients aged 6–17&#xa0;years who received pharmacologic treatment for ADHD were identified from US claims data (October 1, 2015–September 30, 2023) and were categorized into AE and AE-free cohorts, separately for each studied AE. The eight selected AEs had statistically significant risk differences in a matching-adjusted indirect comparison of ADHD treatments and were identifiable from claims with ICD-10-CM codes. Entropy balancing was used to create cohorts with similar characteristics. Total excess healthcare costs and costs associated with AE-specific claims per patient per month (PPPM) were compared across balanced cohorts with vs. without a given AE.</p> Results <p>Overall, 393,919 patients (mean age: 12.5&#xa0;years; male: 65.4%; stimulant monotherapy: 71.8%) were included, among whom 13.6% had ≥ 1 studied AE that resulted in a medical encounter during their treatment episode. The most prevalent AEs were upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%). All AEs were associated with substantial AE-specific costs PPPM (asthenia: $196; somnolence: $171; insomnia: $169; vomiting: $106; dizziness: $92; upper abdominal pain: $91; irritability: $75; decreased weight: $46) and total excess healthcare costs PPPM (asthenia: $1178; somnolence: $821; vomiting: $427; insomnia: $404; dizziness: $380; upper abdominal pain: $336; irritability: $231; decreased weight: $219; all <i>p </i>&lt; 0.01).</p> Conclusions <p>AEs were common during ADHD treatment episodes in pediatric patients and were associated with significant healthcare costs. ADHD treatments with a favorable safety profile could help alleviate the economic burden of AEs.</p>

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Healthcare Costs Associated with Adverse Events in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder (ADHD): A Claims-Based Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月11日

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  • Jeff Schein,
  • Maryaline Catillon,
  • Anaïs Lemyre,
  • Alice Qu,
  • Frederic Kinkead,
  • Marjolaine Gauthier-Loiselle,
  • Martin Cloutier,
  • Ann Childress

摘要

Introduction

Adverse events (AEs) are common in pediatric patients receiving attention-deficit/hyperactivity disorder (ADHD) treatment; however, real-world studies on their costs from a payer’s perspective are lacking. Therefore, this study investigated the healthcare costs associated with selected AEs among pediatric patients receiving ADHD treatment in the United States.

Methods

Using a retrospective cohort design, patients aged 6–17 years who received pharmacologic treatment for ADHD were identified from US claims data (October 1, 2015–September 30, 2023) and were categorized into AE and AE-free cohorts, separately for each studied AE. The eight selected AEs had statistically significant risk differences in a matching-adjusted indirect comparison of ADHD treatments and were identifiable from claims with ICD-10-CM codes. Entropy balancing was used to create cohorts with similar characteristics. Total excess healthcare costs and costs associated with AE-specific claims per patient per month (PPPM) were compared across balanced cohorts with vs. without a given AE.

Results

Overall, 393,919 patients (mean age: 12.5 years; male: 65.4%; stimulant monotherapy: 71.8%) were included, among whom 13.6% had ≥ 1 studied AE that resulted in a medical encounter during their treatment episode. The most prevalent AEs were upper abdominal pain (5.2%), vomiting (3.4%), and insomnia (3.2%). All AEs were associated with substantial AE-specific costs PPPM (asthenia: $196; somnolence: $171; insomnia: $169; vomiting: $106; dizziness: $92; upper abdominal pain: $91; irritability: $75; decreased weight: $46) and total excess healthcare costs PPPM (asthenia: $1178; somnolence: $821; vomiting: $427; insomnia: $404; dizziness: $380; upper abdominal pain: $336; irritability: $231; decreased weight: $219; all p < 0.01).

Conclusions

AEs were common during ADHD treatment episodes in pediatric patients and were associated with significant healthcare costs. ADHD treatments with a favorable safety profile could help alleviate the economic burden of AEs.