Advances in the Management of ADHD in Adult Population - Episode 16

Access to ADHD Treatments

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ADHD experts discuss strategies for improving access to ADHD medications for their patients.

Theresa R. Cerulli, MD: After we get things through the FDA and they’re approved, there’s always the challenge of access.

Andrew Cutler, MD: That’s true.

Theresa R. Cerulli, MD: Birgit, you’re in the trenches on the front line. Access to newly approved medications can be challenging. What advice do you have for other physicians who want to get these in the hands of the patients?

Birgit H. Amann, MD, PLLC: To take it to the patient level, in my practice, when a new medication comes out, I talk with all of my families, patients, and parents about it. I give them some information about it. If somebody is doing well on what they’re on, it isn’t ethical to change them. But I like to give them that information so that if not now, maybe in the future they’ll know that they could call to talk about it.

From the standpoint of physicians, clinicians, or prescribers, on the whole, it’s important to understand new options and what they can offer to patients over what we’ve had before. If it seems as though a new medication would offer longer duration, better tolerability, or something about it would be suitable for the patient they’re treating, it’s important to prescribe it. It’s important to make noise. I’m not afraid to do a prior authorization. Usually, the patients who come into our offices have plenty of ammunition, if you will, regarding past medications that they’ve been on, and we can try to have that go through. They may not be able to use these newer medications in patients who have never been on anything. But with patients who have had a few different medication trials, we need to prescribe these medications for them if we think they’re appropriate.

Andrew Cutler, MD: In my experience, these companies with newer medications have gotten very sophisticated with copay card access and giving us information on what we have to do to get one of their medications. I certainly suggest talking to the company’s representatives and letting them help you.

Theresa R. Cerulli, MD: How nice is that with viloxazine XR [extended release], not just copay cards.

Andrew Cutler, MD: Yes.

Theresa R. Cerulli, MD: It’s a noncontrolled substance. We can provide samples to the patients. Talk to your representative about getting samples for your practice.

Andrew Cutler, MD: Yes. How long has it been since we’ve had ADHD [attention-deficit/hyperactivity disorder] samples in our closets? It’s unbelievable.

Theresa R. Cerulli, MD: We certainly can’t do this with a stimulant.

Andrew Cutler, MD: That’s right.

Theresa R. Cerulli, MD: But with viloxazine XR, it’s been a nice way to get folks started while you’re trying to work on the copay card and prior authorizations. Sometimes it also takes the assistance in working with the pharmacies to make sure they’re comfortable using the cards.

Andrew Cutler, MD: Yes. Good point.

Theresa R. Cerulli, MD: Your representative may be able to assist with that as well. The pharmacists don’t always try too hard. The copay cards work, but they need to be properly utilized.

Andrew Cutler, MD: Sometimes the independent mom-and-pop pharmacies do a better job with that. Maybe cultivate a relationship with some of those pharmacies.

Theresa R. Cerulli, MD: Absolutely.

Transcript edited for clarity