Doctors frustrated after patients face trouble filling Adderall prescriptions

GREEN BAY, Wis. (WBAY) - The first month of the new year has come with unexpected challenges for thousands of people across the state who take prescription Adderall, which is commonly used to treat ADHD.

Doctors tell us a surprise change in Medicaid coverage created a ripple affect of problems for patients.

“If anybody has known anybody that has ADHD before, it can be very, very impairing and their quality of life, their ability to function both in school, at work, in relationships, getting ready to leave the house in the morning... I mean, it can be very, very impactful,” explains Dr. Emily Rademacher, Chair of the Department of Psychiatry at Bellin Psychiatric Center in Green Bay.

To help, many patients are prescribed Adderall, an amphetamine.

Not taking it is something Dr. Rademacher calls ‘very disruptive.’

When the psychiatrist started getting phone calls last month from her patients, saying they were unable to fill their prescriptions, she was immediately concerned and frustrated.

“I would say hours extra each day since the beginning of January trying to get this resolved for patients, because ultimately the patients are the ones that are stuck in the middle,” says Dr. Rademacher.

What’s causing the problem?

Dr. Rademacher says Medicaid coverage for Adderall changed, effective January first, covering only name brand Adderall, not the generic version many patients have been taking.

She says patients were telling her they couldn’t even pay for the medication in cash.

“The reason for the change, apparently, was because the manufacturer of brand name Adderall was offering a rebate that would actually, after the rebate, make the the brand name cheaper than the generic for the state,” explains Dr. Rademacher. “The state knew, obviously, about these changes coming. The pharmacy association knew about the changes coming. Nobody remembered to tell the wholesalers that this change was coming.”

She says that caused a temporary shortage, and just to get by, patients were prescribed other medications that, in some cases, caused new side effects or didn’t even work on some people.

It also created a new issue for pharmacies dispensing a controlled substance that’s also in high demand on the street.

“They don’t take that lightly. They don’t just give that stuff out for fun. It’s very closely monitored. So if they give someone a 30 day supply of another stimulant and then they say, oh, no, I can get my Adderall now, I think a concern is they’re not going be able to get it,” she explains.

Dr. Rademacher says after numerous complaints to state officials over the last few weeks, an extension was issued, allowing people to still receive the generic medication until supply caught up.

But she tells Action 2 News, as of February 2nd, patients are telling her now there’s not enough generic available locally.

A statement from the Medicaid division of DHS to Action 2 News reads:

“Medicaid pays for FDA-approved drugs, prescribed by a qualified health care professional, and for which the manufacturer has a rebate agreement with the federal government. State Medicaid programs may secure additional rebates from drug manufacturers by establishing preferred drug lists. In this case, the Wisconsin Medicaid program, through its preferred drug list, was able to secure additional rebates that lowered the cost of brand name Adderall to be less than that of the generic alternative. In circumstances like these, the Medicaid program requires its members to use the brand name drug instead of the generic.

Notably, in January, the Department of Health Services (DHS) was made aware that major pharmaceutical wholesalers did not have sufficient supplies of the brand name drug Adderall to meet demand. As soon as DHS was advised of this issue, we changed policy to open up access to both the brand and generic versions of Adderall to ensure members were able to fill their prescriptions. This policy was in effect from January 1 – January 30, 2021.

Beginning on February 1, DHS reverted to the previous policy as the major wholesalers confirmed they had adequate supplies of the brand name Adderall.”

Dr. Rademacher is hopeful her patients, caught in the middle of the lack of communication, can again receive their needed medications and not feel a long-lasting impact.