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Use of Drugs for ADHD in the United States. Andrew D. Mosholder, M.D., M.P.H. FDA Division of Drug Risk Evaluation. Topics. Recent epidemiologic data on ADHD from CDC survey (National Survey of Children’s Health) Patterns of ADHD drug use from Verispan database.

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Use of Drugs for ADHD in the United States

Andrew D. Mosholder, M.D., M.P.H.

FDA Division of Drug Risk Evaluation


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Topics

  • Recent epidemiologic data on ADHD from CDC survey (National Survey of Children’s Health)

  • Patterns of ADHD drug use from Verispan database


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CDC 2003 NSCH SurveyMMWR 2005;54:[842-847]

  • National Survey of Children’s Health (NSCH)

    • Telephone survey conducted 2003-4

    • ~100K subjects ages 4-17 years

    • Parents or guardians in household responded to questions about diagnosis and treatment of ADHD

    • Statistical projections to national and state level


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Source: Centers for Disease Control and Prevention. Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].


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Source: Centers for Disease Control and Prevention. Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].


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Source: Centers for Disease Control and Prevention. Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].


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CDC 2003 NSCH Survey Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].Conclusions

  • High prevalence of ADHD diagnosis and medication use in children and adolescents

    • Estimated 2.5 mil children aged 4-17 years receiving medication for ADHD

    • = 4.3% of all children in that age group

    • Males > females

  • Regional variation in ADHD diagnosis and medication use

  • Medication use peaks around ages 9-12

    • 9.3% of boys aged 12

    • 3.7% of girls aged 11

  • Limitations: survey data, dependent upon parental recall


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ADHD Drug Use in the U.S. Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].

  • Data source: Verispan, LLC, Vector One®: National (VONA)

    • Collects data on prescription activity from retail pharmacies from multiple sources

    • Includes data on prescriber specialty, patient age, gender

    • Data available for >1.8 bil Rxs per year, for 150 million patients in the U.S.

    • Does not provide data on indication for Rx, or duration of treatment


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8 Drug Substances Included in VONA data Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].

  • Amphetamine/ Dextroamphetamine combinations (Adderall, Adderall XR)

  • Atomoxetine (Strattera)

  • Dextroamphetamine (Dexedrine)

  • Dexmethylphenidate (Focalin, Focalin XR)

  • Methamphetamine (Rx drug only, Desoxyn)

  • Methylphenidate (e.g., Ritalin)

  • Modafinil (Provigil)

  • Pemoline (Cylert)


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Source: Vector One®: National (VONA) Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].


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Total Number of Retail Prescriptions Dispensed for 8 ADHD Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder – United States, 2003. MMWR 2005;54:[842-847].Drugs by Patient Age: January 2002 to June 2005 by Quarter

Source: Vector One®: National (VONA)


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Top 10 Prescriber Specialties of Retail Prescriptions Dispensed for8 Selected ADHD Drugs: January 2000 to June 2005, all ages

Source: Vector One®: National (VONA)




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U.S. Drug Use Data from Vector One®: National (VONA) Dispensed forConclusions

  • Increasing use of drugs for ADHD by both adults (19+) and children (0-18)

  • Currently, ~1 mil. prescriptions dispensed monthly for adults and ~2 mil prescriptions dispensed monthly for children

  • Methylphenidate products most frequently prescribed, followed by amphetamine, atomoxetine


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Acknowledgements Dispensed for

  • Susanna Visser, MS and Ruth Perou, PhD

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention

  • Carol Pamer, R.Ph.

    • FDA Office of Drug Safety


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