While the cause of ADHD remains unclear, the overall prevalence is estimated to range from three to nine percent for children and three to five percent for adults. It is a neurodevelopmental disorder in which symptoms usually appear in childhood and often continue into adulthood.
Read: Understanding the challenges of managing mental health in the workplace with a focus on ADHD
“Adults with ADHD can be easily distracted and struggle with mental restlessness, disorganization, and procrastination,” Arora said. “They may have difficulty starting and completing tasks, managing time and controlling behaviors and impulses, and managing their emotions.”
ADHD can profoundly affect personal and work life, leading to a chronic sense of underachievement and low self-esteem, he said, noting that adults with ADHD have higher absenteeism and lower productivity. In addition, they tend to channel their physical concerns towards work or sports activities, even going so far as to self-medicate with stimulants or illicit drugs. Over time, hyperactivity and impulsivity can be reduced, Arora noted, and people outgrow these symptoms; however, inattention does not usually change as people age.
According to Sun Life data, ADHD medication claims increased 67% between Q1 2018 and Q4 2021, while the overall growth in mental health medication claims over the same period was 28%. This was driven by growth in the number of applicants taking these medications, which increased 15 percent between 2020 and 2021. Although claims under the age of 15 account for the majority of ADHD applicants, people between the ages of 15 and 45 years saw the largest increase in claimants.
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Several ADHD drugs with the most claimants ranked lower in terms of amount paid, likely due to the availability of generic options, Arora said, noting that several generics are expected in the coming years that could have a impact on spending on ADHD medications. “From a medication management perspective, having mandatory generic substitution can be an important tool to save and promote plan sustainability.”
ADHD lends itself to a holistic approach to management, he said, referring to Canadian ADHD practice guidelines that emphasize the importance of a comprehensive, collaborative, multimodal approach that incorporates psychosocial interventions with medication and is designed to meet the unique needs of each person. This approach “may not only improve core ADHD symptoms, but overall quality of life by improving functional deficits,” she added.
An analysis of Sun Life claims indicated that a minority of applicants for ADHD medication actually turn to their paramedical mental health professionals for support. “While we have seen an increase from 2019 to 2021, only 28 percent of ADHD medication applicants also saw a doctor,” Arora said.
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Plan sponsors can play a key role in supporting their members’ treatment through their workplace benefit programs, he said, noting that they can educate and empower people living with ADHD by providing information about how it can affect your daily functioning, as well as treatment options and strategies. She also suggested that plan sponsors debunk social myths commonly associated with ADHD through their workplace wellness strategies, offer workplace accommodations for those living with ADHD, and provide coverage for necessary psychosocial interventions. .
Ultimately, ADHD can profoundly affect the lives of employees and contribute to increased absenteeism and lower productivity in the workplace, Arora said. “It’s an important condition for employers to consider as part of a larger conversation and a holistic approach to mental health.”
Read more coverage of the On-site Drug Plan Management Forum 2022.
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