Pharmacotherapies for attention-deficit/hyperactivity disorder: Expected-cost analysis

A. Marchetti, R. Magar, H. Lau, E. L. Murphy, P. S. Jensen, C. K. Conners, R. Findling, E. Wineburg, I. Carotenuto, T. R. Einarson, M. Iskedjian

Research output: Contribution to journalArticle

42 Scopus citations


Background: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neurobehavioral disorder characterized by inattention, hyperactivity, and impulsivity. Prevalence estimates in elementary school children generally range from 3% to 8%. ADHD is frequently treated with psychostimulant medications, which have been shown to improve both cognitive and behavioral outcomes for most children. Objective: The goal of this study was to estimate the total expected costs for the treatment and management of school-age children with ADHD using 6 commonly prescribed pharmacotherapies: methylphenidate immediate-release/extended-release (MPH IR/ER), methylphenidate immediate-release (MPH IR), Metadate® CD (branded MPH IR/ER), Concerta™ (branded MPH ER), Ritalin® (branded MPH IR), and Adderall® (a combination of dextroamphetamine and amphetamine salts). Methods: A literature review and clinical assessment using a 27-question survey instrument were used to capture information on the clinical characteristics of ADHD, including common treatment regimens, clinical management of patients, pathways of care, and components of care. A meta-analysis provided response rates for 3 commonly used pharmacotherapies: Metadate CD, MPH IR, and Adderall. Information from the clinical assessment and the meta-analysis were used to populate a decision-analytic model to compute total expected cost for each comparator. Results: The average total annual expected cost per patient was $1487 for Metadate CD, $1631 for Concerta, $1792 for MPH IR/ER, $1845 for MPH IR, $2080 for Ritalin, and $2232 for Adderall. Conclusions: Metadate CD had the lowest total expected cost and Adderall had the highest total expected cost among the ADHD pharmacotherapies evaluated. The differences were attributable to differences in drug-acquisition costs and the need for in-school dosing of twice-daily and thrice-daily medications.

Original languageEnglish (US)
Pages (from-to)1904-1921
Number of pages18
JournalClinical Therapeutics
Issue number11
StatePublished - 2001
Externally publishedYes



  • Amphetamine
  • Attention-deficit/hyperactivity disorder
  • Economic
  • Methylphenidate
  • Psychostimulants

ASJC Scopus subject areas

  • Pharmacology

Cite this

Marchetti, A., Magar, R., Lau, H., Murphy, E. L., Jensen, P. S., Conners, C. K., Findling, R., Wineburg, E., Carotenuto, I., Einarson, T. R., & Iskedjian, M. (2001). Pharmacotherapies for attention-deficit/hyperactivity disorder: Expected-cost analysis. Clinical Therapeutics, 23(11), 1904-1921.