Reported Private-Sector Dispensing Trends of Methylphenidate in Costa Rica, 2017–2024: An Ecological Drug-Utilization Study

Background/Objectives: Methylphenidate is widely used for attention-deficit/hyperactivity disorder and is available in immediate-release (IR) and extended-release (XR) formulations. Long-term reported private-sector dispensing data from Costa Rica remain limited. Because methylphenidate is a controlled medication, longitudinal dispensing trends are relevant for monitoring access, formulation use, and dose-standardized exposure at the health-system level. This study described reported private-sector methylphenidate dispensing trends from 2017 to 2024 by dispensed boxes and Defined Daily Doses (DDDs). Methods: This retrospective ecological drug-utilization study analyzed reported private-sector administrative controlled-substance dispensing records from 1 January 2017 to 31 December 2024. Products were standardized by brand or generic designation, strength, dosage form, and formulation class. Outcomes included annual and cumulative dispensed boxes, formulation-specific share, XR-to-IR ratio, year-over-year change, presentation-level distribution, population-standardized rates, and DDDs calculated using the WHO reference value of 30 mg/day. Results: Total dispensing increased from 988,739 boxes in 2017 to 2,774,698 boxes in 2024 (+180.63%; CAGR 15.88%). Overall, 13,807,824 boxes were dispensed; IR accounted for 9,344,944 boxes (67.68%) and XR for 4,462,880 boxes (32.32%). In DDDs, XR exceeded IR in every study year and represented 61.0% of cumulative dose-standardized exposure. Conclusions: Reported private-sector methylphenidate dispensing in Costa Rica increased substantially between 2017 and 2024. IR predominated by dispensed boxes, whereas XR predominated by DDDs, highlighting the importance of reporting both administrative volume and dose-standardized metrics. These findings provide a private-sector baseline for controlled-medication surveillance and may inform monitoring of access, formulation mix, and dose-standardized exposure to methylphenidate in Costa Rica.