Millions of people in the UK who take drugs for attention deficit hyperactivity disorder (ADHD) are facing difficulties getting their prescriptions filled due to shortages. These shortages are currently affecting four of the five types of medicine licensed in the UK to treat ADHD. Certain products and dosages may be more affected than others.
This severe disruption in supply is taking a toll on many peoples’ mental health and wellbeing and negatively affecting their daily life. Fortunately, it’s expected these shortages will be resolved by the end of 2023.
What’s causing these shortages?
The two major causes of the current shortages appear to be manufacturing issues and an increase in global demand for these products.
Prescriptions for ADHD medications continue to rise globally. Not only that, but a growing number of adults are now being diagnosed with ADHD – meaning that even more people are seeking access to ADHD drugs.
For example, between April and June 2023 about 202,000 new people in England received a prescription for these drugs. This is up from 103,000 in the same period in 2018 and 2019.
The rise of online prescribing for these medicines, which grew during the pandemic, has also led to a greater volume of patients accessing ADHD drugs – and continuing these treatments in the longer term. But, in the UK at least, private assessments of new patients can then cause problems for NHS providers in supplying medicines to meet the assessed need.
When certain prescriptions are in short supply, alternative drugs may be supplied to patients instead. But this can subsequently lead to a domino effect, creating additional shortages – as has been the case with less commonly used ADHD medicines.
The UK isn’t the only place experiencing these shortages. In the US, the ADHD drug Adderall has been in short supply for the past year. Multiple factors have been linked to this shortage – including a manufacturing delays, increased demand, restrictions on what drugs pharmacists can supply and quota issues.
Quotas are government restrictions on the amount of controlled substances (with psychoactive effects) that manufacturers can use to make medicines. In the US, the quotas may be too low, manufacturing may not be optimised, or the right people may not be receiving the products, causing shortages.
Adderall shortages have subsequently led to shortages of Vynase, a substitution drug. There are now reports that people are also having difficulty filling other ADHD medications, such as Concerta and Focalin.
Managing shortages
For patients diagnosed with ADHD, these prescription drugs are important. They can help them concentrate better, be less impulsive, feel calmer and learn and practise new skills. Without them, it can jeopardise a patient’s ability to perform within the workplace or make it harder for children who rely on these to help them in school. Some patients report rationing their prescriptions to make them last longer or have taken to stockpiling them.
Patients who have been affected will have been notified by their normal pharmacy of any supply issues. If you have been affected, you can try contacting other pharmacies to check their stock levels. You may also not receive your usual amount of medication as pharmacies attempt to share the supply equitably. This may mean you may not be able to fill more than six weeks at a time.
Changing medications or prescribed dosages can sometimes be a strategy to manage shortages so that patients can continue treatment. But if this happens, you’ll be given additional guidance from your pharmacist or doctor on how it affects you.
Not all products can be stopped immediately or changed (and not all alternatives are suitable for all patients). Some children may be advised to reduce their doses where safe to do so and select specific times to take their medicines – such as on school days – in order to make their current supply last longer. People should only make such changes in consultation with their pharmacist or doctor.
The government has stated that it is working with product manufacturers to address ADHD product supply continuity. According to the Medicines and Healthcare Products Regulatory Agency, it’s expected the current supply disruption in the UK will be resolved between October and December 2023.
Until then, doctors have been asked not to put new patients on ADHD medicines. Doctors may also prescribe patients alternative products where appropriate.
In the US, the Drug Enforcement Administration has agreed to temporarily increase quota levels and increase production of ADHD drugs to help reduce supply issues. It’s unclear what specific actions government agencies are taking in the UK and Europe. However, the supply chains are global, so resolving the situation in the largest market (which is the US), should also help in smaller markets.
While we know some of the reasons for the current shortage, there’s still a lack of transparency about all of the reasons behind it – and of the scale of it. It’s also unclear if the shortages will be resolved by the end of 2023 as predicted.
What is clear is that there’s a higher demand for these products than there was previously. Given how many people rely on these medications to help them in their daily lives, it will be important for supply issues to be addressed promptly so they don’t happen in the future.