ADHD, or attention-deficit/hyperactivity disorder, is a neurodevelopmental disorder. It exhibits an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, according to the National Institute of Mental Health.
Stimulants are used to treat ADHD, including amphetamines (brand names like Adderall, Dexedrine, and Vyvanse) and methylphenidates (brand names like Ritalin, Concerta, Focalin and Daytrana). Brand-name Adderall is officially no longer in a shortage, according to the U.S. Food and Drug Administration, but generic versions are continuing to face a shortage.
ADHD visits have risen 21% since 2019, according to the IQVIA Institute, a health research firm. Prescriptions for ADHD medication was up 9.4% in 2021.
“We have been more fortunate than some pharmacies out there in just being a pediatric hospital and having staff on a daily basis trying to track down these ADHD medications or appropriate alternatives for our patients,” said Chad Myers, director of ambulatory pharmacy services at Dayton Children’s.
Doctors have had to change what medications some patients are on in order to find available treatments for them, Myers said.
“We’ve been fortunate enough to be able to get enough alternatives in to allow our patients to continue therapy, although they may have had to change to other items,” Myers said. “It is challenge. We’re having to check daily to see what is available out there. Even between one manufacturer and another, that can change on a daily basis.”
Telehealth options, including the ability to prescribe medication through telehealth, were relaxed during the pandemic. Telehealth constitutes 20% of diagnosis visits in mental health areas including depression and ADHD. With more access came more demand for treatment.
“Soon, more people were able to access providers and were diagnosed. We saw hike in how many people were diagnosed with ADHD. So that’s driving the industry, more demand,” Coby said.
Drug manufacturers are citing increased demand for ADHD medications and a shortage of an active ingredient used in the medications in the shortages.
Production limits on ADHD medication imposed by the Drug Enforcement Administration are also inhibiting drug manufacturers, Coby said.
“So it’s it’s not like your usual supply and demand, well if there’s more demand just make more,” Coby said. “Well, if they’ve been capped off for the year, they can’t make any more for that year. There’s one restriction plus the supply chain of ingredients that would meet be needed to make these medications.”
A notice from the Drug Enforcement Administration has responded to these concerns, saying the majority of drug manufacturers have “sufficient quota to meet their contracted production quantities for legitimate patient medical needs.”
Some say the DEA should not be imposing these restrictions and that it should be the FDA’s job to regulate these medications as the FDA can push for more supply, Coby said.
Lawmakers like Virginia’s U.S. Representative Abigail Spanberger have also put pressure on the DEA to initiate a comprehensive federal response to alleviate the nationwide shortage of ADHD medication.
Coby sees this shortage, which officially began in October 2022, stretching into 2024. Pharmacists are hoping to see demand for the drug lessen as doctors sometimes recommend children take a break from taking their ADHD medication during the summer months to decrease potential side effects from ADHD medications, like loss of appetite.
About the Author
