Healthcare resource utilization and costs associated with psychiatric comorbidities in pediatric patients with attention-deficit/hyperactivity disorder: a claims-based case-cohort study

• Published in: Child and adolescent psychiatry and mental health 2024-07, Vol.18 (1), p.80-10, Article 80
• Main Authors: Schein, Jeff, Cloutier, Martin, Gauthier-Loiselle, Marjolaine, Bungay, Rebecca, Chen, Kathleen, Chan, Deborah, Guerin, Annie, Childress, Ann
• Format: Article
• Language: English
• Subjects: Anxiety; Attention deficit hyperactivity disorder; Child & adolescent mental health; Children; Cohort analysis; Comorbidity; Depression; Emergency medical care; Emergency medical services; Health aspects; Health care; Health care expenditures; Healthcare resource use; Medical care; Medical care, Cost of; Medical research; Medicine, Experimental; Mental depression; Patients; Pediatrics; Psychiatric disorders; Psychotherapy; Resource utilization; Teenagers; Utilization
• ISSN: 1753-2000; 1753-2000
• DOI: 10.1186/s13034-024-00770-8

Attention-deficit/hyperactivity disorder (ADHD) has been shown to pose considerable clinical and economic burden; however, research quantifying the excess burden attributable to common psychiatric comorbidities of ADHD among pediatric patients is scarce. This study assessed the impact of anxiety and depression on healthcare resource utilization (HRU) and healthcare costs in pediatric patients with ADHD in the United States. Patients with ADHD aged 6-17 years were identified in the IQVIA PharMetrics Plus database (10/01/2015-09/30/2021). The index date was the date of initiation of a randomly selected ADHD treatment. Patients with ≥ 1 diagnosis for anxiety and/or depression during both the baseline (6 months pre-index) and study period (12 months post-index) were classified in the ADHD+anxiety/depression cohort; those without diagnoses for anxiety nor depression during both periods were classified in the ADHD-only cohort. Entropy balancing was used to create reweighted cohorts. All-cause HRU and healthcare costs during the study period were compared using regression analyses. Cost analyses were also performed in subgroups by comorbid conditions. The reweighted ADHD-only cohort (N = 204,723) and ADHD+anxiety/depression cohort (N = 66,231) had similar characteristics (mean age: 11.9 years; 72.8% male; 56.2% had combined inattentive and hyperactive ADHD type). The ADHD+anxiety/depression cohort had higher HRU than the ADHD-only cohort (incidence rate ratios for inpatient admissions: 10.3; emergency room visits: 1.6; outpatient visits: 2.3; specialist visits: 5.3; and psychotherapy visits: 6.1; all p