The Department has made no assessment but has asked the National Institute for Health and Clinical Excellence (NICE) to develop a clinical guideline on attention deficit hyperactivity disorder. This will include an assessment of the clinical and cost-effectiveness of the drug Ritalin. NICE currently expects to publish guidance in February 2008.
Ritalin is a formulation of methylphenidate hydrochloride. In 2005 the net ingredient cost of prescriptions dispensed in the community in England was £834,500. This figure does not include drugs dispensed in hospitals, including mental health trusts, or private prescriptions.
The Department does not hold data on the number of patients who are prescribed the drug Ritalin.
(2) what assessment she has made of the extent of the inappropriate prescribing of Ritalin to young people.
Information on the number of children prescribed Ritalin (methylphenidate) is not collected.
In March 2006, the National Institute for Health and Clinical Excellence (NICE) published guidance on the use of drugs to treat Attention Deficit Hyperactivity Disorder (ADHD). NICE has estimated that around 5 per cent. of school-aged children meet the diagnostic criteria for ADHD, equivalent to 366,000 children and adolescents in England and Wales, but not all these children will require medication. In the year to 31 August 2006, 384,000 prescriptions for methylphenidate were dispensed in England to children aged 0 to 15 years and those aged 16 to 18 years in full time education.
We have no evidence to suggest that inappropriate prescribing of methylphenidate is widespread. NICE has recommended that drug treatment for ADHD should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis. Continued prescribing and monitoring of drug treatment may be performed by general practitioners, under shared care arrangements.
Methylphenidate is classified under the Misuse of Drugs Regulations 2001 as a schedule 2 controlled drug. As such, it is subject to additional restrictions in its use, for example it must be kept in a secure place that meets the requirements of the Safe Custody Regulations 1973. Amendments to the Misuse of Drugs Regulations in July 2006 brought in a standard prescription form for private prescribing of schedule two and three controlled drugs. Thus, the national data will now cover both national health service and private prescribing of methylphenidate by prescriber but not by patient.