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Cost of ADHD

The economic cost of ADHD is very high for the United States. A comprehensive review of 19 research studies reporting on the excess cost of ADHD in the United States for children and adults found a range between $143 billion to $266 billion (adjusted to 2010 U.S. dollars) every year for the nation. Most of the costs were incurred by adults due to productivity and income losses. For children, healthcare and education were the main costs. Costs borne by family members of individuals with ADHD were also included in the total cost estimates (Doshi 2012).


CHILDREN

9.5% of children ages 417 in the United States have ADHD (Pastor 2015). This was approximately 5.1 million children in 2010. Of the total annual cost of ADHD, 26%–27% were incurred by children ($38 billion–$72 billion). Education and healthcare are the main costs.

The variability of costs is based on the severity of the ADHD, the presence and severity of coexisting disorders and the choice of treatment. The cost of ADHD includes healthcare, education, juvenile justice, and productivity and income costs for children with ADHD and their families.

Children with ADHD often cannot pay attention or sit still in class and fall behind academically without classroom interventions. Many of these students will under-perform and 30%40% will require special education services (Barkley, 2015).

 

Education Costs

Ages 3
$12,447 per person ($5.6 billion total)

Ages 518
$2,222$4,690 per person ($9.36 billion$19.75 billion total)

Where the money goes:  

  • special education
  • occupational, speech and physical therapy
  • grade retention
  • disciplinary incidents and school counseling

 

Health Care Costs

Children with ADHD need evaluation, treatment and doctors visits to monitor and manage the condition. They also have more injuries and visits to the pediatrician and emergency room.

Ages 0–21
$621$2,720 per child ($4.12 billion$18.04 billion total)

Non-ADHD siblings have high health care costs too:

Ages 018
$1,088$1,658 per sibling ($16.97 billion$25.86 billion total)

Where the money goes:

  • primary care
  • pharmacy and medications
  • emergency room
  • behavioral and emotional health
  • Medication costs comprise about 20% of health care costs.

 

Juvenile Justice System

Impulsivity can cause youth with ADHD to have poor judgment and make poor decisions, causing them to get into trouble with the law. They are three times more likely to be involved with the justice system.

Ages 1317
$267 per person ($530 million total)

Where the money goes:  

  • costs of detention centers and arrests.

 

ADULTS

An estimated 4.4% of adults in the U.S. have ADHD (Kessler, 2006). Adults incurred $105 billion–$194 billion (73%74%) of the overall excess cost of ADHD. The primary costs of adult ADHD are loss of income and loss of productivity at work. Household income is $10,532 to $12,189 less per person per year ($90.04 billion$104.20 billion total).

Workplace Concerns

  • Loss of productivity in the workplace costs $209 to $6,699 per person per year depending on the severity of the ADHD, or up to $38.71 billion per year.
  • Earn $2 less per hour compared with other adults without ADHD
  • Lack of productivity
  • Difficulty finding and keeping jobs
  • Increased number of sick days
  • Lower wages
  • Lack of full-time employment
  • More likely to be fired (24 times) or change jobs
  • Difficulty following instructions
  • Trouble getting along with coworkers
  • Struggle to meet deadlines and complete assignments
  • More difficulty managing large workloads
  • Challenges with concentration and paying attention

 

Health Care

Adults with ADHD ages 18 to 64 incur $137$4,100 per person ($1.17 billion$35.05 billion total) more in health care costs. This figure includes mental health care costs and is based on severity of ADHD which dictates the treatments needed.

Adults with ADHD need evaluation, treatment, and doctors visits to monitor and manage the condition. They are at higher risk for coexisting physical health conditions including heart disease and injury. They have more medical problems than adults without ADHD because they are less likely to take preventative health measures.

Adults (ages 19 to 44 years) who live with a family member with ADHD have about $1,051 in added costs, totaling $14.62 billion per year.

 

Crime

Adults (18 to 28 years old) with ADHD who engage in criminal behavior cost $1,204 to $2,742 per person or $2.52 billion$5.74 billion per year.

Where the money goes: 

  • victim and society costs due to burglary, larceny, arrests/convictions, and selling of drugs

Individuals with ADHD, particularly if untreated, come into contact with the justice system at a higher rate than other individuals.

The major symptoms of ADHDinattention and impulsivity/hyperactivitymay lead to acts resulting in contact with the criminal or juvenile justice system.

 

References

Abright, A. R. (2012). Estimating the Costs of Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry 51(10):987989.

Barkley, R. A. (2015). Educational, Occupational, Dating and Marital, and Financial Impairments in Adults with ADHD. In R. A. Barkley (Ed.), Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed. (p. 314). New York, NY: Guilford Press.

Barkley, R. A. (2010). Attention Deficit Hyperactivity Disorder in Adults: The latest assessment and treatment strategies. Sudbury: Jones and Bartlett Publishers.

Beecham, J. (2014). Annual Research Review: child and adolescent mental health interventions: a review of progress in economic studies across different disorders. Journal of Child Psychology and Psychiatry 55(6):714732.

Bussing, R. et al. (2010). Adolescent Outcomes of Childhood Attention-Deficit/Hyperactivity Disorder in a Diverse Community Sample. Journal of the American Academy of Child & Adolescent Psychiatry 49(6):595605.

Doshi,  J. A. et al. (2012). Economic Impact of Childhood and Adult Attention-Deficit/Hyperactivity Disorder in the United States. Journal of the American Academy of Child & Adolescent Psychiatry 51(10):9901002.e2.

Kessler, Ronald C. et al. (April 2006). The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication, American Journal of Psychiatry 163(5):71.

Pastor, Pastor N. et al. (2015). Association between diagnosed ADHD and selected characteristics among children aged 4–17 years: United States, 2011–2013. NCHS data brief, no 201. Hyattsville, MD: National Center for Health Statistics.

   

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