The medical costs of ADHD

Executive summary

Attention Deficit / Hyperactivity Disorder (ADHD) starts in childhood, but persists into adulthood in approximately half of the cases. Not only is this condition impairing for the individual, it is also costly. To gain more insights in these costs, researchers calculated the medical costs of ADHD from anonymised German health insurance data of 3.7 million people. The total surplus medical costs of a person with ADHD were on average 1508 euro. Mosts costs are made in inpatient and outpatient care, with medication costs in third place. ADHD in adults is underdiagnosed in the insurance data compared to world-wide estimates, and hence potentially undertreated. Preventing the development of comorbidites with age should be the focus of mental healthcare, i.e. through continued treatment of adolescents into adulthood.

Symptoms of inattention, hyperactivity and/or impulsivity

Onset before age 12

Impairing in multiple settings (i.e. at school and at home)

ADHD diagnosis

German health insurance data¹

World-wide prevalence of ADHD²′³

Note: As the prevalence of ADHD in the insurance data is lower than world-wide estimates of ADHD, the data likely represent only the more severe cases of ADHD.

3.3 % children with ADHD

0.2 % adults with ADHD

~5 % children with ADHD

~2.5 % adults with ADHD

25,300 individuals in the data had an ADHD diagnosis. A reference group was randomly selected from the data of individuals without ADHD, matched on age and gender with the ADHD group.  

~ 70% boys

~ 50% men

76% boys 

66% men 

Medical costs per person

All age groups

Total surplus medical costs per person with ADHD: €1508,-

Total medical costs increase in adulthood

drop in ADHD medication use and psychiatrist care

Anxiety

Depression 

Obesity

Substance abuse

The risk of developing a comorbid disorder with ADHD is higher for adults

13-17 years

13-17 years

13-17 years

13-17 years

>30 years

>30 years

>30 years

>30 years

increase in other medication, psychotherapist, and sick payment

e.g. 22% of ADHD children and 59% of ADHD adults also have an anxiety disorder

Improving the transition from child to adult mental healthcare may reduce occurence of comorbid disorders, and reduce costs

ADHD is a lifelong, impairing condition that brings along substantial medical costs

ADHD in adults is underdiagnosed. Healthcare professionals need to be trained to recognise ADHD symptoms in adulthood

Improve adult mental health care

Sources: (1) Libutzki, Ludwig, May, Jacobsen, Reif and Hartman (2019). Direct medical costs of ADHD and its comorbid conditions on basis of claims data analysis.  European Psychiatry, 58: 38-44. (2) Polanczyk, de Lima, Horta, Biedermand and Rohde (2017). The worldwide prevalence of ADHD: a systematic review and metaregression analysis.  Am J Psychiatry,164(6):942-8. (3) Simon, Czobor, Balint, Meszaros and Bitter (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br. J. Psychiatry 194, 204–211.

Image attributions: Billing by IconTrack from the Noun Project

Financial support for this study was received from the European Union's Horizon 2020 research and innovation programme

under grant agreement 667302 (Comorbid Conditions of ADHD - CoCA). This infographic reflects only the author's view.

The EC is not responsible for any use that  may be made of the information it contains.  

This infographic is licensed under Creative Commons Attribution-ShareAlike 4.0 international by CoCA www.coca-project.euEu