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Psych Congress  

Medication Regimens Among Commercially-insured Adults with Attention-Deficit Hyperactivity Disorder (ADHD) in the US

Zhoue Zhou, MS
Zheng-yi Zhou, PhD
Sneha Kelkar, MS
Shang Li, MS
Jipan Xie, MD, PhD
Regina Grebla, PhD

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Objective: To examine medication regimens used in Attention-Deficit Hyperactivity Disorder (ADHD) treatment among commercially-insured adults in the US.

Methods: Adults with ADHD who received ≥1 ADHD medication during 2013 were identified from a claims database. Index treatment was the first ADHD treatment lasting for ≥30 days in 2013. Combination therapy was an overlap of ≥30 days between the index and another ADHD treatment(s). Patients were classified into six groups based on the index treatment: long-acting (LA) or short-acting (SA) monotherapy; LA+LA, SA+SA, or LA+SA combination therapy (defined as an overlap of ≥30 days of ≥2 drugs); and >2 therapy combination. Specific medications used by each group were assessed.

Results: Of 206,443 adults (mean age 32.9 years; 51.6% female), LA and SA monotherapy accounted for 56.9% and 30.7%, respectively. The rest (12.5%) received a combination therapy (LA+SA 10.3%, LA+LA 1.3%, SA+SA 0.4%, and >2 therapies 0.5%). The most common monotherapies were extended-release mixed amphetamine salts (MAS-XR, 39.2%), lisdexamfetamine (LDX, 31.5%), and methylphenidate (MPH, 19.9%) for LA, and immediate-release MAS (MAS-IR, 81.7%) and MPH-IR (14.5%) for SA. The commonly used combination therapies were branded+generic MAS-XR (13.7%), LDX+generic MAS-XR (10.8%), and LDX+guanfacine XR (10.7%) for LA+LA, generic MAS-IR+clonidine IR (33.5%), generic MAS-IR+generic MPH-IR (17.9%), and branded+generic MAS-IR (11.1%) for SA+SA; generic MAS-XR/IR (39.2%), LDX+generic MAS-IR (16.7%), and LA+SA generic MPH (12.6%) for LA+SA.

Conclusions: Over 50% of commercially-insured adult ADHD patients were treated with LA monotherapy; however, more than 10% received LA combination therapy, suggesting unmet needs regarding LA monotherapy options.

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