A systematic review and economic model of the effectiveness and ...

MPH, DEX and ATX improve hyperactivity
and QoL (as assessed using CGI as a
proxy) compared with placebo. The validity
of the results is not known for studies of MPH
and DEX, given the poor reporting of study
methodology in the majority of these trials.
The recent trials on ATX are likely to be more
reliable.
There were very few head-to-head studies
comparing MPH, DEX and ATX. No significant
differences between the various drugs in terms of
efficacy or side-effects were found, mainly owing
to a lack of evidence.
The main conclusions from this report are:
● Drug therapy seems to be superior to no drug
therapy.
● No significant differences between the various
drugs in terms of efficacy or side-effects were
found, mainly owing to a lack of evidence.
● The additional benefits from BT (in
combination with drug therapy) are uncertain.
Chapter 8
Conclusion
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Health Technology Assessment 2006; Vol. 10: No. 23
The main additional feature of the economic
model is the consideration of costs. Given the lack
of evidence for any differences in effectiveness
between the drugs, the model tends to be driven
by drug costs, which differ considerably.
Research recommendations
● Future trials examining MPH, DEX and ATX
should include the assessment of tolerability
and safety as a priority. Reporting should be
standardised and transparent. Researchers
should refer to the CONSORT approach to
study design. 159
● Longer term follow-up of individuals
participating in trials could further inform
policy makers and health professionals. Such
data could potentially distinguish between these
drugs in a clinically useful way.
● In addition, research examining whether
somatic complaints are actually related to drug
treatment or to the disorder itself would be
informative.
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