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Trend Watch: ADHD and Your Benefit Plan

Updated: Mar 14, 2023

In this article, we review how claims for ADHD medications have increased since prior to the pandemic, why you should monitor this trend as it relates to your benefits program, and how you can support plan members with ADHD.

ADHD, or Attention-Deficit / Hyperactivity Disorder is one of the most common neurodevelopmental disorders of childhood, and symptoms can persist into adulthood.

These symptoms can cause difficulty at work, at home, or with relationships. And symptoms can become more severe when the demands of adulthood increase. As the world dealt with new challenges associated with a pandemic, those demands on adults significantly increased. Today, ADHD is an important driver in benefits plan claims.

Many adults with ADHD perform their jobs extremely well. Traits such as high energy, problem solving, creativity and being able to hyper focus can offer significant benefits in the workplace.

However, for some adults, the symptoms can interfere with certain executive functions:

· Attention

· Organization and time management

· Self-regulation and monitoring

· Impulsivity

· Working memory

· Processing speed

· Flexibility or rigidity of thinking

· Emotional regulation

With the growth of ADHD claims and claimants, it is an important condition for employers to consider as part of broader conversations around mental health.

People suffering with ADHD often face co-morbid mental health concerns such as anxiety or low self-esteem.

  • Adults with ADHD have higher absenteeism and lower productivity than those who do not have it.

  • Most individuals with ADHD (85%) meet criteria for a co-morbid mental health condition

  • People with ADHD may channel their physical restlessness into work or sports activities, while others may self-medicate with stimulants or illicit drugs.

Since 2018, ADHD drug claims have increased by 67%, while all other mental health drugs increased by 18% in that same period, according to Sun Life Financial. The number of claimants aged 15 – 45 year old has seen the most significant growth.

In terms of the costs around medications used to treat ADHD, some recent and upcoming drug launches may provide some relief for plan sponsors:

  • Vyvanse was responsible for 12.6% of paid claims in 2021 but represented only 4.3% of claimants. The generic version of Vyvanse is expected to roll out in August 2023.

  • Intuniv accounted for 3.2% of paid claims and only 0.8% of claimants. The generic version of that medication was marketed in the first quarter of 2022.

Mandatory generic drug plans could assist in lowering the cost of claims associated with medications used to treat ADHD. Watch your drug claim reports for the incidence of these medications and ensure that plan members are aware that a generic version is available.

A Multimodal Response to Treatment for ADHD

Prescription medication alone may not be the most effective way of dealing with the symptoms associated with ADHD. Psychosocial supports and treatment by a qualified mental health professional is demonstrated to have significant impact on helping people who suffer from ADHD cope with this mental health issue in all facets of their lives.

There is hope in that the cohort of ADHD claimants between the ages of 15 – 35, there has been a 12% year over year growth in claims related to mental health specialists.

Helping Plan Members with ADHD

Employers have a duty to understand ADHD and how it can impact their employees. Here are some tips that can help guide your efforts:

  • Foster a workplace culture where employees can feel safe to disclose their ADHD without fear of stigma or being judged.

  • Set the employee up for success by coming up with accommodations focused on their specific impairments.

  • Highlight to your team what benefits are available.

There are also organizations that offer free guidance to plan members and employers:

Centre for ADHD Awareness Canada lists many options around workplace accommodations for plan members with ADHD. Click here for a handy reference guide.

CANLearn Society offers assessments and supports including ADHD coaching for adults, Let's Talk ADHD, an adult ADHD Group as well as counselling services.

Book a meeting with us if you would like to learn more about how your benefits plan can be used to support plan members suffering with ADHD.


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