■ 学会名
ISPOR Real-World Evidence Summit 2025

■ 発表日
2025/09/28

■ 筆頭演者
Ryutaro SUZUKI¹
1) Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

■ 共同演者
Ryosuke KUMAZAWA², Manabu AKAZAWA², Ken INADA¹
1) Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
2) Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan.

■ 発表形態
Poster

■ 受賞名
TOP 5% FINALIST

■ 要旨
This study investigated prescription patterns for ADHD medications in Japan using health insurance claims data from patients aged 0-17 years diagnosed with ADHD between April 2018 and August 2023. Prescription rates were analyzed by medication type, gender, age, and medical specialty.
Significant changes occurred during the study period. Guanfacine prescriptions increased dramatically from 19.3% to 46.4% (P<0.001), while methylphenidate (64.7% to 47.5%, P<0.001) and atomoxetine (34.4% to 22.4%, P<0.001) declined. Lisdexamfetamine, introduced in late 2019, reached 5.2%. Guanfacine became predominant for females and the 6-12 age group, while methylphenidate remained dominant in adolescents aged 13-17. In psychiatric departments, guanfacine emerged as most prevalent, whereas methylphenidate dominated non-psychiatric settings. Among new prescriptions, guanfacine increased from 27.4% to 41.3% (P=0.0021). Monotherapy rates declined modestly from 82.3% to 79.6%, with methylphenidate-guanfacine combination becoming preferred. This shift toward guanfacine may reflect its lack of distribution regulations, convenient once-daily dosing, and unique pharmacological mechanism. However, with medication costs ranging from $0.60-$1.14 (atomoxetine) to $4.40-$4.88 (lisdexamfetamine), increased treatment costs warrant future cost-effectiveness evaluation.