ADHD claims on the rise: What you should know

August 22, 2023

For business owners, plan sponsors and administrators 

Attention deficit hyperactivity disorder (ADHD) has been understood by many as a childhood condition but is recognized more widely as a condition that continues into adulthood. Over the course of the last five years, Manulife has seen a steady increase in adult claimants for ADHD medications – and the numbers continue to grow. From 2021 to 2022, the number of unique claimants for ADHD medication, ages 18 and over, grew by 24.5 per cent.¹

As of 2022, ADHD is reported to affect about 5 per cent of the population (including children and adults).² About 50 per cent of adults who were diagnosed with ADHD in childhood will meet the diagnostic criteria for ADHD in adulthood.³ This means that, for many adults, ADHD is not something you simply “grow out of.”  Additionally, claims data shows that ADHD medications have been used more widely in the adult market over the last few decades. So, what else is driving these increased numbers of adults with claims for treatments related to ADHD?

ADHD as a risk factor for other health issues

One of the trends that may be driving claims is an increase in knowledge on ADHD within the medical community, which has helped doctors better recognize signs and symptoms.⁴ Doctors are also sensitive to the fact that if left untreated, ADHD is a risk factor for other challenges, including an increased risk of car accidents, injuries, cardiovascular disease, obesity, and financial health concerns.⁵

When left untreated, ADHD can often present alongside other mental health conditions. For example, certain symptoms of ADHD such as reduced motivation or engagement and lower arousal levels also overlap with other mental health conditions, such as depression. In fact, depression is three times more prevalent in adults with ADHD compared to adults without ADHD.^{4, 6} When left untreated, the secondary issues that accompany ADHD, such as low self-esteem, can also be more likely to impact overall mental health.³

Treatment works

Fortunately, doctors who are up to speed on the health risks of leaving ADHD untreated may be more likely to explore the possibility of an ADHD diagnosis and treatment to help patients optimize their health.⁴ Some medications seem to be particularly popular amongst doctors and individuals with ADHD. For instance, Vyvanse (lisdexamfetamine) has recently shown a 20 per cent growth in claim reimbursement by quarter in 2022.¹

Diagnosis of ADHD in women

In addition to the medical community’s expanded understanding of ADHD over the last several decades, one of the difficulties doctors have faced in diagnosing ADHD is the way symptoms present themselves in different genders. While men tend to display more behaviours related to impulsivity or hyperactivity, women tend to exhibit more symptoms related to inattentiveness – which has sometimes been overlooked. "Females of all ages have likely been underdiagnosed for decades,” states Dr. Marie-Hélène Geoffroy, of Cleveland Clinic Canada who specializes in treatment of patients with ADHD. However, in recent years, there has been a consistent increase in claims from middle-aged women (25-45), suggesting that this diagnosis disparity is catching up. This rising trend has grown to reflect a near even distribution of claims between female and male claimants in 2022.¹

Work environment and ADHD awareness

Another factor underlying the increase in claims might be COVID and the “Work from Home” response. This response might have helped surface symptoms of ADHD for adults that had been previously masked by structured work environments. While this may have served to prompt diagnosis for some of the working population, increased awareness of ADHD in general is also likely playing a role in the rise in claims.

Influence of social media on ADHD awareness

Some of the increased awareness of ADHD can also be attributed to social media. As of May 2022, the hashtag ‘adhd’ had 11.4 billion views on TikTok.⁴ “Many people credit these platforms with helping them become aware of the condition, considering if their experiences and their symptoms are consistent with the diagnoses, and subsequently talking to healthcare professionals to review the potential diagnosis, and whether they would benefit from symptom management or treatment,” says Dr. Marie-Hélène Geoffroy of Cleveland Clinic Canada.

The bottom line

Understanding the benefits of ADHD treatment can be a key driver to supporting better health outcomes for affected employees. And as we know, the ways in which employers support the health and well-being of their employees has a major impact on Canadian workforces. Thirty-four per cent of Canadian employees say that health and well-being benefits and services are the most important factor when choosing an employer. Flexibility is cited by 28 per cent while 18 per cent say the type of work is the most important factor.⁷ A survey from 2021 found that 79 per cent of employees believed their company’s well-being programs helped them be as productive as possible.⁸ If these numbers are not compelling enough, for every $1 spent on mental health care at work, there is a $4 return on investment.⁹

What we’re doing to support healthier outcomes

When it comes to ADHD, well-being programs such as enhanced coverage for ADHD treatment and leadership training on neurodiversity in the workplace are among the most successful.¹⁰ To help our clients move toward healthier outcomes, as of October 1, 2023, Manulife will be introducing a pharmacogenetics program to all Extended Health Care plans at no extra cost (Personalized Medicine).

The program involves simple genetic testing to provide insight on how a member may respond to certain medications and may be helpful in guiding treatment decisions which can help their healthcare team find the right medication for them. ADHD is one of the conditions included in the program, along with mental health conditions, chronic pain, and neurological conditions.

References:

¹ Manulife group benefits aggregate claims data, 2023

² Centre for ADHD Awareness, Canada. What you need to know about ADHD, ^{undated, accessed July 2023}

³ Trends in the Prevalence and Incidence of Attention-Deficit/Hyperactivity Disorder Among Adults and Children of Different Racial and Ethnic Groups, ₂₀₁₉

⁴ ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis?, ₂₀₂₂

⁵ Cleveland Clinic Canada – ADHD – Advisory Services, 2023

⁶ The Relationship Between ADHD and Depression _{(verywellmind.com), 2020}

⁷ Over one-third of Canadians prioritize health and well-being benefits when choosing an employer, 2022

⁸ Employees and their opinions towards employer wellbeing programs U.S. 2021 | _Statista

⁹ Your job is starting to invest in your mental health, and they’re seeing a 4x return on investment when they do; _{Fortune, 2022}

¹⁰ Cleveland Clinic Canada – FAQ - Neurodiversity and the Workplace, 2022