Pediatrician offers advice on what to do if a child's ADHD medication is out of stock during the shortage

If you are scrambling to get your child's attention-deficit/hyperactivity disorder prescription refilled, you are definitely not alone. Families across the U.S. have been dealing with an ADHD medication shortage first reported in October 2022 that is now well into its second year.

There are stories of parents and caregivers having to drive as far as 50 miles to find a pharmacy with the brand and dosage their child usually takes. Others have tried rationing doses or skipping meds altogether, with significant impact on their child's well-being. Many have asked their doctors to recommend different brands—which doesn't always work, since a range of ADHD meds are in short supply.

To make matters worse, the cost of ADHD medication has risen sharply throughout the country, federal data shows. This has created hardships for all families, especially those living on a tight budget.

No one can say for sure when the ongoing shortages will end. However, there may be things you can do to ease the impact on your child (and your own stress levels).

First, talk with your child's doctor to explore your medication choices. Brand-name prescription drugs such as Adderall XR, Vyvanse, Focalin, Metadate and Concerta have all been hard to find in recent months. If your child takes one of these drugs or the generic equivalent, continue to work with your child's doctor. For example, you may want to set up an appointment to discuss if it is appropriate to take a longer-acting or shorter-acting version of the same drug; take a different drug that might be well-tolerated; or try a generic version of their usual medication, if available.

Let your pediatrician know about what's happening so you can work together as a team. Every child and family is unique; it may take some careful strategizing to support your child through the next several months.

High prices for ADHD meds might tempt you to ration your child's doses. Instead, consider looking for savings on the prescription that works best for your child. Your pediatrician may have suggestions, since many newer (non-generic) drugs offer coupons and financial assistance programs.

If your family has prescription drug coverage, check to see which ADHD meds your insurer covers. Then you can discuss the alternatives with your pediatrician. It may help to check your insurer's directory of preferred pharmacies. They may offer better pricing on approved prescriptions.

Certain medications may need prior authorizations from your insurance company and extra time for approval. In these cases, your child's doctor can provide additional information about why this medication should be covered.

If your child's ADHD symptoms have been well-controlled until now, you may not have explored other helpful techniques to help your child manage them. Keep in mind that these approaches don't replace your child's medication but may be part of the comprehensive strategy. Consider:

If it seems that no one understands what you and your child are going through right now, please know that your pediatrician is concerned, too. We are deeply worried by the shortage of ADHD meds. In many cases, we're also scrambling to help children waiting for other medications that are in short supply.

Since most ADHD prescriptions are controlled substances under federal law, doctors have to follow very specific rules when prescribing. Pharmacies face equally tough requirements—which is why they can't simply transfer an existing prescription to a new location. The best they can do is suggest another pharmacy that might have supplies on hand.

Once you relay this information to your child's doctor, a new prescription must be sent through the electronic system that handles controlled substances. By the time you arrive at the pharmacy, hoping for a refill, you may find that they ran out within minutes of your doctor's request. You may want to call the pharmacy first to confirm that they have the medication in stock and can fill the prescription.

Pediatricians are also concerned about rising costs for ADHD medications, which add to the burden many families face in caring for kids who live with ADHD.

Issues like this one have an uneven and unfair impact on millions of young people who already face elevated risks for mental health struggles. The American Academy of Pediatrics is advocating for wider access to insurance plans that help cover costs while seeking solutions to rising drug costs.

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