Costs
This guideline provides an overview of the recommended Adult ADHD assessment steps, differentials to be considered and options for treatment according to the best available evidence based guidelines.
ADHD is a costly, chronic disorder, with significant impact on the quality of life of patients and their families. The burden of disease is significant, with the disability-adjusted life years (DALYs) calculated as 424 per 100 000.20 The economic burden of adult ADHD ($3020 per patient per annum) is less than those of depression and diabetes, but more so than seasonal allergy.21
Significant comorbidity, estimated at more than 50% with ADHD, contributes to the burden of disease and reduced quality of life of patients with ADHD. Adults with ADHD are more likely to suffer from comorbid medical disorders (e.g. asthma, unplanned pregnancies and sexually transmitted diseases), as well as psychiatric disorders (e.g. mood disorders, anxiety disorder, substance abuse disorders and behavioural disorders).22,23
(Untreated) ADHD also impairs educational attainment and employment status, impairs work performance (reduced productivity and increased absenteeism), adversely affects interpersonal relationships (irritability and low frustration tolerance) and adds to significant societal costs (because of substance abuse and accidents).24,25,26,27,28,29,30,31
Persons with ADHD have lower self-esteem and general happiness with life, higher divorce rates and problems keeping friends and are at risk of forensic contact.26,32,33,34,35
In a South African study,19 the presence of adult ADHD more than doubled the healthcare costs of medical scheme beneficiaries. However, the costs attributable to direct costs of ADHD formed only 0.56% of the total value of claims. Of this, medication was the largest expense (5.47% of total costs and 38.48% of direct costs), whereas psychiatric services formed only 3.27% of the direct costs. This is in agreement with international findings28 where the cost of medication for treatment of ADHD amounted to 7% of all direct and indirect costs. This would suggest that pharmacological treatment of ADHD is cost-effective.
Individuals with untreated ADHD, their families and other caregivers must be made aware of the impact this disorder may have on them at every stage of life and, correspondingly, the improved outcomes that can be achieved with the successful management of ADHD.
Click here for the ADHD Treatment Armamentarium in South Africa
Schoeman R, Liebenberg R. The South African Society of Psychiatrists/Psychiatry Management Group Management Guidelines for Adult Attention-Deficit/ Hyperactivity Disorder. S Afr J Psychiat. 2017;23(0), a1060. https://doi.org/10.4102/sajpsychiatry.v23i0.1060 - An Update on the ADHD Treatment Armamentarium in South Africa., Prof Renata Schoeman
South African Journal of Psychiatry; The South African Society of Psychiatrists/Psychiatry Management Group the Management Guidelines for Adult Attention-Deficit/ Hyperactivity Disorder, 28 April 2017_An Update on the ADHD Treatment Armamentarium in South Africa, 2023