ADHD Medication Shortages are Continuing to put Patients at Risk in the UK
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Medication for Attention Deficit Hyperactivity Disorder (ADHD) has been severely lacking in the UK in recent years. As a result of this crisis, thousands of patients are searching for other options, doctors are finding it difficult to give proper care, and families are dealing with the fallout. In addition to identifying weaknesses in the pharmaceutical supply chain, the scarcity has brought attention to structural problems with the way ADHD patients are treated.
Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that can be diagnosed in children and adults. The condition affects concentration, restlessness and increases impulsivity. Effective forms of treatment include behaviour specialists and medication that can help control symptoms. If not managed, patients are at risk of losing jobs, not performing at their optimum levels in education and can have severe impacts on their mental stability. Medication offered to treat ADHD comes in forms of methylphenidate (Concerta and Ritalin) and Elvanse, an amphetamine based drugs which helps speed neurotransmitters between your brain and body cells, to reduce fidgeting, increase task completion and aid concentration.
Due to increased awareness and better diagnostic procedures, the number of ADHD diagnoses has increased dramatically over the last ten years. As a result, the demand for pharmaceuticals has increased faster than producers can provide it. This trend was made worse by the epidemic, as more people sought medical examinations during lock downs, which resulted in a backlog of prescriptions and diagnoses. The graph below shows the correlation of ADHD diagnoses and medication prescribed.
Data Collected from: NHS Business Service Authority
As the data shows, ADHD diagnoses have increased drastically in the last 6 years, with an increase of 92% medication prescribed and an 111% increase of patients identified. An acceleration of patients receiving diagnoses can be seen during the last quarter of 2020/21 to the last quarter of 2021/22. A result of this is due to the COVID-19 pandemic where more patients were seeking medical assistance. To find active pharmaceutical ingredients (APIs), the pharmaceutical industry depends on intricate, global networks. Lockdowns, delays in transit, and geopolitical instability can all cause this link to break, which can lead to a chained reaction of raw materials not being received. Increased global demand of the medication implemented a strain across pharmaceutical companies, GP’s, doctor practices and ultimately the NHS.
A survey conducted by The Pharmaceutical Journal from the 17th of April 2023 to the 1st of May 2023 found that of 1,578 pharmacists asked if medicine shortages have put patients at risk in the “past six months”, 902 (57%) of pharmacists responded with ‘Yes’. The survey was taken under a title of “The Pharmaceutical Journal’s salary and job satisfaction survey” and the respondents were professionals working in all sectors of the pharmacy. Highlighting the risk that these shortages are detrimental to patients, coming from a professional in the industry, causes for concern.
To understand how these shortages had an affect on people with ADHD, I undertook an interview with a student from Oxford Brookes University. My interviewee has been diagnosed with ADHD for 2 and a half years now on Elvanse medication, in order to help with his concentration and attention skills in University. He describes this diagnosis as a “relief” for him and noticed a significant increase with his grades in University, along with an improvement in social situations. However, these shortages caused him to have a lack of supply for his medication, causing complications in University and everyday life. He describes that he was “lucky” because after a few weeks he found a way to repurchase his medication, but “would have to travel to different pharmacies within England” to receive the medication. He was also aware that he “didn't have it severe to the point where [he] knew some people would lose their jobs, but it was obviously stressful as [he is] a Uni student and didn’t know if [he] was going to get it or not”. Today, there is still struggles for him to receive the correct supply of medication and will often have to ration his medication to ensure he has enough for when exams and assignment are approaching.
Data Collected from: NHS Grampian
This chart demonstrates the affects the shortages has on the prescription he takes, Elvanse. Elvanse also supplies a prescription specifically for adults, so my data is demonstrating the regular 30mg had no future on when the stock was going to return, but patients could buy the adult prescription, putting children who were on a dosage of 30mg at risk. The instability of the milligrams causes distress among patients as some would have to increase/decrease their dosage, in order to stay on the same medication.
As well as patients being affected by the shortages, parents and caregivers can also face backlash. Parental care giving duties leaves many parents feeling overburdened and unsupported as they try to get the best care for their kids. Children with ADHD may become more impulsive, hyperactive, and inattentive if they are unable to obtain medication. As a result, parents experience more frequent and severe behavioral outbursts, disputes, and trouble regulating everyday activities at home. Amplified pressure can often lead to parents spending more money on receiving private healthcare or seeing alternative therapists in order to receive the right medication / help for their child.
The impact on sourcing the raw materials for the medication ultimately put a strain on the NHS. The factors of COVID-19 and an increase of awareness surrounding ADHD all contributed to the cost in which the NHS has had to put in to supplying the right medication to each patient.
Data Collected from: NHS Business Service Authority
The data above shows an 113% increase in NHS funding over the last 6 years for ADHD medication. With a backlog of patients still waiting to be diagnosed for ADHD and receive their medication, this statistic is likely to increase overtime. Social media platforms, awareness courses for teachers/professors and a surge of mental health advocacy in today’s society is causing more people to attend GP’s and seek medical advice. Whilst it’s important everybody receives help on their needs, the financial burden on the NHS continues to grow.
The scarcity of ADHD medications in the UK serves as a warning to healthcare practitioners, governments, and the general public. It emphasizes the need for a more resilient and flexible healthcare system that can handle emergencies without sacrificing patient care. While fixing the current shortage must be the top priority right now, long-term plans are required to stop such incidents in the future and enhance ADHD treatment in general.
Ignorance of patients and their families is not an option. People with ADHD must be given the care they require to live happy, full lives in the UK. Therefore, the underlying reasons of the shortages need to be addressed by the UK Government and comprehensive solutions put in place. Action must be taken immediately for the benefit of those impacted and for the advancement of society at large.