Could Pharmac’s ADHD medication changes be a game-changer or a risk? - The Front Page

ADHD symptoms can be confused with anxiety or depression, leading to delayed diagnosis. Photo / 123rf

Pharmac is now funding a new medicine and has removed renewal criteria for ADHD treatments.

It will fund lisdexamfetamine, a new stimulant medicine and an additional treatment option as well as removing the renewal criteria for methylphenidate, dexamfetamine, and modafinil, medicines used to treat ADHD and narcolepsy.

This means once a special authority approval has been granted, a doctor or nurse can continue to prescribe it.

Advocates welcome the move, saying it’s a game-changer that will save the health system tens of millions of dollars.

But there are warnings it could lead to over-diagnosing and over-prescribing.

Co-founder of DivergenThinking and registered psychologist, Anton Ashcroft told The Front Page he’s in two minds about this debate.

“I think it’s a practical and pragmatic challenge because if you are prescribing for people who don’t benefit, or it could be detrimental to them, then obviously that’s a bad thing.

“But, if we make our offering of medication so limited and stringent that we are ignoring a lot of people for whom the medication could be helpful just because of how we diagnose ADHD.

“There needs to be a conversation about how we match the benefit of medication to those who are likely to benefit from it,” he said.

This month, Pharmac announced a nationwide shortage of extended-release methylphenidate as demand has increased rapidly here and overseas.

In New Zealand, demand has risen by 140% over the last two years.

In October, the New Zealand Drug Foundation found ADHD patients were more likely to have a substance abuse disorder, and young people who get diagnosed and treated for ADHD are far less likely to develop drug problems later in life.

Likewise, an Australian study of people who regularly used illicit stimulants found that 45% screened positive for adult ADHD.

Ashcroft said the awareness of ADHD and ADD is becoming more prevalent in our society.

“There has been a large undiagnosed population for a long time and now that people are developing the awareness, they’re seeking support.

“Because it’s more popular and it’s being normalised people are thinking ‘Well, maybe I’ve got that too.' So, we do need more support, more stringent or really helpful diagnostic criteria to say whether a person has got ADHD or do they just have the traits,” he said.

There are suggestions that GPs should become able to diagnose ADHD, which Ashcroft said could be a risk if someone has other conditions that may mimic symptoms of ADHD.

“But, what we’re talking about in terms of prescribing is what GPs already do with anxiety and depression meds. We sort of ‘suck it and see’ and if it works, great, if it doesn‘t, let’s try something else.

“In a sense, why would ADHD medication, from its pure therapeutic benefit point of view, why would we look at it in a different way?”

GPs were stripped of their ability to prescribe the medications in 1999 over fears they were being over-prescribed or misused.

Listen to the full episode to hear more about diagnosing ADHD and the new rules that have taken affect.

The Front Page is a daily news podcast from the New Zealand Herald, available to listen to every weekday from 5am. The podcast is presented by Chelsea Daniels, an Auckland-based journalist with a background in world news and crime/justice reporting who joined NZME in 2016.

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