The ongoing shortage of ADHD medications in the U.S. may be driven by international supply chain disruptions, adding a new dimension to concerns that have largely focused on rising demand and federal production limits.
Researchers from New Haven, Conn.-based Yale University analyzed stimulant shortages in 2022 and 2023, a period during which more than 70% of adults taking ADHD medications reported difficulty filling their prescriptions, according to a study published March 22 in JAMA Health Forum. The analysis examined amphetamine imports and included lisdexamfetamine and methylphenidate, which together account for more than 90% of ADHD stimulant prescriptions.
The researchers found that U.S. imports of raw amphetamine and its precursor, phenylacetone, declined sharply during this time, coinciding with production cutbacks among several smaller manufacturers. At the same time, the supply chain appeared highly concentrated: One-third of active pharmaceutical ingredients for the U.S. market came from a single facility, while another 30% came from just two or three sources.
While public discussion has largely focused on increased prescribing rates and DEA production quotas, the study found manufacturers produced only 70% of their allowed quota in 2022. This suggests the shortage may be more closely tied to supply constraints than regulatory limits.
To help prevent similar disruptions in the future, the researchers called for policies aimed at diversifying supply sources and strengthening domestic manufacturing capacity.
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