Many of the ADHD drug shortages that have plagued the United States for the past two years have now been resolved, the Food and Drug Administration says. However, some doctors and patients report still having trouble getting their prescriptions filled.
Dr. Lois Lee, a psychiatrist at the University of Chicago Medicine, said that while supplies are improving, it remains a problem for about one-third of the patients she writes prescriptions for. This means he has to call the pharmacy to check if the drug is in stock, change the patient to another drug, or communicate with the insurance company to confirm coverage. means.
“There are certainly signs that the shortage is easing,” Lee said. “But there's still enough of a shortage that we have to expend a little bit of effort every day because we have to change prescriptions and find them.”
“I think a lot of people still don't have access to treatment,” he added.
According to the FDA's drug shortage database, a total of nine manufacturers have now restored stock of ADHD drugs, up from six in September of last year.
Teva Pharmaceuticals, a leading maker of ADHD drugs, said it has resolved all shortages after months of not having access to certain doses, according to the agency's database. However, supply of the 5-milligram dose of one of the company's drugs remains limited.
SpecGx, which makes a generic version of the ADHD drug Vyvanse, has put all doses of its drug back into stock after being on backorder for most of last year.
Aurobindo Pharma, which makes generic Adderall, still expects the drug to be back in stock in September, after pushing back its initial forecast to December.
Many manufacturers note that there remains unprecedented demand for the drug and that supply could become tight.
An FDA spokesperson said the agency expects additional supplies to return in the coming months after a new manufacturer, US Pharma Windlass, recently began distributing doses. Ta.
“The public should know that FDA is working closely with numerous manufacturers and other companies in the supply chain to understand, mitigate, prevent or reduce the impact of intermittent or reduced availability of certain products. Please rest assured that the situation is being alleviated,” the spokesperson said.
“I just happened to be lucky.”
According to the Centers for Disease Control and Prevention, approximately 6 million children and teens have been diagnosed with attention-deficit/hyperactivity disorder, making it one of the most common neurodevelopmental disorders in children. It is estimated that millions of adults have this disease as well, and some may not know it.
Despite improved supplies, some patients say they still struggle to get their drugs.
Kaja Moen, 30, of Asheville, North Carolina, said her doctor switched her to generic Vyvanse last week after the price of another ADHD drug she was taking rose. However, her CVS soon notified her that her prescription would not be filled and she would be on backorder for several weeks.
She called several local pharmacies, but they too were out of stock on medicines and branded products. Her doctor then ordered a generic version of Concerta, another of her ADHD medications, but that too was in short supply.
It wasn't until Wednesday, when she went to the pharmacy to pick up another medication, that a pharmacist was able to check the drug inventory and fill her prescription.
“I just happened to be lucky,” she said. “It is still uncertain whether we will be able to replenish it next month.”
“It definitely made it difficult to concentrate at work and do things around the house,” she added. “Having medication available to me was a big help because without medication I have a hard time staying motivated to do even simple things.”
People with ADHD may have trouble paying attention, act impulsively, or appear restless. His ADHD medications, such as Adderall, aim to improve concentration while reducing impulsive behavior.
Dr. David Goodman, assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, said not taking the medication can cause major problems in both a patient's personal and professional life.
“Their performance is severely impaired,” Goodman said. “They're more emotionally reactive and more likely to get into unnecessary arguments with their spouses, partners, and co-workers. They're inconsistent in their follow-through, and suddenly their boss says, 'What's wrong with you?' You might say, 'I don't know what's happening.'
Mr. Goodman is a member of a task force that is developing the nation's first clinical practice guidelines for the diagnosis and treatment of ADHD in adults. The guidelines could open the door to greater availability of medicines, he said.
Supply is now improving, he said, noting that while some patients have no problems getting drugs, others still have problems. Depending on the patient, the problem may last for three days or two weeks.
“It's gotten better, but it's very variable,” Goodman said. “There are geographic variations. There are variations in the distribution of pharmacies themselves. Some tablets are available and others are not. And when a generic drug is not available, insurers may choose to brand it.” There will be hurdles with insurance companies as to whether or not they will cover you.”
signs of improvement
Because of the continuing shortage, Lee, of the University of Chicago Medicine, said the school has pharmacists solely to help troubleshoot prescriptions.
“We receive a report on Monday about all of our inventory, so clinicians can respond to that report and say, 'We only had 30 Vyvanse on Monday, there's zero chance we'll be able to get that dose on Friday. “You can know that,” he said. “That’s what our university pharmacy and clinic need to function.”
Lee said he is concerned about equity, adding that not all patients have a health care provider willing to devote resources to finding a prescription.
He encouraged patients to develop a relationship with their local pharmacist and let them know when the drug is back in stock.
“What many patients don't realize is that we have a relationship with the pharmacy and they expect the pharmacy to be able to communicate information to us, as if we have a system that works smoothly. Or maybe they believe it,” he says. “Actually, there is no such system.”
Dr. Michael Caine, a child and adolescent psychiatrist at UNC Medical Center in Chapel Hill, North Carolina, said that although supplies are improving, he still calls local pharmacies to find out when they have the drug in stock. He said there are still patients suffering from the disease. .
“The shortage was certainly worse before,” he says. “I think they’re somewhere between slightly good and moderately good at this point.”
“We're not in a situation where we need medicine for a test tomorrow and no one has it,” he added.
He said clinicians are telling patients to contact their pharmacy a week before they need a refill.
“It's a really difficult site,” he said. “There's really no way to know if that's going to be a problem for a particular patient.”
