A Newcastle mum has described the shortage of a low dose ADHD drug which helps kids focus in school as a "distressing" situation.
A shortage of the medication Vyvanse is listed on the Therapeutic Goods Administration (TGA) website in the 30mg dosage, which is a common medication for school-aged children with ADHD. Supply is expected to be impacted until the end of 2023.
"This shortage is a global problem caused by manufacturing issues," a TGA spokesperson said.
"The Therapeutic Goods Administration is working closely with the Australian sponsor of Vyvanse, Takeda Pharmaceuticals Australia, to resolve the shortage as quickly as possible and minimise the effects on consumers."
A local parent, who did not want to be identified, said she discovered there was a shortage when she had one tablet left for her son and went to fill a replacement script.
"I called my chemist in Newcastle and they said they did not have his medication and it was an industry problem and they would put out an alert on their internal pharmacy intranet system to see if they could assist me," the mum said.
"They suggested I ring around pharmacies.
"Luckily I had an e-script, for the first time ever, which meant that the script could be used at any pharmacy, whereas my son's regular paper script is kept under lock and key at our local pharmacy.
"I was able to find a pharmacy that had the dosage we needed however the pharmacist said it was his last bottle, and there were severe shortages of the 20, 30 and 40mg dosage of the medication."
She said she had not had trouble filling a script in the six years her child had taken ADHD medication.
Several Newcastle pharmacies confirmed they were out of the 30mg dosage. Some had 20mg, while higher doses were in better supply.
Darby Street Pharmacy pharmacist Philip Matthews said the shortage began "a month or so ago".
Merewether Pharmacy owner and pharmacist Fiona Evans said the issue was more difficult than with other drug shortages, as pharmacists could not substitute the brand and script holders were not able to take physical prescriptions to another pharmacy, only e-scripts.
The Newcastle parent was thankful she was able to source the medication, but said the situation was a stressful experience. She said she feared for other parents whose children relied on the medicine.
"I was really panicked before I found a pharmacy that had the medication, because I know that it really helps my son in the school environment and having just become a teenager he's at the age where he's coping with the change to high school and forming new friendships," she said.
"The medication is not just to help him focus, it's really important in helping him to self-regulate better, enabling him to form friendships and create a social network, which is often trickier for neurodivergent children because of different factors.
"It made me worry about other parents whose children might have more complicated needs. Often these parents are primary carers and reliant on the health system to be effective for their kids' needs.
"The medication these kids have is highly regulated for a reason, there needs to be checks and balances to ensure kids have the right medication and holistic care (paediatrician, OT etc) but it is a massive issue if the medication is simply 'not available'.
"It is really distressing for parents but more importantly for children who draw the benefit of the medication, which is given to them after a lot of consultation between parents and health specialists."
Hunter Children's Clinics paediatrician Rob Parry said the shortage came during HSC preparation time, adding an extra layer of stress for some students.
Dr Parry said Vyvanse was useful for kids as it was long-lasting, whereas short-acting medications needed to be taken multiple times a day.
"In terms of management of ADHD, we advocate that it's a combination of lifestyle interventions, behavioural interventions and medications," he said.
"Vyvanse is one of the medications that we use as part of the management process - 30 is the dose we would normally start patients on. It would probably be the most commonly prescribed, so a number of people would be affected by this."
Dr Parry said he could see the situation having a knock-on effect to other medication.
"Australia, unfortunately geographically is removed from other countries, so we are more supply chain dependent," he said.
"In America, there was a shortage of Adderall, which is quite similar to Vyvanse. There was a switch in prescribing from Adderall to Vyvanse and that I suspect is one of the contributing factors, not the whole contributing factor, to the supply issues of Vyvanse.
"I can't speak for every other paediatrician, but my strong suspicion would be there would be an increase in Vyvanse 40 prescriptions from this and that would then have knock-on effects on the supply of that particular dose as well."
Pharmacies are speaking to each other and to doctors about the situation, Ms Evans said.
"When we were notified, we contacted the few specialists who refer to us, to see if they can prescribe something else for the youngsters," she said.
"But for those who have scripts with three to five repeats, they will have to go back to their doctor.
"The company themselves have said it will be the end of the year before it comes back."
Dr Parry said there were other management strategies, including behaviour and lifestyle interventions, as well as other medications.
"For some children that might be just temporarily going onto the short acting dexamphetamine," he said.
"Other workarounds are that you can prescribe a higher dose.
"This is where I think a lot of patients are being directed by the pharmacists to get back into contact with the paediatrician because Vyvanse is a medication that can you can open up the capsules and you can pour, for example, 40 milligrams of Vyvanse into 40ml of water, and you can draw up 30ml of that.
"But it's painful and it's hard for parents to do this, so it adds a lot of stress and burden.
"They have to get in contact with their doctor, the doctor has to prescribe. That's quite challenging because consultation times are generally already filled, and then the substitution medication requires a degree of extra work on the family's side."
The TGA spokesperson said they were closely monitoring supply and the sponsor was working to support "equitable supply of current stocks and speed up the next shipment of the medicine to Australia".
"The TGA appreciates that finding an effective alternative treatment can be time consuming and difficult, particularly because Vyvanse is a restricted medicine and subject to controls based on their state-based regulations," the spokesperson said.
"Parents are advised to seek advice from their pharmacist about continued supply. If they continue to face difficulty in accessing Vyvanse, their treating doctor is best placed to provide advice about treatment options."
Dr Parry said his advice to parents and patients was not to wait until their prescription was low.
"It would be getting in contact with your pharmacist and then potentially your doctor sooner so that there's time to time to have discussions about alternatives," he said.
"The important thing is to remember that medication isn't the sole management method of ADHD and to think about the lifestyle and behavioural interventions which also are fundamental to the management of ADHD.
"That being said, I can understand that there would be a lot of families, especially children who take this medication and have been going very well on a particular dose, so when it becomes unavailable, it can cause considerable stress."
