Healthcare resources utilisation and associated costs of adult Attention deficit hyperactivity disorder in England: A retrospective database study

Date of Approval
Application Number
Technical Summary

This is a retrospective cohort study to describe total healthcare resource use (HCRU) including costs of adult attention deficit hyperactivity disorder (ADHD) patients prior to diagnosis and post diagnosis in England. The study comprises an observation period from 2014 to 2019 and includes all patients aged 18+ years at study start and with an ADHD diagnosis (index date) between 2016 and 2018 (index period), a minimum of 18-months of data available before and after index date and without a history of ADHD including indicated-medication use prior to index date.

Study objectives include the evaluation of HCRU and associated costs in the 18-month period prior to the index date and comparing to those in the 18-month period after the index date. Diagnostic pathways of ADHD and post-diagnosis treatment patterns will also be assessed. Using CPRD-HES linked data, the healthcare records encompass both primary and secondary care and HCRU includes general practitioner appointments, referrals to specialists including mental health professionals, outpatient visits, investigations, A&E visits and inpatient hospitalisations, as well as prescribed pharmacological and non-pharmacological treatments. Costs will be grouped into prescription costs, primary health care consultations, investigations, outpatient appointments and hospital admissions. Patients’ characteristics at index date, such as age and gender, deprivation, comorbidities and region will also be evaluated.

The analysis comprises a description of HCRU and associated total costs in the pre and post index periods and a comparison using descriptive statistical measures for categorical and continuous variables as appropriate. Costs will also be compared using statistical tests.
In addition, the outcomes will be evaluated for the subgroups a) patients managed under the NICE CG72 and b) under NICE NG87 guidelines. In addition, secondary healthcare visits (inpatient, outpatient and A&E) will be grouped into mental disorders, accidents and injuries, and all other conditions.

Health Outcomes to be Measured

Total HCRU including costs in ADHD patients within 18-months prior to diagnosis and total HCRU including costs within 18-months following diagnosis.


Sarah Jenner - Chief Investigator - IQVIA Ltd
Emily Wilkes - Corresponding Applicant - IQVIA Ltd
Lorena Cirneanu - Collaborator - IQVIA Ltd
Margherita Bortolini - Collaborator - IQVIA Ltd
Marios Adamou - Collaborator - Not from an Organisation
Peter Egger - Collaborator - IQVIA Ltd
Sarah Jenner - Collaborator - IQVIA Ltd


HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation