The Big Bucks in Keeping Kids Focused

Not that long ago, if Junior didn’t pay attention in his classroom, he might be sent to the principal’s office or have his parents called in to discuss his “bad” behavior. Today such kids increasingly are being screened for attention deficit hyperactivity disorder, a condition for which diagnoses are soaring across the U.S. Characterized by inattention, overactivity, and impulsiveness, ADHD may afflict an estimated 10 percent of American kids, according to a survey by the Centers for Disease Control and Prevention (CDC), and some researchers link it to drug abuse and an increased likelihood of criminal convictions in adulthood.

That’s been great news for Shire (SHPG), the world’s biggest seller of ADHD drugs. More than 90 percent of the Dublin-based company’s sales of ADHD medicines are in the U.S., where brisk demand since 2007 helped fuel a more than doubling in U.S. annual revenue for the class of stimulants used to treat the condition.

ADHD is diagnosed about 25 times more often in the U.S. than in the U.K. And while attitudes vary by country, many European parents, teachers, and doctors are reluctant to use medication to treat what they see as routine childhood behavioral problems. “There’s been a great deal of resistance to even believing there is a disease,” says Mary Baker, president of the European Brain Council. “Parents are loath to get their child labeled. Children are easy or difficult: That’s the diagnosis in society.”

In the U.S., the No. 1 market for prescription medicines, patients and doctors in recent years have embraced new drugs to treat conditions from erectile dysfunction to restless leg syndrome. Almost 10 percent of U.S. school-age children have been diagnosed with ADHD, according to a survey of parents by the CDC. By contrast, Eric Taylor, professor of child and adolescent psychiatry at King’s College London’s Institute of Psychiatry, estimates that only about 4 of every 1,000 U.K. children have received a diagnosis.

Critics say U.S. doctors overdiagnose ADHD and too readily treat even mild cases with medication. Sami Timimi, a British child psychiatrist who wrote Rethinking ADHD: From Brain to Culture, says he worries Europe is heading down the same path. He warns of a trend of medicalization, a tendency to regard child behavior as a medical condition. “The first-line treatment for all people should be psycho-social approaches,” Timimi says. “We don’t have any evidence that short-term benefits of medication can be sustained.”

The U.K. often acts as a bellwether for Europe in medical matters.

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