Most people work this out on the back of an envelope, in a car park, on their phone. An assessment price on one page, a monthly figure buried on another, and no way to join the two into anything you could take to a partner and call a decision.
Nobody publishes the third number, which is the one that matters: what the whole first year comes to. Here it is, in the order you pay it.
The Five Things You Actually Pay For
- The assessment. One payment, up front, whatever the outcome
- Titration reviews. A monthly fee while your dose is being found. Almost nobody budgets for this
- The medication itself. Paid to a pharmacy, not to the clinic
- Stable prescribing. A lower monthly fee once your dose holds
- The shared care handover. A one-off fee to ask your GP to take over
What the Fees Are
An ADHD adult assessment with us is £650. Titration reviews are £245 per month, and titration typically runs three to six months depending on how quickly you respond.
Once your dose has held steady for three months, the monthly fee drops to £95 for prescribing and monitoring. A shared care agreement, prepared when you are stable, is £150. Medication is separate and averages around £65 a month from our recommended pharmacies, though that varies with the medicine, the dose and the pharmacy.
Putting a Year Together
On the typical adult path, month one is the assessment. Months two to four are titration reviews plus medication. From month five the dose is holding, so you move to the stable rate, and somewhere around month eight the shared care request goes to your GP.
That is roughly £2,200 to £2,500 across twelve months with a three-month titration, and closer to £2,700 if titration runs to six. The assessment fee you compared so carefully at the start is under a third of it.
What Moves the Number
How long titration runs is the single biggest variable. NICE guideline NG87 tells prescribers to titrate against symptoms and adverse effects until the dose is optimised, which has no fixed finish line. NG87 also says titration should be slower where there is a coexisting condition such as autism, anxiety, a learning disability, cardiac disease or epilepsy.
Whether the first medicine suits you is the second. NG87 recommends lisdexamfetamine or methylphenidate first line for adults, and says to consider switching after a six-week trial without enough benefit. A switch resets part of the clock. It is normal, and it adds months at the higher rate.
If Your GP Takes Over Prescribing
NICE expects prescribing to move to your GP under a shared care agreement after your dose stabilises. If yours accepts, your medication moves onto an NHS prescription at £9.90 per item in England, or £114.50 for a twelve-month prepayment certificate. Prescriptions are free in Scotland, Wales and Northern Ireland.
If your practice declines, you stay on the private monthly fee indefinitely. That is the number to model for year two, and it is why the shared care question is worth asking your own surgery before you book anything.
The Costs Nobody Itemises
Three things sit outside the fee list. A validated upper-arm blood pressure monitor is a one-off purchase in the low tens of pounds, because NG87 requires pulse and blood pressure checks before and after each dose change.
The annual specialist review NG87 requires usually stays with the clinic even under shared care. And letters — for work, university, or carrying a controlled drug abroad — are charged separately. Ask for that list up front.
What to Ask Before the First Invoice
Ask any provider what their median adult titration length is, not the range on the website; what happens to the fee if you need to switch medicine; what you pay once you are stable; what a shared care agreement costs; and what you pay if your GP refuses one.
A provider confident in its pathway will answer all five in writing. One that cannot send you a one-page fee list is one that will surprise you in month four.
Frequently Asked Questions
How much does ADHD medication cost privately in the UK?
On a private prescription you pay the pharmacy the full cost with no NHS subsidy. Ours averages around £65 a month, and modified-release preparations generally cost more than immediate-release ones.
Does the cost go down after titration?
Yes. Once your dose has been stable for three months the monthly fee drops from £245 to £95, and it can drop further if your GP accepts shared care.
Conclusion
The honest headline is that a first year of private ADHD treatment costs two to three times the assessment fee, and that almost nobody tells you so before you pay the first one.
Knowing the real number early is worth more than starting a pathway you cannot finish. If the arithmetic does not work this year, say so when you call.
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