Adderall Drug Shortage
A number of moms who have kids with ADHD reached out to me asking why there’s a shortage of their kids’ medication. The shortages of various medications used to treat ADHD have been going on for at least three years. The shortages appear to be easing. There are a number of reasons for drug shortages, but, of course, the essence of the issue is that demand outstrips supply. Here are some reasons for this:
Unnecessary prescriptions of stimulants used to treat ADHD. For example, the government recently prosecuted a case against a telehealth company that was allegedly established to defraud people and insurance companies by unnecessarily prescribing Adderall. The government is alleging a $100m fraud scheme in this case. But there are many others.
Increased demand. Both adults and children are being diagnosed with ADHD at increasing rates over time. Medication is the “most common form of treatment”, and prescriptions are on the rise.
Supply issues
Quotas: DEA sets quotas on how much of the active ingredients can be used, since they are Class II. Some companies use the full quota amount, and others have requested increases in the amounts. However, DEA reported that in 2022, manufacturers didn’t use the full allotment. In 2024, DEA increased the quota. However, manufacturers state that they don’t have a good sense of what is happening in the market; the lack of transparency hampers their ability to act and react.
Manufacturing Issues: Teva had labor issues in 2022, which led to the first shortage. This may have started a ripple effect – other companies followed shortly.
Pharmacy dispensing: Due to opioid disorder concerns, pharmacies are not able to fill “suspicious orders”. The Administration continues to consider this. A final rule on suspicious orders is due to be published.
Other factors may include the use of GPOs and price/cost (which is relevant for a number of generic drugs).
There are a number of ways to address these underlying issues, including
Consider the way DEA regulates active ingredients. Are they being appropriately scheduled? Is the suspicious order implementation filling its purposes? Narrowly?
Increase transparency regarding adderall prescriptions, active ingredients and supply issues.
Ensure that companies are receiving enough money for the drug, and that patients are not paying more than necessary.