How Pharma Monopolies Caused An Adderall Shortage | Breaking Points W/Matt Stoller

In the realm of pharmaceuticals, a curious predicament has emerged—a shortage of Adderall, the lifesaver for those battling ADHD. This scarcity has sparked concern, especially for individuals like journalist Matt Ford, who has relied on Adderall for two decades. Yet, the shortage is more than a mere logistical hiccup; it is a symptom of a broader issue—a monopoly reigning over the pharmaceutical kingdom.

The Adderall Dearth: A Multifaceted Conundrum

The shortage of Adderall, it seems, is not a solitary villain. It arises from a tangled web of factors, each contributing to the widening gap between demand and supply. Supply chain fragility, stringent DEA regulations, and labyrinthine complexities within the pharmaceutical market all play a part. Yet, the true antagonist in this narrative is a monopolistic behavior that barricades new entrants from stepping onto the stage. This barricade not only hampers competition but also obstructs patients from accessing the medication they desperately need.

The Veiled Contracts and Pharmaceutical Predicaments

In the world of pharmaceuticals, secrecy shrouds the contracts that bind pharmacies and distributors. Exclusive agreements, kept clandestine, force pharmacists to source a significant chunk of generic Pharmaceuticals from a solitary distributor. This lack of transparency prompted the Senate finance committee to raise an eyebrow in 2018. Teva, a behemoth in the realm of Adderall production, wields substantial influence in this intricate dance. The article doesn't shy away from spotlighting the role of major distributors like Cardinal in the opioid crisis, exposing instances of illicit dispensing and a failure to report suspicious orders. A 2021 national settlement attempted to address this crisis, demanding hefty payments from distributors, including Teva. However, it seemed more like a monetary band-aid than a surgical strike at the root of the problem.

Navigating Red Flags: A Pharmacy's Dilemma

For pharmacies, the journey through this pharmaceutical labyrinth is fraught with red flags. These warnings, raised by authorities, pertain to licensing compliance, cash transactions, responsiveness to information requests, and the proportion of Controlled Substances prescribed. Algorithms wielded by wholesalers cap the quantities of Controlled Substances a pharmacy can vend, potentially ensnaring legitimate establishments. Government agency rules, coupled with the opacity of wholesalers, cast a murky shadow over pharmacists' path, making it treacherous to traverse.

The Cardinal Cut-off: A David and Goliath Encounter

Picture this: a pharmacy, armed with legitimate documentation, finds its supply of controlled substances severed by none other than Cardinal, a formidable distributor. Pressure from Teva Pharmaceuticals coerced Cardinal into this drastic move, leaving the pharmacy in limbo. This tale illuminates a larger issue—a landscape dominated by colossal distributors like Cardinal, McKesson, and Amerisource Bergen. Exclusive contracts guard the gates, deterring smaller distributors from joining the fray. While laws against such monopolies do exist, enforcement has waned since the 1980s. The opioid settlement, while well-intentioned, missed the mark by failing to tackle these monopolistic practices.

In unraveling the Adderall conundrum, we are met with a crossroads—a choice between maintaining the status quo or forging a path toward a more equitable pharmaceutical landscape. It's time to address these monopolistic practices and forge a future where accessibility to crucial medications is a right, not a privilege. In doing so, we pave the way for a healthier, more inclusive tomorrow.