What's Going on With Australia’s Vyvanse Shortage for ADHD Patients?

Australia has a shortage of ADHD  medicine Vyvanse. It’s been a problem since last year and is not expected to improve until at least the end of April, due to issues with manufacturers and the US Drug Enforcement Administration. So what’s going on, and how do you even “run out” of something like that?

Vyvanse is a medication used to treat ADHD that works by raising the level of dopamine and norepinephrine, helping focus, impulse control, and attention. It’s a fairly common prescription around the world. 

Reports that Australia could face a shortage of Vyvanse first started circulating in August last year. Some patients were told that their usual prescription dose was being changed towards the amounts that were still accessible. Currently, Vyvanse is available in 30, 40, 50, and 60mg strengths.

In August, the chair of the Royal Australian College of General Practitioners (RACGP), Associate Professor John Kramer, said a possible solution would be to break up a higher 60mg capsule with water and then ration that to a patient.

He said: “a patient on 30mg would be given 5ml of the liquid, and the remainder stored in the fridge for the next day.”

This wasn’t just an Australian problem, though. Globally, the Vyvanse shortage began when supply of the drug Adderall dropped in the US. This kicked off a domino effect that eventually meant a shortage of other ADHD medications, like Vyvanse. 

Australians are facing even more time without the drug after the US DEA rejected a request to increase the production of a patented ingredient used in the medication. 

Lisdexamfetamine, an active ingredient in Vyvanse, is made in the US where American authorities set limits on how much the pharmaceutical industry can take because of its potential for abuse. Getting your hands on generic lisdexamfetamine in Australia isn’t an option, either, as the patent for Vyvanse is owned by a company: Takeda Pharmaceuticals.

The DEA is blaming the shortage on manufacturers, saying they hadn’t previously made the maximum amount of ADHD medication they’re allowed to produce, which now means there’s a “shortfall of 1 billion doses” that could have been produced. But Takeda Pharmaceuticals, which brings the drug into the country, told the ABC it has been running at full capacity.

There are alternatives to Vyvanse, sure, but often these are not on the Pharmaceutical Benefits Scheme (PBS) and therefore cost far more. The TGA has even approved access to overseas-registered versions of Vyvanse, but those products aren’t on the Pharmaceutical Benefits Scheme and will also be more expensive.

The ABC revealed in January the Royal Australian and New Zealand College of Psychiatrists had asked for an urgent meeting with the US DEA to try and correct the supply. 

Doctor Elizabeth Moore, president of the RANZCP, told the ABC: “this is a crisis currently and we need to work together to solve this crisis, because people are suffering.” 

As of January, the RANZCP still had not heard a response from the DEA. Meanwhile, the TGA is recommending that pharmacists prioritise giving Vyvanse to ongoing patients.