PMH27 - RETROSPECTIVE HEALTHCARE CLAIMS DATA ANALYSIS FOR CHILDREN/ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER RECEIVING SECOND-LINE PHARMACOTHERAPY IN GERMANY, EVALUATING PATIENT CHARACTERISTICS AND HEALTHCARE COSTS

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous neurodevelopmental disorder associated with persistent and cross-situational occurring symptoms, including inattention, hyperactivity and/or impulsivity. The study aimed to evaluate healthcare claims data (demographics, co-occurring disorders and healthcare costs) for children/adolescents with ADHD treated with second-line lisdexamfetamine (LDX) or atomoxetine (ATX) in Germany. This was a retrospective claims data analysis conducted using the InGef research database containing anonymized healthcare claims of approximately 4 million individuals covered by statutory health insurance in Germany. Children/adolescents (6–17 years) with an ADHD diagnosis and first prescription of second-line LDX or ATX after methylphenidate treatment were included in the study. Demographic characteristics, co-occurring mental and behavioural disorders (by ICD-10-GM code groups) and direct healthcare costs were analysed in an individual 1-year post-index period after identification in 2014. A total of 451 children/adolescents with ADHD treated with LDX and 176 treated with ATX were identified (81% and 79% male patients, respectively). The LDX cohort was statistically significantly older (mean age 11.4 vs 10.9 years; p=0.0065). Behavioural/emotional disorders (F91-98) with specific childhood/adolescence onset were reported for 55% and 58% patients in the LDX and ATX cohorts, respectively. Disorders of psychological development (F80-89) were reported for 47% and 52%, respectively. Lower mean inpatient costs were reported in the LDX cohort compared with the ATX cohort (€1979 vs €3189; p=0.0028). The difference in inpatient costs led to significantly lower mean overall 1-year direct healthcare costs per patient in the LDX than ATX cohorts (€4485 vs €6018; p=0.0004). There may be a need for an individualized approach to the treatment of children/adolescents with ADHD, particularly considering common co-occurring mental and behavioural disorders reported. In Germany, children/adolescents treated with second-line ATX compared with LDX incurred significantly higher overall direct healthcare costs. Further multivariate analyses are needed to validate the study outcomes.