ATTENTION DEFICIT HYPERACTIVITY DISORDER

A systematic review and economic model of the effectiveness and cost-effectiveness of methylphenidate, dexamfetamine and atomoxetine for the treatment of attention deficit hyperactivity disorder in children and adolescents 

Background

This systematic review assessed the clinical and cost effectiveness of methylphenidate, atomoxetine and dexamfetamine relative to other treatments used in the NHS, for ADHD in children and adolescents.

Findings

The review found that drug therapy seems to be superior to no drug therapy. There were no significant differences between the various drugs in terms of efficacy or side effects, but this was mainly because of a lack of evidence. The additional benefits from behavioural therapy (in combination with drug therapy) are uncertain. The main additional feature of the economic model is the consideration of costs. Given the lack of evidence for any differences in effectiveness between the drugs, the model tends to be driven by drug costs, which differ considerably.

Conducted by: S King1, S Griffin2, Z Hodges1, H Weatherly2, C Asseburg2, G Richardson2, S Golder1, E Taylor3, M Drummond2, R Riemsma1

1 Centre for Reviews and Dissemination, University of York; 2 Centre for Health Economics, University of York; 3 Institute of Psychiatry, King's College London

Further details

Project page on NIHR HTA Programme website

Related guidance

Commissioned to inform NICE Technology Appraisal 98: Methylphenidate, atomoxetine and dexamfetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents: guidance. London: National Institute for Clinical Excellence; 2006

Publications

Hodges Z, King S, Golder S, Riemsma R. Adverse effects of methylphenidate, dexamfetamine and atomoxetine in the treatment of children and adolescents with attention deficit hyperactivity disorder: a systematic review. Ital J Public Health. 2005;2(2)

King S , Griffin S, Hodges Z, Weatherly H, Asseburg C, Richardson G, Golder S, Taylor E, Drummond M, Riemsma R. A systematic review and economic model of the effectiveness and cost-effectiveness of methylphenidate, dexamfetamine and atomoxetine for the treatment of attention deficit hyperactivity disorder in children and adolescents. Health Technol Assess. 2006;10(23):1-146

Funding

Commissioned by the HTA Programme on behalf of NICE's Technology Assessment Report (TAR) process