We’ve all experienced the frustration of going to the pharmacy to pick up a prescription only to find that it isn’t ready yet. But as annoying as a delayed prescription may be, you might not realize that pharmacies can also refuse to fill certain medications altogether. In fact, the likelihood of this affecting you may have just increased, as major pharmacies in the U.S. have started blocking prescriptions for one daily medication that millions of people use. Read on to find out if you’ll be impacted by the turn against this common drug.
Telehealth services have been around for years, but they became increasingly important to people during the COVID pandemic. A 2021 analysis from McKinsey & Company reported that the use of telehealth had grown more than 38 times higher than it was before 2020. One of the fastest growing areas of this healthcare rise has been online mental health services. Cerebral, an online mental health company, has provided care to more than 200,000 patients since Jan. 2020, according to Fierce Healthcare.
“You can do psychotherapy and mental health care very well if you have a good quality audio-visual connection” Paul Desan, MD, director of the Psychiatric Consultation Service at Yale New Haven Hospital, explained to Yale Medicine. “It’s much easier for people to schedule a visit and they don’t have to drive there and then wait to be seen. I don’t think the mental health system will ever go back to all in-person sessions as long at the insurers keep paying for it.”
But there are concerns with online mental health services, especially given that the use of certain prescription medications seems to have increased alongside the recent rise of telehealth. Pharmaceutical research provider Iqvia Holdings Inc. reported that Adderall prescriptions dispensed in the U.S. rose to 41.1 million last year, which was more than 10 percent higher than what it was in 2020, according to The Wall Street Journal.
The U.S. Food and Drug Administration (FDA) classifies Adderall as a Schedule II controlled substance, which means it is considered to be a drug that has “high abuse potential” but is still accepted for medical use. As a result, the FDA advises that amphetamines, such as Adderall, be “prescribed or dispensed sparingly.”
“Administration of amphetamines for prolonged periods of time may lead to drug dependence and must be avoided,” the agency says. “Misuse of amphetamine may cause sudden death and serious cardiovascular adverse events.”
As a result of the rise in Adderall prescriptions, major pharmacies in the U.S. have started refusing to fill certain prescriptions from telehealth providers. According to The Wall Street Journal, Walmart, CVS, and Walgreens have all recently blocked or delayed stimulant prescriptions from telehealth providers treating ADHD online, including Cerebral and Done.
A CVS spokesperson told the news outlet that it has a controlled-substance compliance group that flags and interviews clinicians in regards to “potentially excessive prescribing practices,” while Walmart confirmed that “some Done-affiliated prescribers have been blocked by Walmart, and individual pharmacists have refused to fill prescriptions from Done-affiliated prescribers.”
The Wall Street Journal also reported in March 2022 that some nurse practitioners at both Cerebral and Done claim they’ve felt pressured to prescribe Adderall or other stimulants to new patients, even though they did not feel like either of the telehealth companies’ provided evaluations were long enough to properly diagnose patients with ADHD. Both Cerebral and Done told the newspaper that they simply encourage providers to use best practices and utilize the treatment methods they believe are needed.
“There have been incidents where prescriptions have been temporarily delayed by pharmacies due to confusion around today’s telehealth policies,” Cerebral told The Wall Street Journal. “This is an industrywide issue that we’ve seen and experienced with pharmacies across the country.”
On May 4, Cerebral confirmed that it would soon be pulling the plug on Adderall prescriptions. According to an announcement from the company, Cerebral will no longer allow its clinicians to prescribe controlled substances such as Adderall and Ritalin as an ADHD treatment for new patients, starting May 9. Existing patients “will continue receiving their clinically appropriate, prescribed medications,” however. This decision came after Truepill, Cerebral’s preferred online pharmacy, said it would also be temporarily halting prescriptions for Adderall and other controlled substances used to treat ADHD, The Wall Street Journal reported.
“It is regrettable that a helpful class of medication that is considered a first-line treatment option has become so stigmatized,” David Mou, MD, the chief medical officer and president at Cerebral, said in a statement. “We hope this will change as a population of people with clinical needs are no longer able to access care with us.”