Adults new target of ADHD drug sellers

LONDON - Medicating attention deficit disorder, already a US$2.2 billion ($3.57 billion) a year business, is about to get a lot bigger as drug companies expand the treatment from children to adults.

Traditionally associated with children's tantrums, attention deficit hyperactivity disorder (ADHD) has been viewed as an illness which is outgrown in adolescence.

Yet up to 65 per cent of children with ADHD may still exhibit symptoms into adulthood, according to some studies, making grown-ups a lucrative new market for drug manufacturers.

Eli Lilly & Co's Strattera is the only ADHD pill with approval from the US Food and Drug Administration for use in adults. But Britain's Shire Pharmaceuticals Group expects its market-leading Adderall XR to get the green light within the next month or two.

"The adult market is three times the size of the children's market. The market is ripe and is moving in the right direction," said Matthew Emmens, Shire's chief executive.

Much of the past three years of sales growth was, in fact, due to US doctors already prescribing for adults, he added.

Some doctors, however, are uncomfortable at snowballing drug use which is now spreading beyond the United States, where spending on behavioural disorders overtook the cost of antibiotics and asthma medicines for children in 2003.

In Britain, where use of medication is more recent and Novartis' Ritalin dominates, opinion is deeply divided about using stimulants on children and the expansion into adults.

A recent British Medical Association debate found most doctors opposed giving more medicines to children, even though British treatment rates are way below the US level.

Between 3 and 5 per cent of US children are diagnosed with ADHD, a condition which is marked by reduced ability to concentrate, difficulty in organising and impulsive behaviour. In Britain and most of Europe, meanwhile, the rate is a fraction of one per cent.

Which side of the transatlantic divide is right?

David Coghill, senior lecturer in child and adolescent psychiatry at the University of Dundee, is convinced of the benefits of medication and is angered by suggestions that ADHD is not a proper disease.

"At least 80 per cent of the risk of having ADHD depends on your genes, which is a very strong indication of a biological basis for a disorder," he said.

Others, though, are worried by growing pressure to medicate.

"Paediatricians are making quick and dirty assessments and then deciding on treatment, often under great pressure from extremely hard-pressed families," said Harvey Marcovitch of Britain's Royal College of Paediatrics and Child Health.

International studies suggested up to 50 per cent of children receiving medication do not actually meet the clinical guidelines defining ADHD, he added.

The signs are that the ADHD drug market is set to grow.

In the United States, which accounts for the vast majority of prescriptions, sales are increasing at around 20 per cent a year.

- REUTERS