ADHD: Evaluation of Current and Emerging Therapies

A Survey of 20 Psychiatrists, 20 Pediatricians and 20 Pediatric Psychiatrists

March 2007

STUDY DESCRIPTION

OBJECTIVES

To evaluate current use of ADHD medications as well as the potential impact of entry of Vyvanse™ and generic Adderall XR® to this market.

• Quantify current treatment practices in child, adolescent and adult patient populations
• Assess level of concern over use of stimulants in these patient groups
• Determine potential use of Vyvanse following entry into the market
• Identify anticipated future use of generic Adderall XR
• Gauge potential for switching from brand name medications to generic alternatives

Companies and Products Mentioned in This Report 

Key Findings

• Coverage and co-pays a major factor: As may be expected, high co-pays will often drive patients to generic options when available. Price sensitivity appears to be greatest for patients with low fixed income or low socioeconomic status and middle-class families with HMO’s that push generics.  A subset of patients for whom addiction is a serious risk or concern will likely pay for Vyvanse regardless of the co-pay.
• Generic Adderall may be a deal breaker: Availability of generic Adderall XR will inevitably hurt branded products, including Vyvanse.  If Shire contracts heavily with MCOs to achieve preferred status, Vyvanse erosion could be minimized.  Physicians will also want to see more data on addiction risk and cardiovascular side effects before they adopt Vyvanse as a standard of treatment.
• Some safety concerns: Physicians are generally “somewhat concerned” with regard to the safety of stimulants.  For the adolescent population, this concern is more prevalent.  Physicians are concerned about cardiovascular side-effects for all ages. Concerns with the adult population center on abuse potential. Physicians worry more about growth and appetite suppression in children.
• Abuse potential is a major concern: Physicians most often cite abuse potential as the reason for not prescribing stimulants to certain patients, followed by patient or family concerns. Other factors affecting parents’ or patients’ views are the negative coverage in the media and an aversion to the idea of “drugging” their children.
• High levels of drug-treatment: Not surprisingly, the respondents treat most of their diagnosed ADHD patients (90%+ on average) with prescription medication, regardless of age. Adderall XR is the most prescribed medication for ADHD, followed by Concerta and Strattera.

Inclusion Criteria and Respondent Demographics

quantitative survey detailed findings by question

Detailed Findings and Analyses

SECTION ONE: Current Treatment Patterns

In this section, we would like to understand some specifics about your current treatment practice for ADHD.

In answering the following questions, please consider your [Adult or Child] and adolescent patients as separate patient groups.

Question 1

What percent of the [Adult or Child] and adolescent patients that you treat for ADHD receive prescription medication, regardless of other non-pharmacological treatments?

Question 2

Of the patients you treat with prescription medication for ADHD, what percent receive each of the following: