In the latest report from the frontlines in the ongoing battle against prescription drug shortages, a majority of pharmacists report that they lack one or more medicines at least every day and an overwhelming percentage say that shortages, on average, last three weeks or longer. Not surprisingly, most cite shortages of attention-deficit disorder pills, but also topical ointments and creams.
To be specific, 96 percent of pharmacists experienced a shortage in the past six months, with 59 percent reporting a problem daily and 23 percent on a weekly basis, according to the survey of 675 pharmacists who were queried by the National Community Pharmacists Association, a trade group for independent US drug stores. The survey also found that 80 percent of the pharmacists report the average shortage lasts three weeks or longer, and 78 percent of their customers are not taking their meds, which suggests many people are unable to obtain supplies from alternative pharmacies.
Of the 675 pharmacists surveyed last month, 81 percent pointed to shortages of ADHD meds, notably Ritalin and Adderall XR, and their generic equivalents. However, Shire Pharmaceuticals, which sells Adderall XR, disputes that a shortage exists. Late last week, the drugmaker issued a statement in an attempt to clarify what it calls 'misinformation' about the availability of its Adderall XR pill, [UPDATE: as well as the Adderall IR, which it no longer sells.]
"While IMS data indicate there is an Adderall IR shortage, the data does not show a widespread shortage of either Shire’s branded Adderall XR or authorized generic Adderall XR," according to Shire. Due to a settlement over patent litigation, by the way, Shire also makes and supplies the authorized generics distributed by Teva Pharmaceuticals and Impax Pharmaceuticals.
Shire has been on the defensive in recent weeks as reports intensify over Adderall XR shortages that actually began last spring, which the drugmaker acknowledged and described as 'spot outages' of both its brand and the authorized generics. "However, we believe these outages were temporary and that availability of brand and authorized generic Adderall XR quickly improved," Shire argued.
The statement comes shortly after four House Democrats launched a probe that also reflects fingerpointing between the FDA and the US Drug Enforcement Agency, which is responsible for setting quotas of controlled substances (back story). The FDA blamed strict DEA quotas, while the DEA blamed drugmakers for choosing to produce more of the higher-priced brand-name versions.
Shire blamed DEA quotas for the shortages last year, but now insists quotas have risen. "We believe there is currently sufficient product available to meet patient demand for branded and authorized generic Adderall XR," the drugmaker, while adding that "Shire does not control, or have visibility into, Teva and Impax’s distribution of authorized generic Adderall XR to wholesalers and pharmacies."
The current FDA list of shortages includes ADHD meds from Teva (see here), while the agency comments that "product availability for all dosage strengths is adequate" for Shire's Adderall XR, but that was as of last October. We asked Teva and Impax for a response and will update you accordingly. Novartis, by the way, sells Ritalin and we have also sought a comment.
Meanwhile, 31 percent of the pharmacists surveyed also reported shortages of prescription topical creams and ointments, notably methylphenidate and dextroamphetamine
Overall, 81 percent of the pharmacists also say price fluctuations caused higher acquisition costs, but 62 percent say that reimbursement from health plans and pharmacy benefit managers were not sufficiently updated to reflect increases in their acquisition costs. And 52 percent report that payers and PBMs do not cover alternative therapies when the prescribed drug is not available.
pic thx to joguldi on flickr