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- Adderall supply issues, which began in October 2022, are making the medication more expensive.
- The Biden Administration said it's focused on strengthening manufacturing supply chains for Adderall.
- Drug prices are a key economic concern for voters and could impact the 2024 election.
It's been 18 months since the US Food and Drug Administration announced an Adderall shortage. Since then, many Americans have struggled to access their necessary medications due to supply and cost issues.
Forty-one million Americans were prescribed Adderall in 2021 to manage attention deficit hyperactivity disorder, narcolepsy, and other conditions. The shortage and increased costs could impact who many Americans vote for in the upcoming presidential election.
Fifty-five percent of US adults said they worry about being able to afford prescription drug costs, according to a survey of 1,309 people performed between January and February by KFF (formerly known as Kaiser Family Foundation).
In light of the shortage, the Biden administration told Business Insider it is focused on strengthening manufacturing supply chains for Adderall and similar drugs, but did not give specifics as to how to accomplish these goals.
White House is working to strengthen pharmaceutical supply chains
The FDA and Drug Enforcement Administration called on manufacturers to increase the production of ADHD medications in order to meet the quota in a letter published in August 2023.
Because of Adderall's high potential for abuse, the DEA enacts quotas on how much can be produced in the US at one time — but many manufacturers have been producing under quota, contributing to the shortage and higher prices.
"This work to strengthen pharmaceutical supply chains is a continuation of the work that began on day 1 of President Biden's Administration to ensure Americans can access the medicine they need when they need it," The White House said in a statement to BI.
The Biden administration is also working with the Department of Health and Human Services on medical manufacturing policy to prevent future shortages, and has enhanced some pharmaceutical production under the Defense Production Act.
This comes as healthcare access is a leading part of President Joe Biden's reelection campaign. The administration has taken steps to negotiate lower prices with major pharmaceutical companies, make insulin more affordable, and expand healthcare for veterans and Medicare and Medicaid recipients. However, Adderall is not currently on Biden's list of drug price negotiations.
FDA says current Adderall supply does not meet demand
In October 2022, the FDA posted that amphetamine mixed salts — which are commonly referred to as the brand-name Adderall — did not have "sufficient supply to continue to meet US market demand."
Demand for ADHD medications has also spiked since the beginning of the pandemic, per CNN, with women and people in their 20s and 30s receiving the highest increase in prescriptions.
Meanwhile, with limited amounts of Adderall available, pharmacy prices are increasing.
USA Today reported in December 2023 that retail community pharmacies are struggling to stock the medication. The cost of Adderall to pharmacies has doubled, and in some cases tripled, since the shortage began — outpacing inflation.
USA Today reported that pharmacies are then charging consumers higher prices for the prescription. Some people must switch to alternative stimulants, which may or may not be covered by insurance, or choose to forgo their prescription altogether.
The DEA recently announced a quota increase for the ADHD medication methylphenidate, and the FDA approved the use of several generic forms of Adderall in hopes of increasing the overall availability of medication.
Some Americans with ADHD aren't getting the medication they need
A study released on April 2 by Truveta, a health data platform, shows that 1 in 10 Americans who take Adderall have been impacted by the shortage.
The study calculated the monthly rate of prescription fills for 336,355 people taking prescription stimulants between 2018 and 2023. The groups were split into categories of people over 18 and under 18.
The prescription fill rate for ADHD medications fell from 44.5% in December 2022 to 40.7% in February 2023, the study found. Refill rates were also 11.4% lower in the first five months of 2023 compared to the first five months of 2022.
Individuals with ADHD told USA Today that the continued scarcity and high costs of Adderall and related medications have caused them to skip prescription refills or ration doses.
"If the insurance dictates where you get your pills, and that pharmacy doesn't have the pills or that pharmacy chain in your area doesn't have those pills, you're out of luck," Dr. David Goodman, an assistant professor of psychiatry and behavioral sciences also at Johns Hopkins University, told Medscape Medical News.
Like opioids, Adderall use can also lead to addiction, and the federal government is taking steps to make it more difficult to obtain the drug without an in-person doctor's visit. The proposed legislation isn't contributing to the shortage, but it could limit access for people who rely on telehealth for prescriptions if enacted.
Government agencies do not manufacture medications, nor can they require that manufacturers produce or distribute more Adderall. Still, the FDA and DEA said they continue to work with manufacturers to resolve current supply issues and prevent shortages going forward. It's not yet clear when the shortage will be resolved.
Have you been impacted by the Adderall shortage or high prescription drug costs? Are you open to sharing your story? Reach out to this reporter at allisonkelly@businessinsider.com.