According to the American Society of Health-System Pharmacists (ASHP) statistics, a spike in new drug shortages in the year 2022 has led to the highest levels of drug shortages in the United States since 2014. For the first quarter of 2023, the five classes of drugs facing the largest number of shortages include, central nervous system therapies, antimicrobials, fluids/electrolytes, hormones, and chemotherapies.
Medication shortages have plagued the United States since at least the early 2000's, when federal tracking began. In October 2022 the FDA announced a shortage of mixed amphetamine salts, a drug category that includes Adderall and other medications used to treat attention deficit disorder; since then patients ability to obtain ADD medication has ebbed and flowed slightly but remains a challenging and frustrating task.
As a physician who specializes in the treatment of attention deficit disorder, I've spent many hours researching the reasons for the current crisis. Medications containing stimulants or amphetamines are tightly regulated by the Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) because they're considered dangerous drugs prone to diversion and misuse. This tight regulation didn't cause the medication shortage but has made it difficult for healthcare providers, pharmacies and patients to respond when prescriptions can't be filled because pharmacies don't have medication available.
On August 28, 2023 the DEA responded to the situation by changing regulations to allow pharmacists to transfer a patient's prescription to another pharmacy upon their request. It's no longer (legally) necessary for the physician to cancel the original prescription and issue a new prescription to a different pharmacy. Unfortunately we're also dealing with another crisis- a severe staffing shortage at retail pharmacy chains nationwide. Since the new regulation went into effect, I haven't encountered a single pharmacist who feels they have time to transfer controlled substance prescriptions electronically. The olive branch the DEA provided has done nothing to make it easier for patients to fill their prescriptions.
In 2022 and 2023 a few new ADD medications were FDA approved and patents expired on some the existing medications, opening the door for other pharmaceutical companies to manufacture and sell generically equivalent medicine. To my disappointment, this did little to make it easier for my patients to obtain ADD medication. Insurance companies are reluctant to provide coverage for the new, more expensive, medications and generic medications aren't readily available due to manufacturing and regulatory delays.
I don't believe the Adderall shortage will get better in time. There's been a lot of debate and finger pointing regarding what's caused the medication shortage. From my investigation it appears that pharmaceutical companies simply aren't motivated to continue manufacturing medications that are so highly regulated and provide a narrow profit margin. It just isn't good business to continue manufacturing affordable stimulants. As you can see from the information I've posted below, four manufacturers have discontinued their production of generic Adderall and five have no comment regarding their lack of product supply. Most of the Adderall currently in distribution was manufactured by TEVA pharmaceuticals, which makes both name brand and generic Adderall. There isn't a shortage of TEVA's name brand Adderall, which retails for $10-20 per tablet, but TEVA's generic tablets, that retail for $1-2 per tablet, continue to be out of stock at most pharmacies. TEVA also manufactures name brand Vyvanse, which was in short supply in the fall of 2023 when school went back in session. In August and September 2023 news media announced that 14-15 pharmaceutical companies received FDA approval to manufacture and sell generic Vyvanse capsules and chewable tablets. It doesn't appear that any generic chewable tablets are available and only one company, Mylan, has lisdexamfetamine (generic Vyvanse) capsules for sale.
Four manufacturers (Camber, Lannett, Mylan and Zydus pharmaceuticals) have DISCONTINUED manufacture of generic Adderall tablets (most likely due to lack of profitability).
Three manufacturers (Alvogen, Aurobindo and TEVA) refuse to provide an explanation for their shortage of product.
Two manufacturers (Aurobindo and Mallinkcrodt) have refused to provide any information regarding the availability of their product.
One manufacturer (Sandoz) is prioritizing distribution of their product to current customers (pharmacies).
Name brand Adderall (from TEVA pharmaceuticals) is currently available in the following strengths:
5, 7.5, 10, 12.5, 15, 20 and 30 mg tablets
Generic mixed amphetamine salt tablets (from TEVA pharmaceuticals) is available in the following strengths: 5, 10, 12.5, 15 and 20 mg tablets
(The 30 mg generic tablets are in short supply, if your pharmacy is currently out of stock they may have difficulty obtaining their resupply within a reasonable amount of time.)