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

• Main Authors: Carlos R. Maia, Steffan F. Stella, Paulo Mattos, Guilherme V. Polanczyk, Carisi A. Polanczyk, Luis A. Rohde
• Format: Article
• Language: English
• Published: Associação Brasileira de Psiquiatria (ABP) 2015-03-01
• Series: Brazilian Journal of Psychiatry
• Subjects: attention-deficit/hyperactivity disorder; social and political issues; costs and cost analysis; child psychiatry; central nervous system stimulants
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462015000100067&lng=en&tlng=en

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.