Can't get your medication? Here's what to do if drug shortage is affecting you

It started the way most of our family's prescriptions go: The doctor sends a prescription to the mail-order pharmacy for 90-day supplies. The prescription usually arrives a week later in the mailbox.

But in January, the mail-order pharmacy couldn't find the generic equivalent of Concerta, a medication used for attention-deficit/hyperactivity disorder. The pharmacy couldn't find the brand name either. The hunt began. Pharmacy after pharmacy was out.

Finally, a local Walgreens had it. The pharmacy could provide a 90-day supply. The catch: The usual $25 medication was $1,280.

A 90-day supply of Concerta cost $1,280 at Walgreens instead of the typical $25 for the generic at a mail-order pharmacy. Finding attention-deficit/hyperactivity disorder medications has been difficult in recent months.
A 90-day supply of Concerta cost $1,280 at Walgreens instead of the typical $25 for the generic at a mail-order pharmacy. Finding attention-deficit/hyperactivity disorder medications has been difficult in recent months.

The choices: Pay the money and get the prescription filled. Don't pay the money and go without, which might mean an inability to clearly process thoughts or be able to hold a job. Filling part of the prescription wasn't an option without a new prescription.

With two doses left at home, our family filled the prescription.

We are not alone.

For months, methylphenidate, with brand names such as Concerta and Ritalin and generics, has been in short supply.

"The dominoes are falling," said Dr. Karen Keough, a pediatric neurologist at Child Neurology Consultants of Austin. Her office nurses and patients are working together to figure out which pharmacy has which drugs and then try to get a prescription there before the supply runs out.

"There doesn't seem to be an obvious solution," Keough said. "There's no indication there's an end to this."

It's not just these drugs, either.

The American Society of Health-System Pharmacists keeps an up-to-date list of shortages. Last week 234 types of medication were in short supply — everything from antibiotics and asthma inhalers to saline solution for IV bags and lidocaine to numb an area.

"It feels like we didn't have any drug shortages like this five to 10 years ago," said Jodie Pepin, clinical pharmacy program director at Harbor Health and a clinical assistant professor of pharmacy at the University of Texas.

Learn more: Past Dell Medical School dean 'disrupting' primary care with new Harbor Health

Why are medications in short supply?

That's complicated, Pepin said. She explains some of the factors:

  • Some producers of the generics just stopped manufacturing them. Sometimes manufacturers might find it not profitable enough and close down an assembly line for a medication. Sometimes manufacturers cannot get enough raw materials to produce a particular drug.

  • ADHD drugs and other controlled substances are particularly difficult. The U.S. Drug Enforcement Administration has rules about how much of the raw materials manufacturers can buy. The DEA also has quotas for how much wholesalers can purchase and how much pharmacies can buy from them.

  • The black market is also at work, buying up the raw materials and selling them for more as well as buying the manufactured product and selling it for more.

  • The Food and Drug Administration has gotten more strict about inspections of the manufacturers of both the medications and the raw materials.

  • Sometimes it's about higher demand. In the case of ADHD medications, the shortage began with the start of the school year, as more kids were getting diagnosed or returning to taking their medications. In the case of the asthma inhalers, cold, flu and allergy season boosts demand.

  • Sometimes it's just not known why a particular medication is experiencing a shortage.

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What can you do if there is a drug shortage?

  • Don't wait until you are almost out before trying to get a refill. Allow time for the scramble to find your medication.

  • Check the American Society of Health-System Pharmacists to make sure it is a known shortage and find out whether there is a timeline on when it might become available again. Also check to see which similar medication might be available. That information is listed under each shortage medication.

  • Call around to see which pharmacy has the medication before a doctor sends in the prescription. Sometimes smaller pharmacies can come through; sometimes it's the bigger chains.

  • Ask your doctor or the pharmacist if a similar medication is available. Sometimes there are subtle differences between formulas of different brand names that people might tolerate as well as what they were taking.

  • Sometimes in a shortage, pharmacists can get approval to compound a medication that isn't available another way.

  • Call your prescription insurance company. We learned there was a price override that Walgreens didn't know about on buying brand-name Concerta because the generic was not available. Sometimes you can get the insurance company to talk to the pharmacy to lower the price. Sometimes you have to fill out paperwork and get reimbursed for the difference between what you paid for the brand name and what the generic would cost you.

  • If you can't get the price lowered, check for coupons. GoodRx lets you put in the medication and see what price you would pay at each local pharmacy with a coupon. You can then print out the coupon and bring it to the place that has the medication and is the least expensive.

  • Check with the manufacturers. Often they have co-pay assistance programs that can get your payment to $5 or zero. You still have to find the medication, though.

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Put the pharmacist to work

While you're searching for medications in short supply, check with the pharmacist to review all of your medications, including the over-the-counter supplements and vitamins you take. The pharmacist can look for drug interactions as well as tips on making your medications more effective and easier to take.

Doing a pharmacist's checkup is particularly important after discharge from a hospital. Pharmacists can help make sure you understand the instructions for taking the medication and look for any drug interactions for what you are taking or risk factors particular to your health history. They also can explain the side effects and any interactions with foods such as milk or grapefruit. They will know if there is an easier, less expensive equivalent of that medication.

This article originally appeared on Austin American-Statesman: Can't get your meds? What to do if you are affected by drug shortage