by Elisa F. Cascade; Amir H. Kalali, MD; David Feifel, MD, PhD

Ms. Cascade is Vice President, Strategic Research and Safety, Quintiles Inc., Falls Church, Virginia; Dr. Kalali is Vice President, Global Therapeutic Group Leader CNS, Quintiles Inc., San Diego, California, and Professor of Psychiatry, University of California, San Diego; and Dr. Feifel is Associate Professor In Residence, Department of Psychiatry; Director, Neuropsychiatry and Behavioral Medicine Program; Director, UCSD Adult ADHD Program, University of California, San Diego Medical Center, San Diego, California.

Disclosures: Dr. Feifel has received research funding, consulting, or speaking fees from the following pharmaceutical companies: Abbott Laboratories, AstraZeneca, Argolyn Biosciences, Eli Lilly and Co., Bristol-Myers Squibb, Solvay, Janssen, Wyeth, McNeil, and Shire.

Abstract: We investigated use of Daytrana in the first year post-launch in the US: May, 2006 through April, 2007. According to our data, a total of 512,085 prescriptions for Daytrana were written in the first year of launch; psychiatry accounted for 34 percent of these prescriptions. Children and adolescents represented 88 percent of Daytrana users as compared to only 57 percent for the broader ADHD market. Expert commentary describing these trends is provided.

Key words: Daytrana, methylphenidate transdermal system, attention deficit hyperactivity disorder, ADHD, patch

Introduction
In May of 2006, Shire Inc. launched Daytrana (methylphenidate transdermal system), the first patch formulation approved for the treatment of attention deficit hyperactivity disorder (ADHD) in children. In this article, we investigate the use of Daytrana in its first year on the US market.

Methods

We examined retail pharmacy prescription data from Verispan, which captures more than 1.4 billion patient-centric prescriptions per year, nearly half of all prescription activity in the US. This data set includes prescriptions from a variety of retail channels (e.g., national retail chains, mass merchandisers) from a near-census of US pharmacies. The Verispan retail pharmacy database also captures information from all payer types, including cash.

Results

According to data from Verispan, a total of 512,085 prescriptions for Daytrana were written in the first year of launch (May, 2006–April, 2007). Psychiatry represented 34 percent of all Daytrana prescriptions in the first year.

Figure 1 displays total prescriptions for Daytrana and three other new ADHD therapies launched since 2002. As seen in Table 1, total prescriptions for Daytrana were similar to Ritalin-LA, but much lower than Strattera, which had the largest volume of prescriptions in the first year of any ADHD product launched in the last five years.

Eighty-eight percent of Daytrana prescriptions are dispensed to patients under the age of 18: 55 percent under age 12, and an additional 33 percent ages 13 to 17 (Figure 1). In contrast, for the ADHD market, only 57 percent of products are dispensed to children and adolescents.

Expert Commentary

Daytrana is a long-acting, transdermal methylphenidate delivery system. The Trend Watch data indicate that Daytrana’s first year on the market was characterized by a relatively modest number of prescriptions. Furthermore, these prescriptions were mostly given to younger patents with ADHD, with exceedingly few prescriptions for older children or adults. This data is expected. In a marketplace that is already crowded with several other long-acting methylphenidate products, such as Concerta, Focalin XR, Ritalin LA, and Metadate CD, the only unique feature the late-comer Daytrana provides lies in its non-oral delivery system. This feature is important for many very young ADHD patients for whom taking oral medications is extremely problematic if not a non-starter proposition altogether. The younger the patient, the more common the resistance to oral medication is, and so the disproportionate prescription rates of Daytrana for very young ADHD patients is understandable. Thus, while Daytrana is not new in its mechanism of action, it does represent an important addition to the armamentarium available to clinicians, especially those treating younger children with ADHD. Given the marketplace, Daytrana may not ever substantially grow its prescription numbers or market share in the future; however, it will probably always have a modest but important market share as a non-oral alternative methylphenidate option.