Adderall shortage: Exploring first-time ADHD diagnoses and Adderall prescriptions
Sign up for a free account to read full studies, with full transparency into methods and results, and experience the power of Truveta Studio
Authors: Truveta Research ⊕Truveta, Inc, Bellevue, WA
Date: December, 2024
Abstract
Background
The FDA cites an increase in demand as the reason for the amphetamine/dextroamphetamine shortage. We sought to use Truveta Data to understand if increases in ADHD diagnoses and/or amphetamine/dextroamphetamine prescriptions may be contributing to the increase in demand and if there were differences by age groups. Further, we sought to understand if prescriptions were being filled and how this changed overtime.
Methods
We conducted three independent analyses: 1) We calculated the monthly rate of first-time ADHD diagnoses per people with an encounter within the previous two years and no prior ADHD diagnosis. 2) We calculated the monthly rate of first-time amphetamine/dextroamphetamine prescriptions per people with an encounter within the previous two years and no prior amphetamine/dextroamphetamine prescriptions. For questions 1 and 2 rates were calculated overall and for seven age groups. Linear regression models were used to test for changes overtime. 3) We calculated the percent of amphetamine/dextroamphetamine prescriptions that were filled within 5, 10, or 30 days of when the original prescription was written.
Results
Of the 1,033,117 people who received a first-time ADHD diagnosis within the study period, we observed a significant increase in the rate of first-time ADHD diagnoses (p<0.001). The greatest increase in the first-time ADHD diagnosis rate was seen for the 30-44-year-old population (p<0.001).. We found 520,408 people with first-time amphetamine/dextroamphetamine prescriptions during the study period. Overall, we did not see an increase in the rate of first-time of amphetamine/dextroamphetamine prescriptions. We observed significant increases in the rate of first-time prescriptions for all age groups over 30 years of age (p≤0.001), with the largest increases in the 30-44-year-old age group (p≤0.001). We included 181,567 and 498,491 people who met the inclusion criteria for first-time and overall prescription fills analysis. The percentage of first-time prescriptions filled reached a relative peak in October 2022 at 66.9% prescriptions filled per those written within 5 days. The percentage of first-time prescriptions filled reached their lowest rate in March 2023; only 53.7% of first-time prescriptions were filled within 5 days of being written. Overall, prescription fill rates followed similar trends.
Discussion
In this study, we found an increase in ADHD diagnoses since 2021; however, these increases were only seen in age groups over 30 years old. This is also the age group in which we saw the greatest increase in first-time amphetamine/dextroamphetamine prescriptions across the study period. We did not observe increases over time in either first-time diagnoses or prescriptions for populations under 30, which may indicate that the increase in demand is being driven by an adult population. Previous studies have reported a potential under-diagnosis of ADHD in the adult population, which may explain with why we’re seeing an increase in both first-time diagnosis and prescription rates amongst people over 30.
Although the amphetamine/dextroamphetamine shortage was reported to start in October 2022, we did not see substantial decreases in the rate of prescription fills for a few months. We saw the lowest rates in prescription fills in March 2023. Our results may indicate that many people were still able to access their medication; however, it took longer to find pharmacies that had the medications in stock.