Wednesday, May 31, 2023

How the Adderall Shortage is Affecting the Healthcare Industry

The Adderall shortage is now in its fifth month with no end in sight. People that rely on the medication are now looking for alternatives without much luck. In fact, even Adderall substitutes are in short supply. 

In January, the American Society of Health-System Pharmacists (ASHP) reported shortages in nearly 40 different formulations of Concerta, a generic form of Ritalin. While Takeda Pharmaceuticals, which manufactures the drug Vyvanse, says it is not experiencing shortages, dozens of pharmacies report it has been on backorder for several months. 

So what’s the issue? Michael Ganio, the senior director of pharmacy practice and quality at the ASHP says shortages are due to an unexpected rise in demand more so than manufacturing equipment or drug quality problems.

“All of our drug shortage infrastructure and everything we have in place in this country to mitigate the impact of shortages is based on potential disruptions in supply. It’s been very unusual to have a shortage based on increase in demand,” Ganio said. 

In recent years, ADHD medication prescriptions have risen more than drug companies predicted. Prescriptions for Adderall for adults increased by 15.1% in 2020, double the 7.4% rise seen the year before. 

The FDA announced a shortage of Adderall in October which they blamed on “ongoing intermittent manufacturing delays. 

Dr. Sarah Cheyette began switching her patients to alternative ADHD medications due to the shortage, but they didn’t always work out. However, for most, it was better than going without the medication entirely. 

“There’s a spillover from people who couldn’t get Adderall and have turned to other drugs,” says Cheyette, a pediatric neurologist who treats adults and children with ADHD at the Palo Alto Medical Foundation, “and it’s just getting worse.”

Pharmaceutical companies are saying shortages could last well into the spring. Alvogen, which manufactures generic Adderall, expects shortages to last until mid-April. Teva Pharmaceuticals, the world’s largest Adderall supplier, is now well stocked on some of its more expensive, fast-active Adderall dosages, but is still up in the air on a resolution for its more affordable stock. 

A variety of issues have led to an increase in demand. When children started homeschooling during the pandemic, parents noticed they had ADHD symptoms which led to a rise in demand. There’s also a concern that some are self-medicating with Adderall or taking it for recreational purposes. 

The DEA must be brought into the mix to ‘fix’ demand issues. They calculate how much of a given drug ingredient is needed to meet demand and then allocate that precise amount to companies. However, they did not foresee the demand rising so steeply. 

Some have petitioned for a DEA increase in volume with some requests accepted and some denied. 

In the meantime, Cheyette worries that a solution won’t come soon enough. “These are not Beanie Babies that people can’t find. These are medications people depend on to function,” she says.