Estonia to simplify ADHD medication prescribing for children — ERR News
Starting October 1, Estonia plans to simplify the rules for prescribing certain medications for the treatment of attention deficit hyperactivity disorder (ADHD) to children and young people aged 6 to 19. Psychiatrists will no longer need to consult a treatment team before prescribing these medications, ERR News reports.
Which medications the change will cover
The changes are envisaged by a draft regulation of Estonia’s Ministry of Social Affairs. They concern medications containing methylphenidate, sold among others under the brand names Ritalin and Concerta, as well as medications containing atomoxetine, including Atominiex. These medicines are first-line treatments for patients aged 6–19 and are reimbursed at 75%.
Currently, prescribing such medications requires a consultation with a psychiatric treatment team. Its members may include, among others, a clinical speech therapist and two psychiatrists with additional qualifications to work with children. After the rule change, the medications may be prescribed by a psychiatrist or a psychiatrist with additional specialization in child and adolescent psychiatry.
Psychiatrists’ position
Getter Hark, head of the medication reimbursement service at the Estonian Health Insurance Fund, said the changes were developed in cooperation with the Estonian Psychiatric Association. According to her, the aim is to bring the rules for children and young people closer to those for adults and align treatment practice with clinical guidelines.
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Anne Kleinberg, vice president of the Estonian Psychiatric Association, called the current requirement for a team consultation an unnecessary waste of time. She noted that ADHD diagnosis and treatment decisions are a routine part of a psychiatrist’s work, while other specialists on the team do not prescribe medication and do not bear responsibility for it.
The number of prescriptions is growing
According to the Health Insurance Fund, both the number of prescriptions for medications containing methylphenidate and atomoxetine and the number of children and young people receiving them have increased in Estonia in recent years. In 2021, nearly 4,200 prescriptions were issued to children aged 6–10 for about 950 patients. Since the beginning of the current year, nearly 9,600 prescriptions have been issued for the same age group for about 2,430 people.
Experts stressed that the change in prescribing rules will not abolish the thorough process of diagnosis and treatment decision-making. Doctors will continue to follow clinical guidelines and the diagnostic criteria set out in them.
