4 ms·

The adderall shortage is because the DEA sets quotas on how much can be made per year. Despite increased prescriptions, the amounts produced have remained the s

by chroma 3y ago

The adderall shortage is because the DEA sets quotas on how much can be made per year. Despite increased prescriptions, the amounts produced have remained the same.[1][2] The Wegovy shortage is because it was recently approved to treat obesity. The number of new prescriptions was larger than Novo Nordisk predicted, so they're still ramping up production. 1. https://www.federalregister.gov/documents/2021/12/02/2021-26227/established-aggregate-production-quotas-for-schedule-i-and-ii-controlled-substances-and-assessment https://www.federalregister.gov/documents/2021/12/02/2021-26... 2. https://www.federalregister.gov/documents/2022/12/02/2022-26351/established-aggregate-production-quotas-for-schedule-i-and-ii-controlled-substances-and-assessment https://www.federalregister.gov/documents/2022/12/02/2022-26...

kileywm 3y ago
Very interesting document; however, the text seems to disagree with your adderall explanation. https://www.federalregister.gov/d/2022-26351/p-16 https://www.federalregister.gov/d/2022-26351/p-16 > According to DEA's data, manufacturers have not fully utilized the APQ for amphetamine in support of domestic manufacturing, reserve stocks, and export requirements for the past three calendar years 2020, 2021 and 2022. > Based on this trend, DEA has not implemented an increase to the APQ for amphetamine at this time. Which suggests that the DEA's quota for adderall is not (yet) to blame.
- heyoni 3y ago
  > The majority of the manufacturers contacted by DEA and/or FDA have responded that they currently have sufficient quota to meet their contracted production quantities for legitimate patient medical needs. “The majority” “legitimate patient medical needs” sounds like a bunch of trippy legalese. If it’s the majority of the manufacturers they contacted, doesn’t that mean that there’s at least one that has exhausted their production? Could that one perhaps be the largest one, like Teva? If that’s the case, then yes, there could be a shortage. And they’re not increasing it because there’s been a surge of “illegitimate” shops that have popped up and prescribed remotely since Covid that the DEA is investigating and/or shutting down. And that may not even be the real reason. Could be the understaffing issues quoted in august. Either way, that answer from the register is a non-answer.
  - bryanrasmussen 3y ago
    >Could that one perhaps be the largest one, like Teva? maybe, but from my experience with governmental writing it probably means that there are a bunch of companies and some smaller companies they don't want to point out for some reason have exhausted production. If it was the largest company exhausted I would expect it to say something like "although the majority of smaller companies still have not exhausted their productive capabilities, the larger suppliers report that they cannot produce more at this time" Also - I would generally expect that largest suppliers exhaust their capabilities after the smaller suppliers exhaust theirs - although I guess some supply chain studies probably exist that would say if my expectation is off.
    - pseudalopex 3y ago
      Our experiences with governmental writing differ. And I expect large pharmacy chains buy from large suppliers.
  - dragonwriter 3y ago
    > If it’s the majority of the manufacturers they contacted, doesn’t that mean that there’s at least one that has exhausted their production? Could that one perhaps be the largest one, like Teva? Also, if any one doesn’t have enough, that increases the amount needed for legitimate patient needs for all the others: either (1) they all have enough for legitimate patient needs, or (2) none of them do. And, here’s the thing, if there are patients with prescriptions who aren’t able to get them, or are having to scramble to call around to different pharmacy chains with different contracted suppliers to find one that isn’t out and unable to restock the particular dosage capsule (because they aren’t fungible) of the particular drug they are prescribed, then, no, there aren’t enough for legitimate patient needs. “But some prescriptions are illegitimate” – maybe, but supply constraints don’t fix that or target illegitimate prescriptions, they just make it (well, until all supply is exhausted, then everyone is SOL) a lottery for every patient, regardless of legitimacy of their prescription. It adds a whole new problem, rather than solving the notionally motivating problem, and it is so obvious that this is the case that either the people adopting the policy are the biggest fucking idiots in the world, or the policy is outright malicious and not directed at the problem that supposedly justifies it. (Since its part of the War on Drugs, the second option is guaranteed to be part of it.)
- 93po 3y ago
  The problem isn't restrictions on manufacturers, it's DEA restrictions on the pharmacies themselves: https://www.bloomberg.com/news/articles/2023-04-03/adderall-shortages-are-made-worse-by-the-opioid-crisis?leadSource=uverify%20wall https://www.bloomberg.com/news/articles/2023-04-03/adderall-... previous discussion: https://news.ycombinator.com/item?id=35430957 https://news.ycombinator.com/item?id=35430957
eimrine 3y ago
> the DEA sets quotas on how much can be made per year I don't know anything about politics nor medicine but this reminds me a plan economy of my native Soviet Union.
_heimdall 3y ago
For adderall, you need to include the other end of supply and demand. The DEA set quotas that seem to be lower than the rate that is being prescribed. Whether the problem is how much is prescribed or how little is produced is up for debate.
- jjk166 3y ago
  The DEA is not supposed to be restricting prescriptions, it is supposed to be restricting production to what is necessary for prescriptions so there isn't a bunch of controlled substances being sold without prescriptions. If there is a mismatch, it is always a failure on the DEA's part to keep up.
  - _heimdall 3y ago
    The DEA isn't restricting prescriptions though, they're restricting production capacity. Even without all the usual overhead of government bureaucracy its not reasonable to assume a central authority could accurately predict supply needs for legitimate prescriptions, let alone keep that number up to date over time. They're always going to be wrong with their estimates. Unless there's proveable intent behind them underestimsting, what's the problem?
    - pseudalopex 3y ago
      > They're always going to be wrong with their estimates. Unless there's proveable intent behind them underestimsting, what's the problem? The problem is wrong estimates harm people. And the estimates are more wrong than they were. And the purpose of a system is what it does.
      - _heimdall 3y ago
        Sounds like that leads towards a good argument for less regulation and smaller federal government. Count me in, that's almost always the right direction to move towards these days.

by chroma 3y ago

kileywm 3y ago

Very interesting document; however, the text seems to disagree with your adderall explanation. https://www.federalregister.gov/d/2022-26351/p-16 https://www.federalregister.gov/d/2022-26351/p-16 > According to DEA's data, manufacturers have not fully utilized the APQ for amphetamine in support of domestic manufacturing, reserve stocks, and export requirements for the past three calendar years 2020, 2021 and 2022. > Based on this trend, DEA has not implemented an increase to the APQ for amphetamine at this time. Which suggests that the DEA's quota for adderall is not (yet) to blame.

heyoni 3y ago
> The majority of the manufacturers contacted by DEA and/or FDA have responded that they currently have sufficient quota to meet their contracted production quantities for legitimate patient medical needs. “The majority” “legitimate patient medical needs” sounds like a bunch of trippy legalese. If it’s the majority of the manufacturers they contacted, doesn’t that mean that there’s at least one that has exhausted their production? Could that one perhaps be the largest one, like Teva? If that’s the case, then yes, there could be a shortage. And they’re not increasing it because there’s been a surge of “illegitimate” shops that have popped up and prescribed remotely since Covid that the DEA is investigating and/or shutting down. And that may not even be the real reason. Could be the understaffing issues quoted in august. Either way, that answer from the register is a non-answer.
- bryanrasmussen 3y ago
  >Could that one perhaps be the largest one, like Teva? maybe, but from my experience with governmental writing it probably means that there are a bunch of companies and some smaller companies they don't want to point out for some reason have exhausted production. If it was the largest company exhausted I would expect it to say something like "although the majority of smaller companies still have not exhausted their productive capabilities, the larger suppliers report that they cannot produce more at this time" Also - I would generally expect that largest suppliers exhaust their capabilities after the smaller suppliers exhaust theirs - although I guess some supply chain studies probably exist that would say if my expectation is off.
  - pseudalopex 3y ago
    Our experiences with governmental writing differ. And I expect large pharmacy chains buy from large suppliers.
- dragonwriter 3y ago
  > If it’s the majority of the manufacturers they contacted, doesn’t that mean that there’s at least one that has exhausted their production? Could that one perhaps be the largest one, like Teva? Also, if any one doesn’t have enough, that increases the amount needed for legitimate patient needs for all the others: either (1) they all have enough for legitimate patient needs, or (2) none of them do. And, here’s the thing, if there are patients with prescriptions who aren’t able to get them, or are having to scramble to call around to different pharmacy chains with different contracted suppliers to find one that isn’t out and unable to restock the particular dosage capsule (because they aren’t fungible) of the particular drug they are prescribed, then, no, there aren’t enough for legitimate patient needs. “But some prescriptions are illegitimate” – maybe, but supply constraints don’t fix that or target illegitimate prescriptions, they just make it (well, until all supply is exhausted, then everyone is SOL) a lottery for every patient, regardless of legitimacy of their prescription. It adds a whole new problem, rather than solving the notionally motivating problem, and it is so obvious that this is the case that either the people adopting the policy are the biggest fucking idiots in the world, or the policy is outright malicious and not directed at the problem that supposedly justifies it. (Since its part of the War on Drugs, the second option is guaranteed to be part of it.)
93po 3y ago
The problem isn't restrictions on manufacturers, it's DEA restrictions on the pharmacies themselves: https://www.bloomberg.com/news/articles/2023-04-03/adderall-shortages-are-made-worse-by-the-opioid-crisis?leadSource=uverify%20wall https://www.bloomberg.com/news/articles/2023-04-03/adderall-... previous discussion: https://news.ycombinator.com/item?id=35430957 https://news.ycombinator.com/item?id=35430957

eimrine 3y ago

> the DEA sets quotas on how much can be made per year I don't know anything about politics nor medicine but this reminds me a plan economy of my native Soviet Union.

_heimdall 3y ago

For adderall, you need to include the other end of supply and demand. The DEA set quotas that seem to be lower than the rate that is being prescribed. Whether the problem is how much is prescribed or how little is produced is up for debate.

jjk166 3y ago
The DEA is not supposed to be restricting prescriptions, it is supposed to be restricting production to what is necessary for prescriptions so there isn't a bunch of controlled substances being sold without prescriptions. If there is a mismatch, it is always a failure on the DEA's part to keep up.
- _heimdall 3y ago
  The DEA isn't restricting prescriptions though, they're restricting production capacity. Even without all the usual overhead of government bureaucracy its not reasonable to assume a central authority could accurately predict supply needs for legitimate prescriptions, let alone keep that number up to date over time. They're always going to be wrong with their estimates. Unless there's proveable intent behind them underestimsting, what's the problem?
  - pseudalopex 3y ago
    > They're always going to be wrong with their estimates. Unless there's proveable intent behind them underestimsting, what's the problem? The problem is wrong estimates harm people. And the estimates are more wrong than they were. And the purpose of a system is what it does.
    - _heimdall 3y ago
      Sounds like that leads towards a good argument for less regulation and smaller federal government. Count me in, that's almost always the right direction to move towards these days.