Geography of ADD Treatment Is Dynamic

May 21, 2013
Regional variations persist for diagnosis and treatment of attention deficit disorders, but those differences may be fluid.
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  • Attention Disorders

The South still leads the nation in terms of percentages of people diagnosed and people treated for attention deficit disorders, but the Northeast has the highest growth rate for diagnosis, treatment and total associated costs.

These are the findings of Express Scripts research into three years of data related to claims for drugs treating ADD — 2008 to 2010. We presented the research at the annual meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in New Orleans this week.

Express Scripts announced findings last year based on data from 2008 and 2009.

However, the research finds that geographic disparities may be evening out. The South, although it had the highest percentages of people ages 4 to 40 diagnosed and treated for ADD, had the lowest growth rate for overall costs per patient associated with the disorder.

The West region has the lowest rates of diagnosis and treatment, and lowest overall cost per person. It also has the lowest growth rates in all three categories — tied with the South for lowest growth in overall costs.

The North Central region had the highest total medical and pharmacy costs per patient, the data show.

The Express Scripts drug trend forecast released earlier today shows that ADD and diabetes are the only two of the top 10 traditional therapy classes that are likely to have spending increases over the next three years, but those increases will be significant.

Despite the availability of generic equivalents for many ADD therapies, the data project spending in the category to increase approximately 25% over the next three years, driven by increased use among adults and the geographic variation in diagnosis. That variation suggests that some regions, such as the West, could see increases in diagnoses more similar to those seen in other regions.

The research shows that it is important to consider regional variation while implementing utilization management or cost-control initiatives related to ADD. Utilization management programs and cost-containment strategies should be considered to ensure appropriate access, patient safety and cost-effective use of ADD medications.

In addition, regulators implementing policies targeted toward early detection of ADD, promotion of medication to manage this condition and cost-control initiatives should take into account this variation as it might impact the effectiveness of the program.

It is important to note that this research indicates correlation only — not causation — between geography and ADD diagnosis. We can’t look at this data and suggest that any one region of the U.S. is more accurate with its diagnoses than the others.

Further research is warranted to examine the factors underlying these trends.

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