Once a shortage occurs, it can last for years, causing severe stress for patients.

WASHINGTON – Drug shortages like Adderall are growing in the United States, and experts see no clear path to solving them. For patients, this can mean delays in treatment, switching medications and other prescription issues.

In recent months, unexpected spikes in demand, production issues and limited supplies of ingredients have contributed to shortages that are causing stress for patients, parents and doctors. For some drugs, such as stimulants that treat ADHD, several factors have caused shortages, so it’s hard to predict when they will end.

Shortages, especially of generic drugs, have been a long-standing problem. The industry has consolidated, and some manufacturers have little incentive to address shortages because cheap generics bring little profit.

Here’s a deeper look at the problem.


According to the University of Utah Information Service, there were 301 active drug shortages in the first quarter of this year. This is 49% higher than the 202 recorded in the first three months of 2018.

Patients don’t experience drug shortages because doctors can substitute them or because other parts of the drug delivery system are masking the problem, said Stephen Schondelmeier, a professor at the University of Minnesota College of Pharmacy.

“But there are more deficits and they are becoming more visible,” he said.


In the fall, the U.S. Food and Drug Administration announced a shortage of the attention-deficit/hyperactivity disorder drug Adderall due to manufacturing problems. This is maintained and sometimes increased to include other stimulants that treat the condition.

That situation appears to be improving, said University of Utah health researcher Erin Fox. But several doses of the extended-release drug, its most popular form, remain in short supply.

The FDA also tracked a deficit diabetes treatment Ozempic, which doctors also prescribe for weight loss. Ozempic prescriptions promoted by celebrities and others on social media have doubled since the summer of 2021 to more than 1.2 million, according to health data company IQVIA.

A spokesperson for Ozempic manufacturer Novo Nordisk says all doses of the drug are now available in pharmacies across the country.

Last year, an outbreak of respiratory diseases forced pharmacy chains to temporarily limit the purchase of antipyretic drugs for children. Around then, there was a shortage of the antibiotic amoxicillin.

According to data a recent report wrote Sen. Gary Peters, R-Michigan, chairman of the Senate Homeland Security and Public Affairs Committee.


The causes can be varied, and a combination of factors causes many deficiencies.

The problem with the production of Adderall arose when more and more people started taking the drug.

During the pandemic, the number of prescriptions increased as regulators began to allow doctors to prescribe drugs without first meeting the patient in person. According to IQVIA, the number of prescriptions for Adderall and its generic equivalents increased by 20% between February 2020 and the end of last year.

Adderall supplies face an additional challenge as demand rises. Federal regulators limit supplies of the drug every year because it is a controlled substance.

Price can also be a factor for some medications.

Ozempik is a drug for diabetes. The same drug, semaglutide, is sold under another brand name, Wegovy, for weight loss. Schondelmeier noted that the price per milligram of Wegovy can be more than double that of Ozempic.

“They’re running on Ozempic because people don’t want to spend that much on Wegovy,” Schondelmeier said.

Novo Nordisk spokeswoman Alison Schneider said the price was not related to the shortage. She attributed this to a combination of demand and global supply constraints.

Another factor driving the shortage is that drugs like Adderall and amoxicillin bring in little profit, so companies have no incentive to produce and stockpile large quantities in case of shortages, Fox said.

“Once the shortage starts, which you do in time anyway, it’s very difficult to resolve unless all the suppliers come back,” she said.


A deficiency can lead to delays in treatment, which can harm patients dealing with problems such as cancer.

Doctors are sometimes forced to prescribe alternatives that may not be as effective. It can also lead to medication errors if the doctor is less familiar with other medications.

Patients may also run out of prescriptions or be forced to find a pharmacy that has enough stock to refill them.


It is difficult to predict when many of the shortages might be eliminated, in part because it is difficult to measure demand.

“You may think you’re going to increase your production by 10%,” said Mike Gagniot, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, “but is that going to be enough?”

Meanwhile, conditions that could fuel future deficits still exist. The Senate report cited over-reliance on foreign sources as a concern.

Factories in China and India supply most of the raw materials used in American drugs. At the start of the COVID-19 pandemic, India restricted the export of 13 active pharmaceutical ingredients and finished drugs made from these chemicals to protect its domestic drug supply.

Once a shortage occurs, it can last for years. And it can be difficult for patients to get reliable information. Fox said the law does not require drug makers to inform the public.

The Senate report notes that “no single federal agency or private partner has end-to-end visibility into the entire US pharmaceutical supply chain.”

Fox says the shortage of stimulants is particularly frustrating. The companies have said they are not getting enough raw materials to make the drugs, and the federal government says the companies are not using what they have.

“There was a lot of finger pointing back and forth,” Fox said.

The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. This content is the sole responsibility of AP.


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