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Prescriptions of the ADHD drug Ritalin highest in Hamburg
The high prescription rates of the ADHD drug Ritalin (methylphenidate) in children have been the subject of critical discussion for years. The Association of Substitute Health Insurance Funds (vdek) has now determined from an evaluation of the drug billing data that in Hamburg the prescription of drugs against the so-called Zappelphilipp syndrome is once again significantly higher than the national average. The Hanseatic city is in a sad leading position, followed by the federal states of Rhineland-Palatinate and Bremen.
The prescription rate of the active ingredient methylphenidate in Hamburg is around 50 percent above the national average, according to the Association of Substitute Health Insurance Funds. Hamburg's schoolchildren are by far the most frequently given drugs for attention deficit hyperactivity disorders (ADHD). How the extremely high prescription rates come about in Hamburg, but also in Rhineland-Palatinate and Bremen, is not apparent from the evaluation of the vdek. Since it can be assumed that school children nationwide have at least similar prerequisites, there is reason to suspect that ADHD diagnosis is sometimes made faster in Hamburg than in other federal states. The head of department for outpatient care at the vdek regional office in Hamburg, Ralf Baade, emphasized that "it is worrying that schoolchildren in Hamburg receive a comparatively large number of ADHD medications."
Ritalin should not be the first choice of therapy "Medicines like Ritalin should not be the first choice in the treatment of behavioral problems requiring treatment," Baade explained, adding: "They should only be prescribed with caution. Their use should always be embedded in an overall therapeutic concept. ”Even if Baade does not expressly criticize Ritalin prescribing the Hamburg schoolchildren too carelessly, his statement resonates with a clear criticism. At this point, the numbers speak for themselves: With 18.6 DDD, Hamburg holds the top position in the prescribed average daily doses (DDD) of the active ingredient methylphenidate per 1,000 children. As a comparison, the vdek lists the Ritalin regulations in Berlin, where "only half as many doses (9.8 DDD)" are prescribed. Rhineland-Palatinate received 16.7 daily doses and Bremen 15.1 daily doses. Overall, the national average was 12.1 DDD. According to vdek Mecklenburg-Vorpommern, the lowest value was with a prescription quantity of 6.7 average daily doses.
5,000 Hamburg children receive Ritalin Although the replacement health insurers in Hamburg have been committed "for years in the field of child and adolescent health, especially in the prevention of behavioral problems", the prescription rates of the ADHD drug are extremely high. In total, "around 5,000 legally insured children and adolescents in Hamburg receive the prescription narcotic methylphenidate", reports the vdek.
The vdek includes the six replacement health insurance companies Barmer GEK, DAK-Gesundheit, HEK-Hanseatische Krankenkasse, hkk, Kaufmännchen Krankenkasse KKH and Techniker Krankenkasse (TK). Together, they had 4.52 million insured children, adolescents and young adults (insured aged between 0 and 20) in 2012. Almost 127,200 of them lived in Hamburg, according to which almost every second Hamburg citizen of this age group is insured in a replacement fund. This underlines the informative value of the current evaluation of the drug billing data. According to the vdek, a total of approximately 275,200 children and adolescents aged between 0 and 18 should live in the Hanseatic city. (fp)
Picture: Dr. Klaus-Uwe Gerhardt / pixelio.d