Prescribers should not start any new patients on some ADHD medicines because of a national shortage, the Department for Health and Social Care has warned.
GPs are also being asked to identify and contact all patients currently prescribed the medicines to ensure they have supplies to last.
A national patient safety alert said there were ‘supply disruptions’ of various strengths of methylphenidate, lisdexamfetamine and guanfacine.
It follows a previous alert about shortages of atomoxetine capsules in August which is set to resolve next month, DHSC said.
The shortages are due to a combination of manufacturing issues and an increased global demand, the alert explained.
With the latest issues expected to continue to December for some medicines, new patients should not be started on the products affected by shortages until the supply issue resolves, the guidance sent to healthcare professionals said.
Where patients do not have enough to last until the re-supply date – which differs depending on the medicine in question – GPs are being asked to contact pharmacies to find out about stocks and reach out to the patient’s specialist team for advice if a product cannot be sourced.
Current supply disruptions are for:
Methylphenidate:
- Equasym XL 10, 20 and 30 mg capsules
- Xaggitin XL 18 and 36 mg prolonged-release tablets
- Concerta XL 54 mg prolonged-release tablets
- Xenidate XL 27 mg prolonged-release tablets
Lisdexamfetamine:
- Elvanse 20, 30, 40, 50, 60 and 70 mg capsules
- Elvanse Adult 30, 50, and 70 mg capsules
Guanfacine:
- Intuniv 1, 2, 3 and 4 mg prolonged-release tablets
Other ADHD drugs remain available ‘but cannot meet excessive increases in demand’, the notice from DHSC and NHS England said.
To address the shortages unlicensed imports of lisdexamfetamine capsules and guanfacine prolonged-release tablets have been sourced, the alert confirmed but lead times vary.
Professor Azeem Majeed, professor of primary care and public health at Imperial College London, said: ‘This is the latest in the many medication shortages we have seen in the UK in recent years.
‘These shortages are now too frequent and waste the time of NHS staff. They are also very stressful for patients who risk going without key drugs with potentially adverse consequences for their health.
‘We need a much more proactive approach from government which needs to work with drugs manufacturers and wholesalers to ensure the NHS has adequate supplies of key drugs. This could include better data on drug supply and demand to identify problems before they occur; local manufacturing capacity in the UK; price incentives for suppliers; and international collaboration to ensure continuity of drug supply.’
Diagnoses of ADHD have been rising in recent years with NHS figures showing more adults were prescribed drugs for the condition than children for the first time in the past year.
In 2022/23 prescribing of medicines for ADHD increased by 32% in adults and 12% in children under the age of 17, the data shows.
Last year there were 233,000 patients in England prescribed medicines for ADHD – 120,000 of them adults, the annual report said.
GPs have also repeatedly raised questions over shared-care arrangements for prescribing when it comes to ADHD where workload was growing.
Medicines supply now our problem as well as boiler servicing. Silly me thought between patient and pharmacy.
NO
Seriously is there not enough work to do. We are constantly being told that our workload is going to be reduced by reducing administration etc but all we see is an increase in workload. Why not ask pharmacists to do this or the ADHD teams who share the care . It always seems to be either contact your GP, or the GP can do it as NHSE default position
No, not GPs, because GPs are not the prescribers for these drugs. Fortunately!
All these patients are under care of Specialist doctors who retain the Prescribing and Monitoring Responsibility – as recorded in the Shared Services Agreements, and, what is more, they all have specialist support staff such as Nurses who can do this phoning around and putting the heebeejeebies up them about insecure drug supplies, and can tell them that there is no point contacting GPs about it as there is nothing that they can do about it.
Gosh it makes feel all OCD just thinking about it.
Do you have any idea how offensive that comment would be to someone who actually has OCD, a disabling mental health condition?
David Church, mmmh, a bit vulgar don’t you think?
I’m sure nurses love your visual of them putting things up people whilst I’d rather have a nurse putting the what? thehebeejeebee??? up me than Dr Church 😵💫.
So let’s get this straight.
GPs are now responsible for non-existent drugs (that they know nothing about) for what many GPs consider a non-existent condition (that they know nothing about).
Glad we we sorted that out, then.