The Brazilian policy of withholding treatment for ADHD is probably increasing health and social costs

Braz J Psychiatry. 2015 Jan-Mar;37(1):67-70. doi: 10.1590/1516-4446-2014-1378.

Abstract

Objective: To estimate the economic consequences of the current Brazilian government policy for attention-deficit/hyperactivity disorder (ADHD) treatment and how much the country would save if treatment with immediate-release methylphenidate (MPH-IR), as suggested by the World Health Organization (WHO), was offered to patients with ADHD.

Method: Based on conservative previous analyses, we assumed that 257,662 patients aged 5 to 19 years are not receiving ADHD treatment in Brazil. We estimated the direct costs and savings of treating and not treating ADHD on the basis of the following data: a) spending on ADHD patients directly attributable to grade retention and emergency department visits; and b) savings due to impact of ADHD treatment on these outcomes.

Results: Considering outcomes for which data on the impact of MPH-IR treatment are available, Brazil is probably wasting approximately R$ 1.841 billion/year on the direct consequences of not treating ADHD in this age range alone. On the other hand, treating ADHD in accordance with WHO recommendations would save approximately R$ 1.163 billion/year.

Conclusions: By increasing investments on MPH-IR treatment for ADHD to around R$ 377 million/year, the country would save approximately 3.1 times more than is currently spent on the consequences of not treating ADHD in patients aged 5 to 19 years.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / economics*
  • Brazil
  • Central Nervous System Stimulants / economics*
  • Central Nervous System Stimulants / therapeutic use
  • Child
  • Child, Preschool
  • Cost Savings
  • Cost of Illness*
  • Drug Costs*
  • Female
  • Government Regulation
  • Health Policy / economics
  • Humans
  • Male
  • Methylphenidate / economics*
  • Methylphenidate / therapeutic use
  • Withholding Treatment / economics
  • World Health Organization
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate