Preferences for Attention-Deficit/Hyperactivity Disorder (ADHD) Non-Stimulant Treatment Characteristics Among Children and Adolescents With ADHD and Their Caregivers

• Published in: Journal of health economics and outcomes research (Online) 2016-10, Vol.3 (1), p.56-72
• Main Authors: Flood, Emuella, Gajria, Kavita, Sikirica, Vanja, Hodgkins, Paul, Erder, M. Haim, Lopez, Frank, Connor, Daniel
• Format: Article
• Language: English
• Subjects: Psychological Conditions
• ISSN: 2327-2236; 2326-697X; 2327-2236
• DOI: 10.36469/9842

Background: Understanding patient and caregiver preferences for treatment is important for optimizing treatment decisions. Non-stimulant therapies are an alternative treatment option to stimulant therapy for attention-deficit/hyperactivity disorder (ADHD). Guanfacine extended release (GXR) and atomoxetine (ATX) are two non-stimulant medications approved in the United States for the treatment of ADHD. Objective: To identify non-stimulant ADHD medication attributes important to caregivers/patients. Methods: US caregivers of ADHD patients (6–17 years) and child/adolescent patients (10–17 years) completed an adaptive conjoint analysis survey. Respondents selected between hypothetical treatments with different attributes. Ordinary least-squares and hierarchical Bayes regression using Sawtooth Software were used to calculate utilities, importance ratings, and preferences. Results: 483 caregivers (mean age: 41.9 years, standard deviation [SD]: 8.7; 75% female) and 211 children/adolescents (mean age: 14.5 years, SD: 2.2; 70% male) completed the survey. Based on importance ratings, the most influential attributes for both caregivers and children/adolescents were chance of somnolence, efficacy, and for caregivers, effect on oppositionality and black box warning. Most caregivers (95.3%) and children/adolescents (93.8%) preferred GXR over ATX. In several sensitivity analyses in which attribute levels varied, GXR remained the preferred medication with the exception of one scenario. Conclusions: Children/adolescents and caregivers demonstrated in this study that they can clearly express their preferences for treatment attributes and treatment choices; in this case they preferred GXR to ATX. Patients and caregiver preferences could be useful inputs to the treatment selection decision-making process.