Emma* says she was made to feel “like a drug addict” simply because she was trying to access medication for her ADHD.
When she was prescribed Vyvanse in June, she was relieved to realize she had found a treatment that would make it easier to live with the developmental disorder that affects the brain’s executive functioning.
When she was first diagnosed in 2022 at age 41, the initial prescription of Ritalin relieved some symptoms, but it also made her feel anxious.
However, Emma’s “magical month of feeling great” on Vyvanse came to an end when she tried to have the prescription renewed, only to find that many pharmacies were out of stock.
After visiting and calling more than 15 stores over five hours, she went home empty-handed after going through “the most dehumanizing medical experience” of her life.
Her search drew suspicion from pharmacists because Vyvanse is a stimulant, subject to strict prescribing and dispensing regulations due to the drug being sometimes abused and used for recreational purposes.
“I was made to feel like a drug addict – I wonder if anyone would treat people who need medication for other chronic conditions like diabetes or heart disease the same way?”
Emma says the psychiatrist who prescribed her Vyvanse failed to mention that there is an ongoing global shortage due to a global increase in demand. The medication has not been regularly available in Australia for over a year.
The medicines regulator, the Therapeutics Goods Administration (TGA), announced that the shortages of 30mg, 40mg, 50mg and 60mg experienced last year had been resolved in April this year, only for shortages to be declared again on June 14 for 20mg and 60mg doses.
A spokesperson for the TGA said the shortages were due to manufacturing issues across almost all strengths of the product. As a result, “the 20mg strength experienced increased demand due to patients switching to it due to unavailability of other strengths”.
Finally finding a medicine that worked well for her, only to learn there was no certainty of access to it, “feels pretty cruel”, Emma said.
Without it, she said, she would struggle to be as productive and to find relief from sometimes feeling overwhelmed and burned out.
Dr Karuppiah Jagadheesan, chair of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) ADHD Network, said the shortage was worrying, particularly as there were no alternatives. The drug was available in Australia from only one company, Takeda, which manufactured it in the US.
It was first listed on the Pharmaceutical Benefits Scheme for children diagnosed with ADHD in 2015, then extended to those diagnosed as adults in January 2021. Since then, prescriptions have almost doubled, with 623,611 in 2021 and 1,384,302 in 2023, according to the TGA.
to newsletter promotion
A Takeda spokesman said that in addition to the previous shortages and increased demand, its ability to replenish supplies was limited because the complexity of the manufacturing process – using an active pharmaceutical ingredient registered as a controlled substance – was highly is regulated.
The company said it was using the full quota of the drug it was allocated by the US Drug Enforcement Administration (DEA).
Jagadheesan said both Ritalin and Vyvanse were effective drugs, but it was difficult for psychiatrists to know which patients would respond better.
RANZCP sought a meeting with the DEA to discuss accelerating the supply of Vyvanse, as well as increasing Australia’s quota, but the DEA rejected the plea.
Takeda’s patent for Vyvanse expired in the US in August last year and other companies are making alternatives such as Adderall XR. Jagadheesan said it should be approved in Australia.
The TGA spokesperson said: “While the TGA is not responsible for coordinating the supply of medicines in Australia, it takes medicine shortages very seriously and works with pharmaceutical companies (known as sponsors) to help mitigate the effects on patients.”
The shortage of Vyvanse 20mg is expected to be resolved by August 21, the spokesperson said. “Takeda anticipates that by this date there will be enough stock available to meet normal demand at all major pharmaceutical wholesalers.”
The 20mg that Emma takes is the lowest dose of Vyvanse available. The advice many pharmacists gave her was to get a prescription for a higher dose that was not in short supply.
Jagadheesan said it was “absolutely dangerous” for people with ADHD to change doses, but that the pharmacists’ advice may have referred to an alternative method to be able to take a 20mg dose from the 40mg capsule.
While capsules could not be split in half like a tablet, there was a method of mixing the capsule in water and drinking half for each dose, Jagadheesan said. However, this needs to be explained to patients, he added.
A spokesperson for the Pharmacists Guild of Australia said: “The Guild agrees that patients should not have to search for their essential medicines.
“Manufacturers, wholesalers and the government have a role to play in ensuring that adequate supplies are available in Australia so that patients can get their essential medicines when and where they need them.”
* First name is used only to protect medical information
