On Monday, the Food and Drug Administration announced it approved the generic version of Vyvanse, the second most popular stimulant medication used to treat attention deficit hyperactivity disorder, or ADHD, in children and adults.
The decision comes right on the heels of what has been a tumultuous several months for those who rely on ADHD medications—like Vyvanse and the more popular Adderall—in the United States. Beginning in October 2022, up to 97% of independent pharmacies announced they were experiencing a shortage of supply in stimulant medications. Coloradans who rely on these medications to function in their day-to-day lives are hoping that the new FDA rollout of generic Vyvanse will make things easier.
Tim Smith, a cyber security manager, described trying to do his job without his ADHD medication “like being in a computer game with the difficulty set to hard. When I do have them, it’s set to easy. It makes such a difference.”
The first time he was told his prescription was out of stock at his pharmacy, and that he may not find any in the surrounding area, it was a shock.
“Then for me to validate this by going to a few pharmacies and them being out was so hard,” he said.
He ultimately went to his doctor who had to switch him to Concerta, a different stimulant medication than the one he was originally on. After going several weeks sans medication, he said it made him realize how dependent he is on them to perform his job requirements.
“It has a huge impact on my life when I don’t have them. If I was not able to perform in my role I would risk not only my welfare but the welfare of the company I’m protecting,” he said.
The stimulant shortage is due to a number of factors, that experts call a “perfect storm.” One of the leading causes is the rise in ADHD diagnoses and thus, demand for stimulants, in recent years. It is ultimately a supply and demand issue. According to the CDC, the COVID-19 lockdown caused a significant rise in individuals seeking help for mental health challenges. More doctors diagnosed patients with ADHD via telehealth than ever before, and the prescribed number of stimulants saw an increase of roughly 10% from 2020 to 2021.
Priya Barney, a psychiatric nurse practitioner in Denver who specializes in the treatment of ADHD, said there are misconceptions among the general population as the disorder has become diagnosed more often in recent years. According to Barney, many people believe people with ADHD don’t actually need medication, or that doctors are handing out diagnoses without reason.
“That is simply not the case. We have further developed our understanding of ADHD in the medical community, and are able to better identify the symptoms of ADHD, especially among women who get diagnosed later in life. Medication isn’t necessary for everyone, but for those who need it, it is critical,” she said.
Shae Smith, a Fort Collins resident, is one of many who has experienced the effects of the shortage. She takes 70mg of Vyvanse, and just last month, while trying to fill her medication, she had to call four different pharmacies.
“Honestly, it’s really difficult knowing that I may not be able to refill my meds every month. I need the meds to function day to day and it’s definitely a noticeable difference when I don’t have them,” she said.
This month, she had to have two separate doses filled to get a full month’s supply and was given a bottle of 30mg Vyvanse and a bottle of 40mg Vyvanse. This resulted in her copay being twice what it usually is since she had to pay for two bottles.
“And on top of all of that, I got pushback from my doctor’s office because I switched the prescription to a different pharmacy twice in one day,” she said. “I had to play phone tag to verify I wanted to keep switching the prescription.”
Barney said she hopes that the rollout of generic Vyvanse does help to mitigate the problem, but with the back-to-school season starting, ADHD medications will be in higher demand than ever.
“I hear from parents all the time,” she said. “There are children who go off of their ADHD medications in the summer and do fine without them, but once school starts, if they can’t get their medications, they’re in trouble. They fall behind. This is a larger issue than just parents who are overmedicating their children. Again, that is a misconception. Kids can get held back a grade, high school seniors who are taking tests for college can struggle. These medications—for those who truly need them—are critical.”
Shae Smith, who received her diagnosis when she was older, said when she got on medication things just clicked. “I could suddenly get out of bed and clean my house or shower before I was running late for work. I could do my schoolwork without waiting until 10 minutes before it was due,” she said. “Simple activities in my daily life seemed so impossible before being on meds and now they’re not.”
Tim Smith said that before he had his ADHD meds, he would forget things and constantly run late. He also found it difficult to articulate himself and make complex plans.
“When I started on meds, I was able to plan better and be more consistent. The biggest thing was my memory and the way I am able to articulate myself. This negative behavior was often articulated about me as me being “dizzy” or “confused.” Since having the meds I have not been called “dizzy,” and I am able to hold and initiate complex discussions about detailed subjects. I am also now able to plan and remember to uphold those plans, and not forget to do the items I set out to do.”
The stimulant shortage has clearly had a significant impact on individuals with ADHD who rely on these medications to function in their everyday lives, including the six million children across the U.S. who struggle, and although there is significant hope that the rollout of generic Vyvanse can help eliminate some of the problems, the question remains to be seen whether this will be enough, or if the shortage will get worse before it gets better.