The High Council for Health (SHC) has issued a formal opinion calling for medication used in the treatment of ADHD to be reimbursed for everyone, not only young people under 18.
ADHD, or attention deficit hyperactivity disorder is, as the name suggests, a cognitive disorder characterised by a lasting pattern of difficulty in concentrating and/or hyperactivity or impulsivity. It often but not always manifests in childhood.
In its opinion of 2013, the Council made clear that the matter of diagnosis is not one for GPs, school staff or other first line professionals, but should be left to second or third line experts, particularly in the case of adult cases.
In its latest opinion, the Council stresses the first approach to treatment should take the form of psycho-educative therapy, regardless of the patient’s age, which also includes their family and surrounding group. Only when that proves insufficient should other methods be considered.
Medication is not advised for children under the age of six. But otherwise, the Council says in a press release, “a purely drug treatment, a purely non-drug treatment or a combination of both can be initiated”.
In Belgium at present, however, medication for the treatment of ADHD, most commonly methylphenidate – more commonly known as Ritalin – is only reimbursed for patients under the age of 18. Adults receive no reimbursement at all from ordinary medical insurance.
“To put these recommendations properly into practice, the organisation of mental health care and the reimbursement of interventions must be adapted,” the Council states. “The SHC recommends reimbursing all forms of medication if the prescriber follows the guidelines. The SHC also recommends that psychological support should not be a condition for the reimbursement of medication, as this support is not always necessary, or may not remain necessary once the patient has stabilised.”
The Council also points out that non-drug therapies are either not sufficiently available in Belgium, or that the reimbursement of costs leaves them out of the reach of many families.
It also says that alternative treatments like relaxation techniques, neuro-feedback, computerised cognitive training, exercise therapy and specific diet have insufficient scientific basis to allow them to be recommended – “although a healthy lifestyle and diet are of course recommended.”