ADHD spread Hamburg frequently on Ritalin

Prescriptions of the ADHD drug Ritalin in Hamburg highest

08/01/2013

For years, the high prescription rates of the ADHD drug Ritalin (methylphenidate) have been critically discussed in children. Now, the Association of Ersatzkassen (vdek) has found in an evaluation of the drug settlement data that in Hamburg, the prescriptions of drugs against the so-called Zappelphilipp syndrome once again significantly higher than the national average. The Hanseatic city occupies a sad leading position here, followed by the federal states of Rhineland-Palatinate and Bremen.

The prescription rate of the active ingredient methylphenidate in Hamburg is about 50 percent above the national average, according to the announcement of the association of alternative health insurance companies. Accordingly, Hamburg's schoolchildren are by far the most frequently given drugs for attention-deficit hyperactivity disorder (ADHD). How the extremely high prescription rates in Hamburg, but also in Rhineland-Palatinate and Bremen come about, does not emerge from the evaluation of the vdek. Since it can be assumed that the schoolchildren have at least similar conditions nationwide, however, it is suspected that the ADHD diagnosis in Hamburg is sometimes made faster than in other states. The Head of Outpatient Care at vdek-Landesvertretung Hamburg, Ralf Baade, emphasized that it was „Worrying that Hamburg schoolchildren receive comparatively many ADHD drugs.“

Ritalin should not be the first choice of therapy
„Medications such as Ritalin should not be the first choice in the treatment of behavioral problems requiring treatment“, Baade explained, adding: „They should be prescribed with restraint. Their use should always be embedded in a therapeutic overall concept.“ Even though Baade does not expressly criticize Ritalin's presumptuous prescription for the schoolchildren in Hamburg, his comments are marked by a clear criticism. The figures speak for themselves: At the prescribed average daily doses (DDD) of the active ingredient methylphenidate per 1,000 children, Hamburg occupies the top position with 18.6 DDD. As a comparison, the vdek lists the Ritalin regulations in Berlin, where „only half as many doses (9.8 DDD)“ be prescribed. Rhineland-Palatinate came to 16.7 daily doses and Bremen to 15.1 daily doses. Overall, the national average amounted to 12.1 DDD. According to vdek Mecklenburg-Western Pomerania, the lowest value was with a prescription amount of 6.7 average daily doses.

5,000 Hamburg children receive Ritalin
Although the Ersatzkassen in Hamburg according to own data „for years in the field of child and youth health, especially in the prevention of behavioral problems“ committed, the prescription rates of the ADHD drug are extremely high. Total received daily „around 5,000 Hamburg children and adolescents insured the prescriptive anesthetic methylphenidate“, reports the vdek.

The vdek includes the six replacement cash registers Barmer GEK, DAK health, HEK Hanseatic health insurance, hkk, commercial health insurance KKH and the Techniker Krankenkasse (TK). In 2012, they totaled 4.52 million insured children, adolescents and young adults (insured between the ages of zero and 20). Almost 127,200 of them lived in Hamburg, according to which nearly every second Hamburg citizen of this age group is insured in a substitute fund. This underlines the informative value of the current evaluation of the drug billing data. Altogether, according to the vdek, about 275,200 children and adolescents between the ages of zero and 18 years should live in the Hanseatic city. (Fp)