Attention-deficit-hyperactivity disorder (ADHD) affects over 40 million people—children, adolescents, and adults—across the major pharmaceutical markets. The key treatment goals for both pediatric and adult ADHD include controlling the core symptoms of the condition—inattention and/or hyperactivity/impulsivity—as well as improving patients’ overall functioning and quality of life. Psychostimulants are the predominant drug class prescribed for both pediatric and adult ADHD, though nonstimulant therapies serve as alternative or later-line options. Shortcomings in existing therapies, however, represent potential areas of opportunity for emerging therapies to be differentiated from competitors. Furthermore, recognition and diagnosis of adult ADHD continues to grow, particularly in the United States, but this population remains underdetected and undertreated, representing a sizable market opportunity.

Questions Answered

  • What is the current state of treatment for pediatric and adult ADHD across the G7, and what needs are left unfulfilled by current ADHD therapies?
  • How has the entrance of generic competition to key drugs (e.g., Eli Lilly’s Strattera [atomoxetine]) modified the ADHD treatment landscape?
  • How have newer-to-market and brand-only agents (e.g., Shire’s Mydayis, Neos Therapeutics’ Adzenys ER) been incorporated into medical practice? What are physicians’ perception of these therapies?
  • What emerging therapies do ADHD thought leaders consider the most promising for pediatric ADHD and adult ADHD?

Product description: Disease Landscape & Forecast provides comprehensive market intelligence providing world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.

Primary research: Approximately 16 country-specific interviews with thought-leading psychiatrists and pediatricians, supported by survey data.

Epidemiology: Prevalence of ADHD by country, segmented by pediatric and adult ADHD.

Emerging therapies: Phase II: 6 drugs; Phase III: 6 drugs; preregistration/registration: 2 drugs. Coverage of select preclinical and Phase I products.

Market forecast features: Ten-year, annualized, drug-level sales and patient share of key ADHD therapies through 2027, segmented by brands/generics and pediatric/adult ADHD.

Key companies: Shire, Janssen, Novartis, Eli Lilly, Arbor Pharmaceuticals, Neos Pharmaceuticals, Pfizer, Ironshore Pharmaceuticals, Supernus Pharmaceuticals, Sunovion.

Key drugs: Vyvanse, Concerta, Strattera, Adderall, Ritalin, Mydayis, Focalin, Dexedrine, Intuniv.

Table of contents

  • Attention-Deficit-Hyperactivity Disorder - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • December 2018
    • Market Outlook
      • Key Findings
        • Market Overview
        • Total Market Share of ADHD Drug Classes: 2017
        • Total Market Share of ADHD Drug Classes: 2027
        • Market Share of Drug Classes for Pediatric ADHD: 2017
        • Market Share of Drug Classes for Pediatric ADHD: 2027
        • Market Share of Drug Classes for Adult ADHD: 2017
        • Market Share of Drug Classes for Adult ADHD: 2027
        • ADHD SWOT Analysis
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for ADHD?
        • What Factors Are Constraining the Market for ADHD?
        • Key Market Events for ADHD: 2017-2027
        • Major-Market Sales of ADHD Drug Classes and Total Patient Share: 2017-2027
      • Drug Class-Specific Trends
        • United States Total ADHD Market Sales and Patient Share of Methylphenidates by Drug: 2017-2027
        • European Total ADHD Market Sales and Patient Share of Methylphenidates by Country: 2017-2027
        • Japanese Total ADHD Market Sales and Patient Share of Methylphenidates by Drug: 2017-2027
        • Major-Market Sales and Patient Share of Methylphenidates by Population: 2017-2027
        • United States Total ADHD Market Sales and Patient Share of Amphetamines by Drug: 2017-2027
        • European Total ADHD Market Sales and Patient Share of Amphetamines by Country: 2017-2027
        • Japanese Total ADHD Market Sales and Patient Share of Amphetamines by Drug: 2017-2027
        • Major-Market Sales and Patient Share of Amphetamines by Population: 2017-2027
        • United States Total ADHD Market Sales and Patient Share of Dopaminergic/Noradrenergic Agents by Drug: 2017-2027
        • European Total ADHD Market Sales and Patient Share of Dopaminergic/Noradrenergic Agents by Country: 2017-2027
        • Japanese Total ADHD Market Sales and Patient Share of Dopaminergic/Noradrenergic Agents by Drug: 2017-2027
        • Major-Market Sales and Patient Share of Dopaminergic/Noradrenergic Agents by Population: 2017-2027
        • United States Total ADHD Market Sales and Patient Share of Adrenergic Receptor Agonists by Drug: 2017-2027
        • European Total ADHD Market Sales and Patient Share of Adrenergic Receptor Agonists by Country: 2017-2027
        • Japanese Total ADHD Market Sales and Patient Share of Adrenergic Receptor Agonists by Drug: 2017-2027
        • Major-Market Sales and Patient Share of Adrenergic Receptor Agonists by Population: 2017-2027
      • Alternative Market Scenario
        • Alternative Scenarios for the ADHD Market Through 2027
    • Forecast
      • Sales of Drugs to Treat ADHD in the Major Pharmaceutical Markets: 2017-2027
    • Etiology and Pathophysiology
      • Disease Overview
        • The Etiology of ADHD
      • Genetic Factors
        • Select Genes Related to ADHD
      • Environmental Factors
        • Key Environmental Risk Factors in ADHD
      • Key Pathways and Drug Targets
        • Methylphenidate’s Mechanism of Action
        • Key Drug Targets for ADHD
        • Dopaminergic Pathways Associated with ADHD
    • Epidemiology
      • Key Findings
        • Epidemiology Populations
          • Disease Definition
          • Methods
          • Sources Used for Total Prevalent Cases of Adult ADHD Based on the DSM-IV
          • Total Prevalent Cases of Adult ADHD Based on the DSM-IV: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Total Prevalent Cases of Pediatric ADHD Based on the DSM-IV
          • Total Prevalent Cases of Pediatric ADHD Based on the DSM-IV: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Total Prevalent Cases of ADHD Based on the DSM-IV
          • Total Prevalent Cases of ADHD Based on the DSM-IV: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Total Prevalent Cases of ADHD Based on the DSM-5
          • Total Prevalent Cases of ADHD Based on the DSM-5: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Total Prevalent Cases of Pediatric ADHD Symptoms
          • Total Prevalent Cases of Pediatric ADHD Symptoms: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Prevalent Cases of Pediatric ADHD by Subtype
          • Prevalent Cases of Pediatric ADHD by Subtype: 2017-2027 (thousands)
          • Disease Definition
          • Methods
          • Sources Used for Prevalent Cases of Pediatric ADHD by Comorbid ODD
          • Prevalent Cases of Pediatric ADHD by Comorbid ODD: 2017-2027 (thousands)
          • Diagnosed Prevalent Cases of Pediatric ADHD: 2017-2027 (thousands)
          • Diagnosed Prevalent Cases of Adult ADHD: 2017-2027 (thousands)
          • Drug-Treated Prevalent Cases of Pediatric ADHD: 2017-2027 (thousands)
          • Drug-Treated Prevalent Cases of Adult ADHD: 2017-2027 (thousands)
      • Current Treatment
        • Key Findings
          • Treatment Goals
            • Key End Points Used in Clinical Trials for ADHD
          • Key Current Therapies
            • Overview
            • Mechanism of Action of Key Current Drug Classes Used for ADHD
            • Current Treatments Used for ADHD
            • Market Events Impacting the Use of Key Current Therapies for ADHD
            • Advantages and Disadvantages of Methylphenidate IR
            • Expert Insight: Methylphenidate IR
            • Advantages and Disadvantages of Methylphenidate ER
            • Advantages and Disadvantages of Methylphenidate SR
            • Advantages and Disadvantages of Methylphenidate MR
            • Expert Insight: Methylphenidate ER/SR/MR
            • Advantages and Disadvantages of Methylphenidate CR
            • Expert Insight: Methylphenidate CR
            • Advantages and Disadvantages of Dexmethylphenidate
            • Expert Insight: Dexmethylphenidate
            • Advantages and Disadvantages of Transdermal Methylphenidate
            • Expert Insight: Transdermal Methylphenidate
            • Advantages and Disadvantages of Mixed Amphetamine Salts IR
            • Expert Insight: Mixed Amphetamine Salts IR
            • Advantages and Disadvantages of Mixed Amphetamine Salts ER
            • Expert Insight: Mixed Amphetamine Salts ER
            • Advantages and Disadvantages of Mixed Amphetamine Salts DR
            • Key Results from Select Clinical Trials Investigating Mixed Amphetamine Salts DR for the Treatment of ADHD
            • Key Ongoing Clinical Trials of Mixed Amphetamine Salts DR in the Treatment of ADHD
            • Expert Insight: Mixed Amphetamine Salts DR
            • Advantages and Disadvantages of Lisdexamfetamine
            • Expert Insight: Lisdexamfetamine
            • Advantages and Disadvantages of Dextroamphetamine
            • Expert Insight: Dextroamphetamine
            • Advantages and Disadvantages of Amphetamine Sulfate
            • Key Ongoing Clinical Trials of Amphetamine Sulfate in the Treatment of ADHD
            • Expert Insight: Amphetamine Sulfate
            • Advantages and Disadvantages of Amphetamine ER ODT
            • Advantages and Disadvantages of Amphetamine ER Liquid
            • Expert Insight: Amphetamine ER
            • Advantages and Disadvantages of Atomoxetine
            • Expert Insight: Atomoxetine
            • Advantages and Disadvantages of Bupropion
            • Expert Insight: Bupropion
            • Advantages and Disadvantages of Clonidine
            • Expert Insight: Clonidine
            • Advantages and Disadvantages of Guanfacine
            • Expert Insight: Guanfacine
            • Advantages and Disadvantages of Wakefulness-Promoting Drugs
            • Expert Insight: Wakefulness-Promoting Drugs
          • Medical Practice
            • Overview
            • Treatment Guidelines
            • Country-Specific ADHD Treatment Guidelines
            • Factors Influencing Drug Selection in ADHD
            • Treatment Decision Tree for ADHD: United States
            • Treatment Decision Tree for ADHD: Europe
            • Treatment Decision Tree for ADHD: Japan
        • Unmet Need Overview
          • Current and Future Attainment of Unmet Needs in ADHD
          • Top Unmet Needs in ADHD: Current and Future Attainment
          • Expert Insight: Unmet Need in ADHD
        • Emerging Therapies
          • Key Findings
            • Pipeline Trends in ADHD
          • Key Emerging Therapies
            • Notable Developments Among Key Emerging Therapies for ADHD
            • Key Therapies in Development for ADHD
            • Estimated Launch Dates of Key Emerging Therapies for the Treatment of ADHD
            • Key Results from Select Clinical Trials Investigating Jornay PM for the Treatment of ADHD
            • Analysis of the Clinical Development Program for Jornay PM
            • Expert Insight: Jornay PM
            • Expectations for Launch and Sales Opportunity of Jornay PM in ADHD
            • Likely Uses of Jornay PM in ADHD Treatment
            • Key Results from Select Clinical Trials Investigating KP-415 for the Treatment of ADHD
            • Analysis of the Clinical Development Program for KP-415
            • Key Ongoing Clinical Trial of KP-415 in the Treatment of ADHD
            • Expert Insight: KP-415
            • Expectations for Launch and Sales Opportunity of KP-415 in ADHD
            • KP-484 Profile
            • Analysis of the Clinical Development Program for KP-484
            • Expert Insight: KP-484
            • Expectations for Launch and Sales Opportunity of KP-484 in ADHD
            • Key Results from Select Clinical Trials Investigating Molindone for the Treatment of Impulsive Aggression in ADHD
            • Analysis of the Clinical Development Program for Molindone
            • Key Ongoing Clinical Trials of Molindone in the Treatment of Impulse Aggression in ADHD
            • Expert Insight: Molindone
            • Expectations for Launch and Sales Opportunity of Molindone in Impulsive Aggression in ADHD
            • Likely Uses of Molindone in ADHD Treatment
            • Key Results from Select Clinical Trials Investigating Dasotraline for the Treatment of ADHD
            • Analysis of the Clinical Development Program for Dasotraline
            • Key Ongoing Clinical Trials of Dasotraline in the Treatment of ADHD
            • Expert Insight: Dasotraline
            • Expectations for Launch and Sales Opportunity of Dasotraline in ADHD
            • Key Results from Select Clinical Trials Investigating Centanafadine for the Treatment of ADHD
            • Analysis of the Clinical Development Program for Centanafadine
            • Key Ongoing Clinical Trials of Centanafadine in the Treatment of ADHD
            • Expert Insight: Centanafadine
            • Expectations for Launch and Sales Opportunity of Centanafadine in ADHD
            • Key Results from Select Clinical Trials Investigating Viloxazine for the Treatment of ADHD
            • Analysis of the Clinical Development Program for Viloxazine
            • Ongoing Clinical Trials of Viloxazine in the Treatment of ADHD
            • Expert Insight: Viloxazine
            • Expectations for Launch and Sales Opportunity of Viloxazine in ADHD
            • Likely Uses of Viloxazine in ADHD Treatment
            • Key Results from Select Clinical Trials Investigating Fasoracetam for the Treatment of ADHD
            • Analysis of the Clinical Development Program for Fasoracetam
            • Expectations for Launch and Sales Opportunity of Fasoracetam in ADHD
          • Early-Phase Pipeline Analysis
            • Notable Developments in the Early-Phase Pipeline for ADHD
            • Select Phase II Compounds in Development for ADHD
            • Select Phase I and Preclinical Development Programs for ADHD
        • Access & Reimbursement Overview
          • Region-Specific Reimbursement Practices
            • Key Market Access Considerations in ADHD: United States
            • General Reimbursement Environment: United States
            • Key Market Access Considerations in ADHD: EU5
            • General Reimbursement Environment: EU5
            • Key Market Access Considerations in ADHD: Japan
            • General Reimbursement Environment: Japan
          • Looking for More?
        • Appendix
          • Key Abbreviations Related to ADHD
          • Brands, Marketers, and Generic Availability of Key Therapies for ADHD by Market
          • Attention-Deficit/Hyperactivity Disorder Bibliography

      Author(s): Joyce Spadafora, ALM; Andrea Witt, PhD; Niyati Khetarpal, Ph.D; Mudasir Khan, M.P.H.; Shefali Gulati, MBA Pharm

      Joyce is a business insights analyst in Decision Resources Group’s central nervous systems and ophthalmology division, where she provides expert insight into commercial aspects of drug development and market sizing across psychiatric and pain indications. She has worked extensively in DRG’s schizophrenia and chronic pain content.

      Prior to joining DRG, Joyce spent several years in the biotech industry focused in research and development and in biotech consulting. Her project experience covered indications including psychiatry, pain, infectious diseases, respiratory, and ophthalmology. Beyond my therapeutic and industry knowledge, she holds a Masters in Extension Studies in Psychology from Harvard University and a B.S in Mechanical Engineering with Biology from the Massachusetts Institute of Technology.

      Andrea S. Witt, Ph.D., is Therapy Leader of the Central Nervous System and Ophthalmology Disorders Portfolio at Decision Resources Group where she oversees a team of 14 Business Insights Analysts and Senior Directors responsible for market research encompassing Neurology, Psychiatry, Pain, and Ophthalmology.

       Dr. Witt has been with Decision Resources Group for over 12 years, following CNS markets and trends. Her interests beyond specific CNS indications included the market potential for neuroprotectants and the impact of biomarkers on CNS markets. Dr. Witt’s research, analysis, and commentaries have appeared in Barron’s, Pharmaceutical Executive, PharmaVoice, Nature Medicine, and CNBC. Dr. Witt’s previous experience includes 10 years of scientific research conducted on neurodegenerative disorders at Harvard Medical School/Brigham and Women’s Hospital, Duke University, and the University of Texas-Southwestern Medical Center, where she earned her Ph.D. degree.

      "Niyati Khetarpal is a business insights analyst on the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group. In this role, she conducts primary and secondary research to analyze pharmaceutical markets, with a focus on neurology indications, including epilepsy and MS. She also has specific expertise in patent/IP research. Prior to joining the company, Niyati obtained her doctorate from the International Centre for Genetic Engineering and Biotechnology for her research on Dengue virus vaccines. She received the Fulbright-Nehru doctoral scholarship in 2014 for her research on Dengue and West Nile virus envelope proteins.”

      Mudasir works as an associate epidemiologist within the epidemiology team at Decision Resources Group. He specializes in developing epidemiological forecasts for multiple indications within the DRG syndicated portfolio.

      Mudasir holds a masters in public health specializing in epidemiology from TISS, Mumbai.

      Shefali Gulati, Associate analyst, is part of the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group.

      She is responsible for performing extensive secondary market research and analysis for major pharmaceutical markets. She comes with one year of experience working on multiple client projects revolving around opportunity assessment, competitive landscape, pipeline analysis, and key product profiling. She holds a MBA degree in Pharmaceutical Management from the National Institute of Pharmaceutical Education and Research (NIPER) in India and Bachelor’s in Pharmacy from DIPSAR.