Questioning the growing popularity of drug treatments

Posted by on June 24th, 2007 | Comments off

The Tide of Medicine Is Rising

A great read is LIDIA WASOWICZ’s Suffer the Child: How the Healthcare System Is Failing Our Future, published by Capital Books.

Wasowicz questions the growing popularity of drug treatments as an almost reflexive action by healthcare providers. She indicates that current research shows a steady rise in the use of prescription drugs by children and adolescents, particularly among girls.

Wasowicz says in a recent article for United Press International, that “Numerous studies document the favoritism shown pharmaceuticals over non-chemical solutions. In many instances, medicines are the optimal option, but some worry parents, patients and practitioners are over-relying on drugs in certain cases at the cost of safer, less expensive and more effective alternatives.”

Some amazing statistics she provides:

177.9 “doctor visits with at least one drug” per 100 population, meaning for every infant, toddler and adolescent, there were nearly two meetings with a physician during which a pharmaceutical – prescription or not – was ordered, continued, administered or otherwise provided.

While many of these medications are beneficial like penicillins, antiasthmatics bronchodilators, antihistamines, etc, Wasowicz sites “…market analysts have noted a seismic shift is in an “unparalleled” jump in the number of adolescent girls using prescription drugs to treat diabetes, sleep disturbances and such psychological problems as ADHD.”

This is quite a good read and should accompany Dr. Lawrence H. Diller’s book, The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs. Both are balanced and based on fact rather than emotional pharmaceutical smashing.

A different vantage point can be viewed in a study published in the May 2007 issue of the Journal of Attention Disorders. The authors of that study contend that ADHD has been traditionally viewed as a childhood disorder while ADHD in adults has been underdiagnosed and undertreated.

The study shows that treatment rates have been increasing in all age groups; however female patients show the greatest increase of all. The study also concluded that there exists a rapid growth of ADHD medication use in all demographic groups except seniors, with some groups showing markedly faster rates than others.

“Between 2000 and 2005, treatment rates grew more rapidly for adults than for children, more rapidly for women than for men, and more rapidly for girls than for boys. Interestingly, researchers found that methylphenidate and dextroamphetamine [Speed] use declined for both children and adults, the use of amphetamine mixtures increased for adults, atomoxetine [Strattera®]use grew rapidly across both groups, use of extended-release products increased in children more dramatically than adults, and generic ADHD medication use declined significantly in pediatric patients while remaining relatively stable in adults.”

They should thank good marketing for the shift.

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The Global Market For ADHD Medications

Posted by on April 22nd, 2007 | Comments off

The Global Market For ADHD Medications

The University of California, Berkeley reports that ADHD has more than tripled worldwide since 1993. Researchers at UC, Berkeley found that the United States, Canada, and Australia “presented higher-than-expected rates of ADHD medication use between 1993 and 2003 – based on predictions from per-capita GDP indicators – a country-by-country analysis showed increases in ADHD drug consumption in countries ranging from France and Sweden, to Korea and Japan.” The US still leads the world in dollars spent on ADHD medication at $2.7 billion in 2006.

The University of California at Berkeley study was published in the journal, Health Affairs.  Researchers reviewed data on ADHD medication use among 5-19 year-olds in countries belonging to the Organization for Economic Cooperation and Development (OECD), whose members are largely economically fit North American, European and Northeast Asian nations.

The researchers stated that one in twenty-five children is taking medication for ADHD in the US. However, their research also suggests that the diagnosis of ADHD and subsequent use of medications to control it is now spreading worldwide.

Dr. Richard Scheffler, a UC Berkeley distinguished professor of health economics and public policy Overall thinks the study reflects global trends. “Given the global diffusion of ADHD medications, as well as the prevalence of this condition, ADHD could become the leading childhood disorder treated with medications across the globe,” Scheffler said. “We can expect that the already burgeoning global costs for medication treatment for ADHD will rise even more sharply over the next decade.”

The Berkeley researchers also cite that “Growth trends indicate that other countries are following in its tracks. For example, global spending on ADHD medications increased nine-fold among OECD countries during the time period studied. This increase is largely due to the advent and availability of more costly and long-acting medications such as Concerta™, Strattera™ and Adderral XR™”.

The use of medications outside of the US is still primarily short acting amphetamines. However, the pharmaceutical industry is well aware that they cannot reach the estimated $3.4bn by 2015, unless it is led by the launch of drugs with novel delivery mechanisms such as improved durations of action and anti-abuse profiles as media are raising the abuse flag significantly. These custom drugs will help differentiate these pipeline drugs from the current established ADHD therapies and increase market share.

It is important to note that although ADHD drugs have demonstrated efficacy in improving the three main symptoms of ADHD – inattention, hyperactivity and impulsivity – none have shown efficacy in treating the cognitive deficits of ADHD.

Drug makers are likely to increase the costs of these novelty release (e.g. long acting) drugs globally as they become more prevalent outside the U.S. in order to reach the estimated $3.4bn target in 2015.

Back to Berkeley, using the IMS Health MIDAS™, an international pharmaceutical database, researchers looked at data and found that between 1993 and 2003, “the number of countries using ADHD medications rose from 31 to 55, with the U.S. share of global market decreasing from 86.8 percent to 83.1 percent. Meanwhile, countries with traditionally low and moderate consumption of ADHD drugs were showing steady upswings.”

Stephen Hinshaw, who is frequently approached by the media to comment on ADHD, is chair of UC Berkeley’s Department of Psychology was a co-author of the study. Commenting on this study, Hinshaw states, “The results temper some key criticisms of ADHD. A common misconception is that ADHD only exists in the U.S. and that the pharmaceutical firms are getting bigger sales because of the ‘creation’ of the disorder in the U.S. Yet cross-cultural research has shown that ADHD exists in nearly any culture that has compulsory education. Clearly, ADHD–which has a substantial genetic liability–is not just a figment of American doctors’ imaginations.”

In a nutshell, here’s Hinshaw’s argument: The use of stimulant
medication in wealthy member nations of the OECD outside of the U.S. is
growing, therefore, “ADHD is not just a figment of American doctors’
imaginations.” I’m not arguing that ADHD is real or not real. I am
simply citing that pharmaceutical marketing dollars greatly contribute
to the rise in use of stimulant medications in these nations. For
example, when adult ADHD medication was marketed heavily in the U.S.,
sales of the drug skyrocketed. Did the number of diagnosed cases
increase? Yes. Did that mean more people had the disorder? No. If this
poor logic and poor research is the best Berkeley and Hinshaw can
produce, then the students that are graduated from Berkeley are doomed!
But, wait, that’s also a non causa pro causa!

Hinshaw has essentially committed a non causa pro causa (false cause). He’s co-authored a study of data from a pharmaceutical database and citing that the number of persons outside the U.S. in the Organization for Economic Cooperation and Development (OECD), whose members are largely economically fit North American, European and Northeast Asian nations. The pharmaceutical industry has spent many millions of dollars over the past few years to increase their profit in these nations in an effort to obtain their estimated goal of $3.4bn by 2015.

What can be clearly gleaned is that the Berkeley study is meaningless. It might have some teeth if the researchers actually correlated the marketing dollars spent by the pharmaceutical manufacturers to the numbers of persons using their medications in the OECD. It would be interesting to see the data on usage in third world countries who cannot afford it. I’d wager that they have far fewer cases of ADHD and use far less medication.

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Are ADHD drugs safe? Report finds little proof

Posted by on September 13th, 2005 | Comments off

M. ALEXANDER OTTO;
The News Tribune
September 13th, 2005

At a time when millions of children and adults are taking drugs for Attention Deficit Hyperactivity Disorder, the most comprehensive scientific analysis of the drugs to date has found little evidence that they are safe, that one drug is more effective than another or that they help school performance.

The 27 drugs studied included Adderall, Concerta, Strattera, Ritalin, Focalin, Cylert, Provigil, and others that, in some households, are well-known for their sometimes calming affects.

The 731-page report was done by the Drug Effectiveness Review Project, based at Oregon State University. The group analyzed 2,287 studies – virtually every investigation ever done on ADHD drugs anywhere in the world – to reach its conclusions

They found:

• “No evidence on long-term safety of drugs used to treat ADHD in young children” or adolescents.

• “Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors, social achievements” and other measures.

• Safety evidence is of “poor quality,” including research into the possibility that some ADHD drugs could stunt growth, one of the greatest concerns of parents.

• Evidence that ADHD drugs help adults “is not compelling,” nor is evidence that one drug “is more tolerable than another.”

• The way the drugs work is, in most cases, not well understood.

The findings do not mean ADHD drugs are unsafe or unhelpful, just that sound scientific proof is lacking.

The Pharmaceutical Research and Manufacturers of America, the Washington, D.C.-based drug industry lobby group, had no comment on the report, but its senior vice president, Ken Johnson, said the benefits of most drugs “clearly outweigh the risks.”

ADHD is suspected when people have a harder time than others their ages paying attention, sitting still or controlling impulses. To be diagnosed, those tendencies must interfere with work, school or other activities.

Nationally, about 4.4 million kids between 4 and 17 fit the bill. Of those, more than 2.5 million take ADHD drugs. Up to 8 percent of kids in Washington state have been diagnosed with the condition.

The Drug Effectiveness Review Project was formed in 2003 to give consumers and state insurance plans trustworthy information about pharmaceuticals.

Industry studies, which researchers have shown sometimes are rigged for favorable outcomes, don’t give the confidence “many of us would like to decide whether or not we should be using a given medication,” said the project’s deputy director, Mark Gibson.

Complicating efforts to get reliable information, the U.S. Food and Drug Administration doesn’t require companies to compare new drugs to ones on the market. Most times, firms instead compare their wares to sugar pills because it is easier to show benefit and get approved for sale.

The problems leave insurers and patients in the lurch when they need to know what drugs work best. That’s where the Drug Effectiveness Review Project comes in. Its physicians and pharmacists analyze virtually every study on a given class of pharmaceuticals to find the best drugs.

The American Association of Retired Persons and Consumers Union, the publisher of Consumer Reports, use the project’s findings to tell people what drugs give the most for the money. Fourteen states, including Washington, also use its services to decide what drugs to cover for beneficiaries. Those states are the project’s chief funders.

For ADHD, the project analyzed published studies as well as unpublished data from the six leading makers of ADHD drugs. The group rejected 2,107 investigations as unreliable, and reviewed the remaining 180 to find superior drugs.

Instead, it found that evidence to choose one drug over another for safety or effectiveness is “severely limited” by a lack of studies measuring “functional or long-term outcomes.”

The project could not find a “good quality” study that tested the drugs against each other. It also could not find comparative evidence to determine which ADHD drugs are less likely to cause tics, seizures and heart and liver problems.

That evidence is needed. Canadian authorities have recently warned against using Adderall Extended Release in patients with heart problems. Cylert and Strattera have been linked to liver damage, the report said.

Until better research is done, the findings mean that choosing the right ADHD drug is largely a matter of trial and error. They also suggest some people might do as well or better on cheap generic Ritalin, sold by its scientific name methylphenidate, instead of far more expensive, newer options such as Concerta and Adderall.

In fact, in the few instances where the Oregon group could draw conclusions, it found Concerta “did not show overall difference in outcomes” compared to generic Ritalin, and proof that Adderall is better “lacking.” What little evidence there is comparing another newer expensive drug, Strattera, to generic Ritalin “suggests a lack of difference in efficacy.”

Gibson cautioned that his project’s latest report is still open for public comment and possible fine-tuning. But the overall results did not surprise Libby Munn, a nurse practitioner at Greater Lakes Mental Healthcare in Lakewood.

“I’ve never been aware of any evidence of any one being better than another,” said Munn, who treats patients for ADHD and other conditions. “That’s true of antidepressants and antipsychotics, too. Once you compare meds for a given disorder, there are often no proven differences.”

Tacoma psychiatrist Dr. Fletcher Taylor, an expert in adult ADHD at Rainier Associates, works with drug companies to develop new products. He said he stands by the effectiveness and safety of the drugs.

Still, he said, Adderall and Concerta are largely equal in their effect, though some people do better on one than another. Their greatest advantage over generic Ritalin is that people take fewer pills during the day.

ADHD DRUG COSTS*

• Methylphenidate (generic Ritalin) $15.69

• Ritalin (brand name): $27.79

• Amphetamine/dextroamphetamine (generic Adderall): $47.09

• Adderall (brand name): $94.49

• Concerta: $103.99

• Strattera: $123.99

• Focalin: $25.99

*Comparisons based on the lowest dose for 30 days.

Source: Walgreens Pharmacy

FIND THE RIGHT DRUG

These Web sites offer help comparing drugs to find what works best:

• The American Association of Retired Persons lets you compare drugs at www.aarp.org/health/comparedrugs/

• Consumers Union, the publishers of Consumer Reports, gives tips on the best drug buys for safety and effect at www.crbestbuydrugs.org/

• The consumer-advocacy group Public Citizen has a solid record of spotting problem drugs, calling, for instance, for the removal of Vioxx in 2001, when few knew there were problems. The group is now worried about the cholesterol pill Crestor. Public Citizen’s drug information site is www.worstpills.org/

• The Oregon State University Drug Effectiveness Review Project is online at www.ohsu.edu/drugeffectiveness/

M. Alexander Otto: 253-597-8616 alex.otto@thenewstribune.com

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New ADHD Drug to Fix Your Child

Posted by on September 8th, 2005 | Comments off

McNeil Consumer & Specialty Pharmaceuticals, a division of Johnson & Johnson (“J&J”), announced that an agreement with  Cephalon, Inc. to Co-Promote Modafinil for Attention-Deficit/Hyperactivity Disorder (Thursday September 1). McNeil currently manufactures and distributes Concerta for AD/HD.

Modafinil (coated tablet) is a form of Provigil which is used to alleviate excessive sleepiness  (narcolepsy) and other sleep disorders. Cephalaon and McNeil are awaiting U.S. Food and Drug Administration (FDA) approval for the treatment of attention- deficit/hyperactivity disorder (ADHD) in children and adolescents.

By combining sales forces totaling more than 700 sales reps between the two companies and by marketing heavily, the agreement may produce heightened sales figures for both companies in a competitive multi-billion dollar market. Cephalon will pay McNeil commission fees calculated as a percentage of annual net sales of Modafinil during the term of the agreement according to their press release.

Look for Shire Pharmaceuticals to market a new drug ostensibly in the same manner as J&J to compete.

In J&J’s press release they say that “Our company has extensive experience with ADHD and the pediatric medical community,” said Colin F. Watts, president, McNeil Consumer & Specialty Pharmaceuticals, a subsidiary of Johnson & Johnson. “We are excited about the prospect of collaborating with Cephalon on this new ADHD therapy.”

The most frequently reported adverse events in clinical trials with PROVIGIL were headache, nausea, nervousness, stuffy nose, diarrhea, back pain, anxiety, trouble sleeping, dizziness and upset stomach.

It has always been a concern of mine that ventures like these will reap a large profit without addressing cognitive, behavioral, and social needs of the end user. The public’s current perception is that using these medications will indeed ‘fix’ their broken child. Unfortunately, and according to the National Institutes of Health, more than medication is needed to address the full needs of AD/HD children. So, as long as pharmaceutical companies keep marketing in a manner which encourages the public’s ‘fix’ perception, we’ll continue to have kids who historically remove themselves from medication whenever they can (usually upon emancipation) and carry their AD/HD into adulthood with no compensatory skills.

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ADHD ADD Drug Adderall XR Back on the Market in Canada

Posted by on September 8th, 2005 | Comments off

Bloomberg reports  Shire Says Canada Allows Sale of Adderall XR Again  after appealing Health Canada’s decision to pull Adderall XR from Canadian shelves.

h Canada’s decision was based on Adderall XR’s link to 20 deaths.

Bloomberg cites that “Adderall XR, used to treat attention deficit hyperactivity disorder or ADHD, will return Aug. 26, the Basingstoke, England- based company said today in an e-mailed statement. The medicine was taken from the market Feb. 9 at the request of Health Canada.

Shares of Shire fell 10 percent the day after the removal in Canada, which only accounted for $10 million of the product’s $606.7 million in 2004 sales. Adderall XR, which has about 25 percent of the hyperactivity market, is also facing patent challenges from companies including Barr Pharmaceuticals Inc. and Impax Laboratories Inc.”

Shire is the UK’s third largest pharmaceutical company.

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Strattera and ADHD – “Show me the money…”

Posted by on August 16th, 2005 | Comments off

The following press release makes it clear why so much attention is paid to prescribing medication to the ADHD market: MONEY. It’s a $2.6 BILLION market with annual compound growth of 36.7% since 2002.

The press release:

Commercial Insight: ADHD – Strattera Will Reign Supreme When Branded Stimulants Slump
Published: 22 Jul 2005, Publisher: Datamonitor

Introduction

With annual revenues of over $2.6 billion in 2004, and a compound annual growth rate of 36.7% since 2002, the ADHD market is one of the most rapidly growing CNS markets. This growth is primarily attributed to the launches of several novel, once-daily ADHD therapies initially in the US and then periodically across the remaining major markets since 2000.

Scope
  • Overview of current market including profiles of key brands and key events impacting each brand during 2004-2005
  • Assessment of current and future opportunities and threats in the ADHD market across the seven major pharmaceutical markets
  • Global sales for leading ADHD products from 2002-2004 are presented, with projections for future performance up to 2015
  • In-depth discussion of assumptions and events used in forecast analysis
Highlights

US revenue growth within the ADHD market follows a distinct annual cycle, with the highest revenue growth occurring in August and September, coinciding with the end of the school summer vacation. Manufacturers wishing to maximize revenue potential on drug launch should therefore take advantage of this period of high drug revenue growth.

Drugs licensed for the treatment of adult ADHD are driving growth in this sector of the market, and derive significantly greater revenue shares as compared to drugs that are used off-label. Datamonitor believes that now is an ideal time for manufacturers to gain approval for adult ADHD in the US, and enter this expanding market.

Strattera was the most rapidly growing drug in the US ADHD market with 2004 revenues of $632m, However, Q1 2005 revenues of the drug fell by 25.1% over Q4 2004, as a result of a product warning and other adverse market events. Nevertheless, Datamonitor forecasts that Strattera will bounce back and become market leader form 2007 onwards.

Why you should buy this report
  • Assess leading ADHD drugs and identify key success factors within this sector
  • Understand key market drivers and predict the future performance of key compounds
  • Benchmark pipeline ADHD drugs against currently marketed products and assess their future market potential
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Children: Adderall and Safety

Posted by on July 25th, 2005 | No Comments

Medical News Today reports that ADDERALL XR® from Shire Pharmaceuticals Group plc has been indicated for use among adolescents aged 13 to 17 with attention deficit hyperactivity disorder (ADHD) by the US Food and Drug Administration. (ADHD – FDA expands indication for ADDERALL XR® (CII) confirming safety and efficacy in adolescents)

The drug was originally approved for treatment in ADHD children aged 6 to 12 years in October of 2001 and since August 2004 in adults 18 years and older. ADDERALL XR is currently the most commonly prescribed brand of ADHD medication in the United States.

“There has long been an unmet need for ADHD research and treatment among the adolescent population despite an increasing awareness of ADHD’s potential impact on quality of life. Therefore, approval of an ADHD treatment for this underidentified age group is an important milestone,” explained Dr. Timothy Wilens of Massachusetts General Hospital. “The symptoms of ADHD often continue past childhood into adolescence and adulthood, where they can have a significant impact on an individual’s family, academic performance, and overall quality of life. Stimulant therapies are effective and generally well tolerated, and have been used medically in patients for more than 60 years.”

This directly contrasts with Health Canada’s decision to remove ADDERALL from the Canadian market (Health Canada Suspends ADHD drug Adderall XR) due to 20 or so deaths associated with the drug’s use. According to Shire Pharmaceuticals, “ADDERALL XR may not be right for everyone. ADDERALL XR was generally well tolerated in clinical studies. The most common adverse events in pediatric trials included loss of appetite, insomnia, abdominal pain, and emotional lability. The most common side effects in the adolescent trial included loss of appetite, insomnia, abdominal pain, and weight loss. The most common adverse events in the adult trial included dry mouth, loss of appetite, insomnia, headache, and weight loss.

The effectiveness of ADDERALL XR for long-term use has not been systematically evaluated in controlled trials. As with other psychostimulants indicated for ADHD, there is a potential for exacerbating motor and phonic tics and Tourette’s syndrome. A side effect seen with the amphetamine class is psychosis. Caution also should be exercised in patients with a history of psychosis.”

One must wonder whether the side effects are worth using a drug whose efficacy has not been evaluated for long-term use. Terms like ‘emotional lability’ appear as an attempt to obfuscate. It is much clearer to say, ‘emotional change or breakdown.’

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A Probe into the Side Effects of ADHD Drugs

Posted by on July 22nd, 2005 | No Comments

The FDA probes side effects of ADHD drugs Government plans to strengthen label warnings.

From CNN.com

Thursday, June 30, 2005; Posted: 11:27 a.m. EDT (15:27 GMT)

WASHINGTON (AP) – The government is planning to strengthen warnings about possible psychiatric side effects from Concerta and related treatments for attention deficit hyperactivity, and is probing whether other ADHD drugs need updating, too.

Concerta is a long-acting form of methylphenidate, sold generically and under the brand name Ritalin. For years, those drugs’ labels have listed possible psychiatric side effects, such as agitation, psychosis or transient depression.

But a routine Food and Drug Administration review of Concerta’s use in children turned up more reports of psychiatric reactions than anticipated, including some that aren’t explicitly labeled, such as suicidal thoughts, hallucinations and violent behavior. A subsequent review of all methylphenidate products found similar reports.

The FDA can’t say if the drugs actually causes those side effects – the reports are from a database of reactions reported by medication users that make such determinations very difficult.

But, in a statement posted on its Web site, the agency said it does intend to strengthen the labeled warnings for all methylphenidate products.

Currently, the drugs’ labels may downplay the seriousness of psychiatric side effects, and suggest they’re only a risk in people who’ve already experienced psychiatric disorders, wrote FDA drug safety evaluator Kathleen Phelan.

Indeed, stimulant drugs “may exacerbate symptoms and reveal them for the first time” in children with previously unrecognized psychiatric illnesses, she wrote.

But, among 36 cases of psychiatric side effects in child Concerta users, six report histories of psychiatric illness, three deny such histories and there’s no information on the rest, Phelan wrote. Further investigation is needed to determine if such side effects may also occur in people without underlying illness, she added.

FDA said it doesn’t intend to change the drugs’ labels right away. It is investigating whether similar behaviors are seen with additional ADHD treatments, such as Adderall and Strattera – to avoid people switching drugs over the concern “based on incomplete safety assessments,” said an FDA document prepared for a meeting of the agency’s scientific advisers on Thursday.

That probe should be finished early next year.

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ADHD Drug Treatment

Posted by on July 21st, 2005 | No Comments

Wouldn’t you know it, but research says the people who use medicines the most to treat ADHD are wealthier and have better medical plans from their HMOs. It would be equally interesting to see just how poorer families cope and if their children perform accordingly.

FSU researcher puts attention on ADHD drug treatment

by Jill Elish

The use of drugs to treat attention deficit hyperactivity disorder has grown in the last decade, but it’s those who live in the most affluent areas of the United States who are most likely to get medication for the disorder. Dr. Farasat Bokhari

Florida State University Economics Professor Farasat Bokhari was the co-author of a study published in the journal Pharmacoepidemiology and Drug Safety that found wide variations in the distribution of pyschostimulant drugs to treat ADHD. The study raised a number of questions for which the author and his colleagues received a $900,000 grant from the National Institute of Mental Health to further research the economic issues and policy decisions surrounding the use of ADHD medications.

ADHD is the most commonly diagnosed behavioral disorder in children and is considered a major public health concern, according to Bokhari. Between 3 percent and 5 percent of U.S. school-age children are estimated to have ADHD, and these children often have problems that take a toll on schools, social service agencies and health care and criminal justice systems.

“People are really polarized on this thing,” Bokhari said. “States are passing laws about whether teachers can talk to parents about psychostimulant drug treatments, and there’s a lot of disagreement about both the diagnosis and the treatment of ADHD.”

Some states, such as Michigan, Georgia and Virginia, have a tradition of using ADHD drugs more than others, such as California and New York. Bokhari and colleagues Rick Mayes at the University of Richmond and Richard Scheffler at the University of California at Berkeley wanted to find out why. Using data from the Drug Enforcement Administration, the researchers looked at the distribution of ADHD drugs to each county in the United States.

The researchers found that the counties where ADHD drug use was the highest had higher per capita income, lower unemployment rates, greater population density and more access to health care, meaning more HMOs and a higher percentage of people enrolled in them. Given the cost-saving objectives of HMOs, the researchers theorized that HMOs could be authorizing ADHD drug therapy because it is cheaper than counseling.

These high-use counties also had a higher ratio of younger-to-older doctors, prompting the researchers to question whether younger doctors just happen to locate in more affluent areas or whether younger doctors are more likely than their older counterparts to prescribe ADHD medication.

They also found that areas with high use have a higher student-to-teacher ratio. The researchers suggested that the greater burden on teachers may cause them to send more children to the school psychologist for screening, resulting in higher detection rates of ADHD and use of medication to treat the disorder.

In addition, the researchers found that high-use counties have, on average, slightly fewer children as a proportion of the population—a finding that seems counterintuitive given that ADHD is primarily diagnosed among children. However, Bokhari cited previous research that has shown that children of smaller families are more likely to use ADHD medication.

The findings are significant because nobody has really looked at the variation in the use of these drugs across the country, Bokhari said. He and his colleagues will next conduct a market analysis of the factors influencing the supply and demand for ADHD drugs.

“Some people who need medication aren’t getting it and some who don’t need it are,” he said. “You could be playing the lottery whether your child gets the drug or not. It often seems to depend as much on where you live as on medical science.”

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Pharmaceutical Makers : Follow the Money

Posted by on July 20th, 2005 | No Comments

Ever wonder why so much hoopla surrounds ADHD? The media know it’s a top of mind issue for parents. However, pharmaceutical makers also know where their bread is buttered. The following article reflects the vast sums of money involved in the business of ADHD medications.

Press Release Source: Research and Markets Ltd.

Research and Markets: Current Global ADHD Market Is Worth $2.7Bn and is Expected to Reach $3.4Bn by 2015
Tuesday June 14, 10:15 am ET

DUBLIN, Ireland–(BUSINESS WIRE)–June 14, 2005–Research and Markets (http://www.researchandmarkets.com/reports/c19199) has announced the addition of Pipeline Insight: ADHD – Shire Driving Diversity in ADHD to their offering.
The current ADHD market has long been saturated with traditional methylphenidate and amphetamine based drugs, with the only innovations being the development of extended release versions. However, the recent launch of Strattera (atomoxetine) has already shattered the traditional approach to drug therapy, opening the door for the uptake of new novel drug therapies.

This report provides an overview of the epidemiology, diagnosis and management of ADHD across the seven major pharmaceutical markets. In includes an examination of the ADHD pipeline with in-depth clinical and commercial profiles of late-stage candidates. Seven market sales forecasts, commercial potential and research/clinical/commercial assessment of late-stage products to 2015 are provided together with insight and commentary from qualitative interviews with ADHD opinion leaders in the US and Europe.

The current global ADHD market is worth $2.7bn and is expected to reach $3.4bn by 2015, driven primarily by the launch of pipeline drugs and the continued growth of Strattera.

Innovation is key – manufacturers can no longer expect significant returns on standard extended release formulations. The current pipeline offers drugs with novel delivery mechanisms; improved durations of action and anti-abuse profiles, which will help differentiate these pipeline drugs from the current established ADHD therapies.

Although ADHD drugs have demonstrated significant efficacy in improving the three main symptoms of ADHD – inattention, hyperactivity and impulsivity – none have shown efficacy in treating the cognitive deficits of ADHD.

This report will give you an understanding of the unmet needs in the ADHD market based on opinion leader comments regarding both currently marketed and pipeline products. It can help you benchmark key late-stage ADHD compounds against current market leaders and assess the global sales forecasts of late-stage pipeline drugs for ADHD and examine their clinical and commercial potential.

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