Cost-Effective Second-Line ADHD Drug with Better Efficacy Reported

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About one-third of patients with ADHD have an inadequate response to initial stimulant treatment and consequently might be considered for treatment with one of two second-line treatment options—lisdexamfetamine dimesylate (LDX) or atomoxetine. A recent study by two RTI-HS researchers published in CNS Drugs found which of those two treatments is more cost-effective.

The economic analysis, conducted by Evelina Zimovetz, MSc, and Josephine Mauskopf, PhD, using data from the head-to-head trial, showed that LDX is a cost-effective treatment option compared with atomoxetine in children and adolescents who have had an inadequate response to the currently recommended first-line stimulant treatment.

The study, titled A Cost-Utility Analysis of Lisdexamfetamine Versus Atomoxetine in the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Inadequate Response to Methylphenidate published last week, found that LDX was associated with a faster and more robust treatment response than atomoxetine, as demonstrated in a 9-week, head-to-head, randomized, double-blind, active-controlled study.

"Our model found that LDX is highly cost effective relative to atomoxetine, providing better efficacy at a small increased cost. Thus, LDX would provide a good additional second-line stimulant option," says lead author Evelina Zimovetz, Associate Director in the Market Access and Outcomes Strategy group. "The option of using LDX may be particularly valuable for patients for whom atomoxetine is contraindicated or for those patients who prefer a stimulant with an adverse-event profile that is similar to that of other established stimulants."

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