Managed Care's Guide

Safety Data

Complete FDA FAERS Q1 2024 analysis — concomitant rates, OTC comparisons, and head-to-head drug data.

Source: FDA FAERS Q1 2024 — 169,640 total reports across 18,048 drugs. ADHD medications appeared in 1,341 reports (0.79% of all reports).

Understanding FAERS Classification

The FDA classifies each drug in an adverse event report as one of three roles:

  • Suspected — The drug is believed to have caused or contributed to the adverse event
  • Concomitant — The drug was present but is not believed to have caused the event
  • Interacting — Two or more drugs interacted to produce the event

A high concomitant rate is a positive safety signal. It means the drug appears in reports because patients take multiple medications — not because it caused harm.

ADHD vs. All Other Drugs

CategoryReportsSuspected RateConcomitant Rate
ADHD Medications1,34125.2%75.2%
All Other Drugs168,299~100%~0%

The average drug across all 18,048 tracked is suspected in virtually every adverse event report it appears in. ADHD medications are suspected in only 25.2% — 4× less likely to be identified as the cause.

Concomitant Rate by Individual Drug

DrugConcomitantSuspectedReportsSource
Adderall92.9%6.8%560FDA
Ritalin84.6%14.7%136FDA
Strattera68.3%31.7%60FDA
Focalin~61.0%~39.0%est.Aggregate
Vyvanse58.5%41.3%472FDA
Dexedrine~57.0%~43.0%est.Aggregate
Concerta55.3%44.1%170FDA
All ADHD combined75.2%25.2%1,341FDA

OTC and Formulary Comparison

DrugSuspected RateCategory
Adderall6.8%ADHD Stimulant
Tylenol (acetaminophen)11.0%OTC — unrestricted
Aspirin13.3%OTC — unrestricted
Advil (ibuprofen)13.8%OTC — unrestricted
Ritalin14.7%ADHD Stimulant
Atorvastatin (Lipitor)19.7%Formulary Rx
Amlodipine20.5%Formulary Rx
Metformin24.5%Formulary Rx

Managed Care Implications

Step therapy and prior authorization policies applied to ADHD medications are not supported by the FAERS safety profile. Adderall (6.8% suspected rate) has a lower causation signal than Tylenol (11.0%), which requires no authorization at any formulary tier.

  1. The 75.2% concomitant rate is consistent across all 7 ADHD drugs — not a single-drug anomaly
  2. ADHD stimulants account for 0.79% of all FAERS reports despite being among the most prescribed drug classes in the U.S.
  3. Adderall's 6.8% suspected rate is lower than Tylenol (11.0%), Aspirin (13.3%), and Advil (13.8%)
  4. These figures are the FDA's own classifications — not industry-sponsored interpretations

All data: FDA FAERS Q1 2024.

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