ADHD costs: the true price of costs and treatment

If you think you’re hearing more about ADHD lately, you’re not imagining it. Diagnoses of ADHD (which stands for attention deficit hyperactivity disorder) are on the rise in Australia, largely as a result of increased public awareness around the condition. While there’s still a way to go, the condition is becoming more broadly understood. 

With more attention on ADHD, researchers like Deakin University’s Ha Le are turning their focus to the cost of diagnosis and treatment in children specifically, as well as barriers to services and the overall effectiveness of care models. Here, Le helps us explore the true costs of ADHD diagnosis and treatment. 

What is ADHD? 

Before we talk about ADHD costs and diagnoses, let’s quickly recap on the condition itself. Around 800,000 Australians currently live with ADHD and it’s especially common in children, with estimates suggesting the condition affects one in 20 kids, making it the most common mental health condition in the country.  

So, what is ADHD, exactly? According to Australasian ADHD Professionals Association signs of ADHD (particularly for children) include inattention or hyperactive-impulsive symptoms.  

Do I need an ADHD diagnosis?  

With dialogue about ADHD becoming more prevalent online, you may have come across posts detailing common ADHD symptoms. Perhaps such posts have led you to wonder if you or a child you know might need an ADHD diagnosis.  

‘The most common symptoms that prompt caregivers or individuals to seek ADHD diagnosis could include the low concentration/focus ability, hyperactivity (e.g. cannot sit still or focus on learning activities), overactive, anxiety and/or depressive symptoms or sleep problems,’ says Le. 

So, what constitutes ADHD diagnostically? Healthdirect Australia lists typical childhood symptoms including inattention and difficulty concentrating, becoming distracted, occasional hyperactivity and being impulsive. 

Do ADHD tests cost money? 

Unfortunately, ADHD assessments are not fully subsidised, especially for the assessments at private clinics. This means that they will likely cost you some money.  

Le’s research reveals the vast discrepancy in the cost of ADHD assessments for children depending on their place of residence.   

‘We found that the total out-of-pocket cost for an ADHD assessment at a private clinic with a paediatrician was higher in metropolitan areas ($607) compared to regional areas ($401) and higher in high socio-economic areas ($633) compared to low socio-economic ($465) areas,’ Le says.  

On the other hand, Le found that for those going to psychologists, the cost of ADHD diagnosis is fairly standard across the board, ranging from ‘$1975 to $2000, with no significant differences by geographical or socio-economic area within Victoria.’ 

How long does an ADHD assessment take? 

While there is effective treatment for ADHD, the waitlist for an ADHD assessment is long.  

‘The increase in ADHD awareness recently has led to an increase in ADHD diagnosis,’ Le says. ‘Currently, the surge in ADHD diagnosis demand amid the shortage of ADHD specialists (psychiatrists, paediatricians and psychologists) has overwhelmed the public healthcare system.’ 

For many, the time investment is one of the greatest non-financial costs of ADHD diagnosis. 

How long is the waiting list for ADHD assessment? 

So, how long will you need to wait for an ADHD assessment? Le’s research suggests patients can expect to wait anywhere from one to six months for private clinics. This waiting time could be up to 2 years at public hospitals, e.g. RCH Melbourne. 

‘Median wait times for an initial assessment appointment were 21 weeks for a paediatrician, 15 weeks for a psychiatrist and 4.8 weeks for a psychologist private clinic,’ says Le. ‘Wait times were generally longer for paediatrician and psychologist private clinics in regional areas and low socio-economic areas compared to metropolitan and high socio-economic areas, although these associations were not statistically significant.’ 

What are the barriers to ADHD diagnosis? 

There’s no doubt that growing awareness of ADHD signs and symptoms is a positive thing. Despite this, though, Le says there are some barriers to diagnosis. 

For example, initial assessments might prioritise referrals for patients with more severe symptoms over those with more mild symptoms.  

Le also notes there is ‘a lack of acknowledgement or expertise among parents, clinicians, and teachers, stigma, waiting times and structural/logistic barriers (i.e., challenges to obtain a referral, poor availability of services and practitioners, and cost and financial difficulties). These barriers have led to substantial unmet needs in ADHD diagnosis and treatment’ 

How much does ADHD medication cost?  

Here’s the good news: in Australia, many ADHD medications are available under the Pharmaceutical Benefits Scheme (PBS), meaning the cost of ADHD medication is often heavily subsidised, with the intention that all eligible Australians can access necessary medicines at affordable prices. However, the cost of some medications can still be high for individuals from low-income backgrounds, and medications are not always available. Australia is currently experiencing a shortage of ADHD medicines like Vyvanse and Concerta, as well as Ritalin and Artige. This is due to manufacturing issues overseas and Australia relying almost entirely on imported prescription medications, making it difficult to combat supply shortages with locally produced alternatives. 

What if I can’t afford an ADHD diagnosis?  

Being unable to access or afford the cost of an ADHD diagnosis can be incredibly stressful. Le’s research offers a few suggestions that could make the system work harder for everyday Australians amid the cost-of-living crisis. 

‘The government can consider reviewing PBS and Medicare Benefits Schedule (MBS) to reduce out-of-pocket costs for ADHD diagnosis and ongoing treatment such as including some items in MBS to include ADHD assessment in the current Medicare-funded Mental Health services (up to 10 services per year) under a healthcare management plan,’ Le says. ‘Furthermore, bring back the reimbursement for telehealth consultations with a specialist for GPs or providing educational support and incentives for GPs or mental health nurses to support the assessment and ongoing treatment with ADHD specialists.’ 

Is ADHD a long-term condition? 

As Le explains, ADHD is a long-term condition . ‘ADHD cannot be cured, but can be managed effectively and improved daily functioning,’ says Le. ‘Le research also shows that ADHD is associated with significant social and economic costs and reduced health-related quality of life in children and adolescents.  

This reaffirms the importance of improving access to diagnosis (including reducing wait times) and ensuring that medications are available to those who need them. 

In conclusion: the true cost of ADHD diagnosis 

As Le’s research makes clear, the true cost of ADHD diagnosis and treatment is quite varied depending on whether you’re visiting a paediatrician or psychologist and location (between accessing medical services in regional or metro Australia, or high and low socio-economic areas). Other issues, like access to medications and assessment, can all add to the overall economic cost. 

With lessons from passionate researchers like Ha Le campaigning for change, there’s real hope that the true cost of ADHD diagnosis will fall in the future.