Prescription drug shortages
Americans face a shortage of several key drug treatments.
Some cancer patients have difficulty getting chemotherapy drugs. Antibiotics are in short supply after the severe winter flu season. Medications for attention deficit hyperactivity disorder are scarce. Even Tylenol for kids is hard to find my colleague Christina Jewett wrote.
“This, in my opinion, is a public health emergency,” said Dr. Amanda Fader of the Johns Hopkins School of Medicine.
Today’s newsletter will focus on the ADHD medication shortage, which is a reflection of many of the wider drug supply problems. The Food and Drug Administration first recognized the shortage in October. Patients complain that they have to shop at pharmacies to get their medicines, if they can find them at all. And without the drugs, many say they can’t function.
Edward DiNola, a game programmer and designer, told The Times that stopping the ADHD medication Adderall had made his sleep schedule fragmented and unpredictable. After a week without drugs, he went to bed at 7 o’clock one day. “It’s a bit of a curse not to have control over your own energy,” he said.
The wider shortages partly reflect problems in the supply chain for generic drugs, which make up 90 percent of prescriptions. But the shortage of ADHD medication is greater because it also affects brand name products such as Adderall. As a result, more people are without the medicines they need.
Increasing demand
One reason for the shortage of ADHD medication: The use of such drugs has skyrocketed in recent years. From 2020 to 2021, the number of prescriptions will increase by more than 10 percent in many age groups, a recent CDC study found.
Why? Experts point to the clash of two recent trends in the US: the growing acceptance and recognition of mental health issues, and policy changes due to the Covid pandemic that have increased the use of telemedicine.
First, activists and policymakers have been pushing Americans for decades to take mental health issues more seriously—to view them not as moral failings or character flaws, but as health problems in need of treatment.
ADHD is an example of this acceptance. Experts long thought it mostly affected adolescent boys. In recent years, activists and patients have argued that ADHD can be a lifelong condition and that it is underdiagnosed and undertreated in girls and adults. Their view has gained ground, despite some criticism that ADHD is already being overdiagnosed in boys who are then treated with powerful, potentially dangerous stimulants.
Second, telemedicine received a big boost during the pandemic, as policymakers and medical institutions sought to limit in-person doctor visits. The shift not only allowed existing patients to continue their treatment, but also allowed new patients to be treated who may not have previously gone to a doctor’s office or a hospital.
These two trends worked together to increase the demand for ADHD medication. As more people began to take their mental health more seriously, their access to treatment increased. So more drugs for ADHD
Supply chain issues
In addition to demand, several issues may have limited the supply chain. Drug companies claim government-set quotas have hindered supply, though the Drug Enforcement Administration has said companies have not fully used what they have. Some pharmacies also quarrel that stricter regulations on opioid painkillers have spilled over to other drugs, making it more difficult to get the supply they need.
For generic drugs, there is a more systemic problem. The companies are under constant pressure to provide the lowest prices possible, and they often cut corners to cut costs and keep prices down. That leaves them unprepared to increase supply as needed if, say, demand rises.
All of these factors likely play a role in the ADHD medication shortage, said Erin Fox, a drug supply chain expert at the University of Utah. But because much of the drug supply chain is opaque, it’s hard to know exactly what’s going wrong.
The lack of transparency is itself a problem, not just for ADHD drugs, but for other drug shortages as well. If the public and policymakers don’t know what’s going wrong, they have no choice but to look for a solution.
For more: Medicine shortages are likely to get worseexperts say.
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