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Doctors in England told not to start new patients on ADHD drugs due to shortage (www.theguardian.com)

submitted 9 months ago by [email protected] to c/[email protected]

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[-] [email protected] 50 points 9 months ago* (last edited 9 months ago)

Amazing there is a shortage right at the same time that Vyvanse has finally become a generic. I haven’t had Vyvanse for 2 weeks now due to the shortage. It’s been… difficult.

Edit: I also take Adderall for long days at work and it’s been in short supply for over a year now which has made it even harder.

[-] [email protected] 25 points 9 months ago

My pharmacy switched me to the generic and my insurance company required another pre-auth for it. 3 years of taking Vyvanse and suddenly they're like "No, we don't wanna pay for the cheaper stuff". Morons.

[-] [email protected] 6 points 9 months ago

I think the pre-auth is a normal thing every 3 years. I get inconvenienced by that on the same schedule and have been told that the insurance company requires the pre-auth from time to time.

[-] [email protected] 3 points 9 months ago

Yeah I’m waiting for the generic to become available to see if my insurance will cover it. But my dr already set me up in that they requested the generic for the last year even though it wasn’t available and it was instead filled with the brand name. So when it comes to availability it shouldn’t be anything other than filling with the generic.

[-] [email protected] 8 points 9 months ago

I'm not sure of the exact reasons for the shortage but one possibility is supply chain disruption from the pandemic. The base materials are often produced in huge batches over a period of years and then stockpiled while the plant is reconfigured for another drug. If the demand fluctuates and the stockpile is not enough to cope, it can take months to get back on track.

[-] [email protected] 2 points 9 months ago

Definitely seems like a contributor. I wonder, also, how much of the delay was because pharmacies were told that the generic was coming, decided not to buy much of the more expensive stuff and hoped their stock would get them by until the generic was readily available.

[-] [email protected] 3 points 9 months ago

I had no idea a generic was available, that should be good news. I hope there's no pharmaceutical shenanigans, AKA patent extensions.

[-] [email protected] 4 points 9 months ago

I hear ya. I only recently got Vyvanse for the first time in about 5 weeks. Finally the generic drops, I call about a week after to see about getting that or the brand named version and they are out of generic.

Also, as if anyone needed a reminder, but insurance companies are such stupid fucks. I tried to fill my original script for the named version and my insurance refused to authorize it, citing they will only approve the generic version now that it's out. Like, WTF do they think can happen in 1-week? Did anyone there take any economics classes?

So I contacted my provider and they wanted to write me physical scripts I'd have to drive across town to get. My pharmacy didn't have any 70mg available, which was why they offered. I pushed the point about not wanting to drive to the office, monthly (because this government is shit and we can't get any larger supply), and they managed to get authorization for a 30mg and 40mg supply.

I took my only ADHD medicine for the first time in over a month this last Friday. I be turned 39 on Tuesday off last week...

[-] [email protected] 46 points 9 months ago

From the article: Henry Shelford, the CEO and a co-founder of ADHD UK, said: “ADHD is a disability and the sudden removal of medication is akin to removing a wheelchair from a disabled person that needs it.”

Ok, but you’re still refusing to let another disabled person have a wheelchair in the first place so…

[-] [email protected] 46 points 9 months ago* (last edited 9 months ago)

Are you saying the CEO of the charity organization, ADHD UK, is making the drug policy?

[-] [email protected] 8 points 9 months ago* (last edited 9 months ago)

No, (I get why you asked that, I should have worded my comment differently) it’s just funny to me this idea of fairness is to exclude those who haven’t yet been afforded the thing that would put them on more even footing with neurotypical individuals. I did read the article, I just am surprised that that’s how someone would say well let’s not help anyone that we’re not already helping, because fair’s fair. I also noticed it only seems to include 3 medications, so there are other options. I just kind of chuckled at the idea of no new wheelchairs angry face emoji

[+] [email protected] -25 points 9 months ago

[deleted]

[-] [email protected] 34 points 9 months ago

As far as I have followed this issue, this is a US problem. Pharmaceuticals are treated very differently in Europe. For example, there’s no public ads for prescription drugs allowed, meaning that patients usually don’t push doctors to prescribe random stuff they've heard about on TV.

[+] [email protected] -14 points 9 months ago

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[-] [email protected] 12 points 9 months ago

In the UK the NHS uses NICE guidelines for prescriptions. A doctor would be expected to justify prescribing outside of this.

Additionally, ADHD charities report that it is under diagnosed in people in the UK. With many parents suspicious of medicating children.

[+] [email protected] -4 points 9 months ago* (last edited 9 months ago)

[deleted]

[-] [email protected] 10 points 9 months ago

Unfortunately, that study was done a couple of hundred years after the UK lost control of North Carolina, so it doesn't support the claim that ADHD medication is overprescribed in the UK.

[-] [email protected] 8 points 9 months ago

This is a little misleading. Like most macro trends, the actual situation is far more complicated. Here's a study describing under diagnosis of ADHD in adults

While it's likely true that the condition is overdiagnosed in adolescent populations, it's also widely acknowledged that ADHD is less commonly diagnosed once in adulthood.

[-] [email protected] 3 points 9 months ago

North Carolina is neither in the UK or Europe

[+] [email protected] -4 points 9 months ago

[deleted]

[-] [email protected] 4 points 9 months ago

Your quote doesn't say they calculate the result globally. It's estimated based on the results in Carolina. They say estimate because the don't have the data to say it is true.

ADHD administrative prevalence (based on rates of diagnosis and/or prescriptions) in children and adolescents in the UK has been estimated to fall between 0.2 and 0.9% since the mid-2000s (39). These rates remain below community prevalence estimates in the UK estimated at around 2.2% in 1999 and 2005 (55, 56), with more recent estimates of 1.6% in 2017, based on the more restrictive ICD-10 Hyperkinetic Disorder criteria (57). Administrative prevalence of adult ADHD in the UK stands at around 0.1% (40), far below even some of the lowest prevalence rates documented in adults (9).

Failure of Healthcare Provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: A Consensus Statement, 2021

This suggests about 1% of the UK population has ADHD and isn't diagnosed. The would be more than 600,000 people.

[-] [email protected] 2 points 9 months ago

You were replying to a comment on ADHD in the UK

[-] [email protected] 3 points 9 months ago

This used to be true and perhaps still is in some places, but in some European countries the laws have changed a bit recently which means bad time for pharma companies. They now don't have enough finances to bribe doctors effectively. (Source: family member in European pharma.)

[-] [email protected] 2 points 9 months ago

I had to jump through multiple hoops and complete a nearly perfect CAARS test before I could even get into contact with my psych. And then it was roughly a couple months talking with her before I was diagnosed. All in podunk USA. So it’s not rampant everywhere, especially since it’s nearly impossible to even find a psychiatrist within 150 miles of my house.

[-] [email protected] 22 points 9 months ago

US as well. I have ADHD family members and literally every time the script comes up for refill it’s delayed due to inability to get the medication. Doesn’t matter if it’s big national chain pharmacies or (if you can find one) a local pharmacy. It’s bullshit, stressful, and frustrating…try not hyperfocusing on knowing you may not be able to get your meds that help you not hyperfocus as an ADHD sufferer.

[-] [email protected] 7 points 9 months ago

My wife is the same. She calls a few days before the script is up to see if they can fill it. If not then she calls around neighboring pharmacies to see if they have it available and if they do has to contact her med manager to get it transferred. It's a huge PITA but she's only missed a day or two thanks to keeping on top of it. It seems like the different chains and grocery stores are on different delivery schedules so someone usually has just gotten some in.

[-] [email protected] 6 points 9 months ago

She is lucky she can even do that. If it were an opioid they would just be like "no". At least that was the case for my aunt before she passed. She just would have to wait in pain until it was available. I think it's up to the pharmacy if they will accept it or not, and in the best cases they would politely just say "we can't do that", some pharmacy techs would directly accuse her of trying to pharmacy shop to get a script fill duplicated. Luckily it didn't happen often, I think when it did it was because there are now DEA stock limits, so it can take a while before the next order comes.

[-] [email protected] 4 points 9 months ago

Staying in top of is so hard, especially once you run out of medication

[-] [email protected] 7 points 9 months ago

This is the best summary I could come up with:

Doctors in England have been told not to prescribe ADHD drugs to new patients because of a national shortage, as charities warn that the supply problems are devastating for people living with the condition.

A national patient safety alert from the Department of Health and Social Care said the shortages were down to a combination of manufacturing issues and increased global demand, and could last until the end of the year.

ADHD, which stands for attention deficit hyperactivity disorder, is described by the NHS as a condition that can make it hard to concentrate and may mean people act on impulse.

“Other ADHD products remain available but cannot meet excessive increases in demand,” the DHSC alert states.

Dr Andrew Hill, a senior visiting research fellow in the department of pharmacology and therapeutics at the University of Liverpool, said the problem lay in how medicines were sourced.

A Department of Health and Social Care spokesperson said: “We are aware of supply issues affecting medicines used for the management of ADHD due to increased global demand, and we have issued communications to the NHS to advise healthcare professionals on management of patients during this time.

The original article contains 751 words, the summary contains 193 words. Saved 74%. I'm a bot and I'm open source!

[-] [email protected] 5 points 9 months ago

I don’t understand how I’ve managed to never have a problem getting any drug I’ve needed from CVS.

I’ve been through Adderall, amphetamine salts, dexamphetamine, atomoxetine, and lisdexamphetamine all within the last year with the worst case being (come back tomorrow, when we get our weekly shipment in)

[-] [email protected] 1 points 9 months ago

A national patient safety alert from the Department of Health and Social Care said the shortages were down to a combination of manufacturing issues and increased global demand, and could last until the end of the year

Assuming CVS is that American chain who do the long meme receipts, you probably feel the international side of things less as I imagine the US is first choice in market.

[-] [email protected] 2 points 9 months ago

That’s them alright, maybe you’re right. Idk much about production and distribution of pharmaceuticals

[-] [email protected] 4 points 9 months ago

Doctors in England have been told not to start anyone on ADHD therapy, I know this from personal experience. Our system is bankrupt and broken. All of my coping mechanisms are DIY, developed over a lifetime. I still have 5g of the amphetamine sulphate that I was using instead of officially sanctioned medication and it looks like there's a risk I will need to go back to that.

[-] [email protected] 3 points 9 months ago

In Spain there's a shortage too for ADHD

I've been over a week off Atomoxetine, I'm getting ready for my anxiety to come back...

[-] [email protected] 5 points 9 months ago

In the US we’ve had ADHD med shortages on and off for years. I switched to vyvanse because I got tired of calling around before every appointment to find which pharmacy to have my adderall prescription sent to. Somehow vyvanse doesn’t have this problem.

this post was submitted on 01 Oct 2023

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