Friends of the Behavioral Economics Blog, this week we present the paper “Economic burden of attention-deficit/hyperactivity disorder among children and adolescents in the United States: a societal perspective”, by Schein, J.; Adler, L. A.; Childress, A.; Cloutier, M.; Gagnon-Sanschagrin, P.; Davidson, M.; Kinkead, F.; Guerin, A. and Lefebvre, P. (2022), in which authors carry out an investigation to know, from a societal perspective, what is the cost derived from living with an attention-deficit/hyperactivity disorder. 

Attention deficit/hyperactivity disorder (ADHD, hereinafter) is one of the most common neurobehavioral disorders in childhood, characterized by levels of inattention, impulsiveness, and hyperactivity that are not appropriate or beneficial to the child’s stage of development.

ADHD is most often diagnosed in children, however, it can occur at any stage of life.

The percentage of people with ADHD in the United States is between 10 and 6.5% for children and 4.4% for adults.

People living with this disorder may have functional and psychosocial deficiencies in the academic and/or work environment.

Furthermore, the burden borne by children and adolescents extends to their parents and caregivers as well. For example, parents of children with ADHD must spend their money on doctors, special education, or extra care services for their children, as well as other indirect losses related to absences from work, if they are necessary to care for their children.

In addition, the difficulties children with ADHD face are likely to continue into adolescence if their symptoms are not properly identified or managed early on.

Teens with ADHD generally face greater academic, work, and social demands, and may also be more vulnerable to substance use or traffic accidents.

In addition, it is known that ADHD can become a chronic problem for patients, with a percentage that varies between 35-78% of children and adolescents who maintain symptoms in adulthood. Therefore, adolescents with ADHD are at risk of experiencing adverse conditions associated with the disorder during their transition to adulthood.

Since the manifestation of ADHD often has direct implications for how patients interact with society, it is imperative to consider the full societal costs associated with this condition in order to understand the true economic burden from a societal perspective.

However, despite the extensive body of research conducted on children and adolescents with ADHD, previous studies that have attempted to quantify the economic impact have mostly been from a payer perspective, assessing only direct health care costs, or have focused on one or just a few components of ADHD.

In this article, the goal was to provide a comprehensive assessment of the economic burden of children with ADHD on the one hand and adolescents with ADHD on the other. The main cost components that contribute to the associated social economic burden were sought, which can help promote new clinical and social policies to mitigate the impact of the disorder on patients, their relatives and, in general, society.

The applied approach was based on prevalence, mainly with a “bottom-up” method, to estimate the excess costs incurred by a person with ADHD compared to a person with neurotypical development.

The obtained data comes from different places. For example, direct health care costs come from health insurance, while the prevalence of ADHD in children and adolescents was obtained from the 2018 US National Survey of Children’s Health.

The results obtained indicated that the total social costs associated with ADHD in the United States in 2018 were 19.4 million dollars for children and 13.8 million for adolescents. These results are further developed by area in the article.

The findings show that the economic burden of living with ADHD is important, so it is necessary to seek solutions. 

Education costs accounted for approximately half of the total figure, standing at around 11.6 million for children and 6.7 million for adolescents. This may be because there are costs that may be related to tutoring, the use of specialized teachers, as well as expenses associated with material items (books, technological support, etc.).

Authors conclude that the development of improved intervention strategies and ADHD awareness policies are needed to overcome diagnostic barriers, improve treatment adherence, alleviate educational and medical difficulties, and minimize stigma. .

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