# Presentation: 665619

## 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

## CDC 2003 NSCH SurveyMMWR 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

## 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].

*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].*

## 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].

## 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].

## CDC 2003 NSCH Survey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

## ADHD Drug Use in the U.S.

- 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

## 8 Drug Substances Included in VONA data

- 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)

## Source: Vector  One®:  National (VONA)

## Total Number of Retail Prescriptions Dispensed for 8 ADHDDrugs by Patient Age: January 2002 to June 2005 by Quarter

- Source: Vector  One®:  National (VONA)

## Top 10 Prescriber Specialties of Retail Prescriptions Dispensed for8 Selected ADHD Drugs: January 2000 to June 2005, all ages

- Source: Vector  One®:  National (VONA)

## Source: Vector  One®:  National (VONA)

## Source: Vector  One®:  National (VONA)

## U.S. Drug Use Data from Vector  One®: National (VONA)Conclusions

- 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

## Acknowledgements

- 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