Shortages of medications for attention deficit hyperactivity disorder (ADHD) are leaving parents and patients scrambling. According to the Wall Street Journal, shortages of Adderall XR and its generic equivalents (also known as amphetamine mixed salts), as well as of methylphenidate (a generic version of the brand-name drug Ritalin) have recently been reported in Pennsylvania, Maryland, Minnesota, Washington state and elsewhere.
Parents are on the hunt for pharmacies that stock the medications, or are dipping into their pockets to pay full-price for alternatives. Or, in some cases, they’re rationing out their supplies:
Pharmacists say some customers have to pay the entire cost of a brand-name drug — which can exceed $200 a month — because their health plans cover only generics. The higher the price of a drug, the greater the likelihood a patient will not take a drug as prescribed, said Timothy Davis, pharmacist at Beaver Health Mart Pharmacy in Beaver, Pa. Mr. Davis said he has become adept at helping patients request that drug-benefit plans cover branded alternatives to generics that are in short supply.
To keep costs down, some patients have switched from one generic to another generic of a different drug. Generics are supposed to be therapeutically equivalent to branded drugs, but some patients experience differences going from one to the other. Others may switch from formulations taken once or twice a day to those requiring more frequent dosing — a disruption for school children who must leave class to take their dose at the nurse’s office.
Currently about 9.5% or 5.4 million children 4-17 years of age have been diagnosed with ADHD, according to statistics from the Centers for Disease and Control Prevention. Demand for the drugs has increased as diagnoses of ADHD have risen. According to IMS Health, medications for ADHD generated a combined 24.2 million prescriptions in 2010.
But the reason for the shortage is due to a delay in the U.S. Drug Enforcement Administration releasing extra supplies of the drug’s active ingredients, according to Matt Cabrey, spokesman for Shire PLC, which manufactures Adderall and its generic versions. The DEA monitors the active ingredients of some ADHD drugs as controlled substances. For instance, methylphenidate has been shown to have some benefits as a replacement therapy for individuals dependent on methamphetamine; methylphenidate has also been said to have a “high potential” for abuse and addiction.
Increased supplies of the ingredients should be available this month, so the shortage will most likely end. But perhaps the medicine shortage is a sign to give pause and consider whether there might be other ways to help those with ADHD besides medications and to ask if some may have become too reliant on them.
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