Authorized Generic Concerta Update

Concerta generic

Having trouble receiving the authorized generic Concerta—again?  Well, you’re in the right place.

I’ve been covering this issue for six years (see list of posts). Today I nailed down the latest details. But be warned: This is a rapidly changing scenario—and much depends on your particular insurance pharmacy benefit. Much also depends on your willingness to self-advocate.  And, since March, COVID has added another variable.

To print a copy of this for your physician or pharmacist, click here:  Authorized Generic Concerta Update 3/9/20 PDF

Update 11/15/20: Concerta Savings Card

Concerta manufacturer Janssen offers a savings program.  Check the terms at the link.

Update 3/9/20: Walgreen’s, Rite-Aid and Possibly Other Stores

Walgreen’s corporate headquarters confirmed with Patriot that all Walgreen’s stores should be able to order the Concerta authorized generic for you.

If you encounter resistance, ask that an Exception Process be ordered for you. Still trouble?  Call Patriot at 215-325-7676

Allegedly, Rite-Aid also has an Exception Process as well but I have not yet been able to confirm that with the corporate headquarters.

Other drugstores might be implementing such a policy. But no announcements have been made.

To date, CVS has chosen not to participate.

Walgreen’s  Your Best Bet Now—and Since This Issue Began

I have no business interests with Walgreen’s.  I can simply confirm that, since I first started to report on the Concerta generics issue (2014), Walgreen’s has been the most customer-focused chain. (Wegman’s, too, though Wegman’s stores are much smaller in number and regional.)

Walgreen’s must be taking a financial hit on this, so what’s the decent thing to do? Do your drugstore-sundry shopping at Walgreen’s, too.

Please note: I have not updated the rest of this post in light of this new information. If you remain confused about genetic vs. authorized generic and the historical changes, however, you’ll find it useful to read the details—Gina

Quick Summary of this Post

In this post, you will

  1. Learn to please stop asking for Actavis/Teva; you’ll be in for an unpleasant surprise.
  2. Gain an overview of what’s been happening on this topic since June 2010.
  3. Learn that the authorized generic is the brand; it’s simply sold as a generic.
  4. Know that the authorized generic (brand marketed and sold at generic prices) is now distributed by Patriot Pharmaceuticals, a subsidiary of Janssen, Concerta’s manufacturer.
  5. Be sure to read closely the section below under the heading: How to Specify the Authorized Generic Concerta
  6. Find a bulleted summary of the main points at the end of this post—and a new infographic, because some readers are still having trouble understanding the details.
  7. Consider getting the brand until the dust settles, if it’s affordable, or trying one of the new methylphenidate medications  (Ritalin, Daytrana, Aptensio XR, Metadate CD, Methylin, Quillivant XR, Jornay PM, Adhansia XR, Cotempla, etc.)
  8. If you participate in an ADHD-related forum or another type of group, please share the link to this blog post.  I’m seeing folks repeat tidbits from this post but out of context and without updates—and therefore unhelpful.
  9. If you’d like to share a copy of this post with your prescriber or pharmacist—or anyone—click here to download Authorized Generic Concerta Update.

First, some background and context.

Tricky  Transition Time Now

Even though the Concerta authorized generic is available, will your particular pharmacy agree to order it? Uncertain. Some pharmacies are more helpful than others, even within the same chain (e.g. Walgreen’s, etc.).

Overall, pharmacies are increasingly choosing profits over customers. Regular generics tend to be more profitable than authorized generics. A reader commented on this post that, as an independent pharmacist, they lose $100 on every authorized generic Concerta prescription.

Meanwhile, the clown car of new Concerta generics expands at a dizzying rate. We get two inferior generics downgraded one year and out pop several more the next!  (See Victory! Concerta Generics Downgraded)

To be clear: I receive no pharmaceutical funding of any type, and that includes from the makers/sellers of Concerta!

As I mentioned in the update above, Walgreen’s seems to be the only chain officially committed to helping its customers get their prescriptions filled with the authorized generic of Concerta. There might soon be others, though.

generic concerta

Once Again: What Is An Authorized (or Branded) Generic?

A bit of background first.

Recently, Concerta users are starting to realize: The distributor of the authorized generic has changed again. From Watson to Actavis to Teva and now to Patriot Pharmaceuticals. Now, what should their prescriber specify?  As always, I suggest forgoing the distributor name. It’s too subject to change. I’ll provide an alternate suggestion below.

To recap: Do you know the difference between “authorized” and regular generic medications? Many readers seem to remain confused.

I understand the confusion.  Even many pharmacists and physicians can’t tell you the difference. Moreover, many also insist that regular generic medications are “exactly the same” as brand. They are not. Consumer beware.

I’ve covered it before (again, the roundup of blog posts)  but here are the basics:

1. Authorized generic (aka branded generic):

In fact, the authorized generic is the brand. It’s only marketed and sold as a generic.

This typically happens when a brand drug patent nears expiration. Another company strikes a deal with the brand manufacturer: “We’ll delay introducing our regular generic if you agree to let us sell your brand as a generic.”

That’s what happened with Concerta several years ago.  The manufacturer, Jannsen, agreed to let a company named Watson sell its brand Concerta as an authorized generic. As time went on, Watson became Actavis and Teva purchased Actavis.

Newsflash: Now Teva-Actavis has it’s own generic

(but it’s not the authorized generic). 

If you are used to associating “Watson/Actavis/Teva”

with the authorized generic, please know that is outdated information.

In the past, the prescriber could specify on the prescription: “authorized generic Concerta/Watson, etc.”—or simply OROS.

OROS is Concerta’s patented extended-release technology, owned by a company called Alza and used by Janssen in making Concerta. (The osmotic-controlled release oral delivery system, OROS, takes the form of a rigid tablet with a semi-permeable outer membrane and one or more small laser-drilled holes in it.)

Since then, for a variety of reasons, it’s gotten more challenging.  Pharmacies are consolidating and are less “consumer-oriented.”  Some of the new generics use other osmotic technology. As a result, some pharmacists mistake “osmotic technology” for the proprietary OROS from Alza.

2. True generic:

This is what most of us regard as a generic medication.  It’s a cheaper alternative to a brand medication.  It is made by a different company, not the brand’s manufacturer.

Even though it is often claimed to be “exactly the same” as the brand, it is not. Unfortunately, pharmacy insurance benefits increasingly force consumers to accept these generics or pay a very high cost for the brand.

For more details, read Consumer Q&A on Concerta Generics

New Concerta Generics From At Least Nine Companies

Over the last two years, the situation has grown even more confusing. At least seven (SEVEN!) companies released Concerta generics since July 2017:

  1. Manufacturer: ACTAVIS LABS FL
    Approval date: March 21, 2018
    Strength(s): 54MG [AB]
  2. Manufacturer: ACTAVIS LABS FL
    Approval date: March 22, 2018
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB]
    NOTE: Actavis used to be the distributor for the authorized generic Concerta; now it has its own generic.
  3. Manufacturer: ALVOGEN PINE BROOK
    Approval date: November 30, 2018
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  4. Manufacturer: AMNEAL PHARMS
    Approval date: February 1, 2018
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  5. Manufacturer: ANDOR PHARMS
    Approval date: April 24, 2019
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  6. Manufacturer: ANI PHARMS INC
    Approval date: July 14, 2017
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  7. Manufacturer: MYLAN
    Approval date: October 21, 2016
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  8. Manufacturer: OSMOTICA
    Approval date: July 28, 2017
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB]
  9. Manufacturer: PAR PHARM
    Approval date: July 15, 2019
    Strength(s): 36MG [AB], 54MG [AB]
  10. Manufacturer: ASCENT PHARMS INC
    Approval date: September 3, 2019
    Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB ]
    NOTE: The Ascent generic (distributed by Camber) uses a barrell-shaped pill. It seems designed to fool consumers/physicians/pharmacists that this generic uses OROS. It does not.

 

authorized generic Concerta
Note red arrows for two points of identifying the authorized generic Concerta: NDC code (last two numbers will differ by dosage) and distributor (Patriot Pharmaceuticals)

Who Sells the Authorized Generic Concerta Now?

Now the new seller is Patriot Pharmaceuticals, as shown on the label above.  Patriot is a subsidiary of Concerta manufacturer Janssen.  The corporate office tells me there is no planned termination date for this arrangement. Meaning, it should continue …… until it doesn’t.

In the old days (about 4 years ago), the companies made public these marketing deals.  Consumers knew when the deal would take effect, when it was set to expire, when it expired or was re-negotiated—and how long that would last. After Teva purchased Actavis in 2016,  however, I found impossible to extract any details from the company.

Since that time, Teva has removed the authorized generic from its website. Actavis/Teva now sells its own generic. The marketing deal to distribute the authorized generic has gone to Patriot Pharmaceuticals.

Authorized Generic ConcertaPatriot Pharmaceuticals Is The New Distributor

In fact, Patriot Pharmaceuticals is a subsidiary of Concerta maker Janssen.  It sells only authorized generics. As its website tagline says: One Word Stands Out—Authorized.  (See blurry screen capture above.)

Just in case visitors also don’t understand the term authorized generic, the website spells it out:

Patriot Pharmaceutical Generics are authorized for sale to trade customers by the NDA holder of the innovator product. [Note: NDA stands for New Drug Application.  It the vehicle through which a company proposes that the FDA approve a new pharmaceutical for sale and marketing in the U.S.. Not a new generic of an existing brand, a new pharmaceutical altogether.]

The entire Patriot family of products is made by the same manufacturers that are approved in the NDAs of the innovator products.

The same qualities you relied on in the innovator pharmaceutical products during their branded lifecycle are now available in Patriot’s authorized generic line of products. [A branded life cycle means “before the patent expires”.]

You’ll find Patriot’s handy Q&A here: About Authorized Generics

authorized generic Concerta

**This is it!!!  How to Specify the Authorized Generic Concerta**

As promised, here are the updated details, including the unique identifying number, a list of distributors, and the name of the drug.  I accessed this information from the U.S. National Library of Medicine “Daily Med” website.

1. Name:

Methylphenidate HCl Extended-release tablets

NOTE!  You cannot rely just on the name; all the Concerta generics (including the authorized generic) are named this!

2. You Will Need The  Identifying NDC Code:

Each FDA-approved medication (brand or any kind of generic) is assigned a code, the NDC (National Drug Code). Here are the numbers for Concerta’s authorized generic (the last two numbers vary by dosage):

  • 10147-0685-1 – 18 mg
  • 10147-0688-1  – 27 mg
  • 10147-0686-1  – 36 mg
  • 10147-0687-1  – 54 mg

My advice is: Ask your prescriber to specify the NDC number.

Note: If your pharmacy says that number is not coming up in their database, they might instead find the 11-digit billing code.  For example, the 36 mg replaces one hyphen with a zero.  That is, NDC 10147-0686-1 has a billing code of NDC 10147068601. For the full details, click here: NDC 10147-0686-1 METHYLPHENIDATE HYDROCHLORIDE.

If your insurer or pharmacy needs more information, click here to download my highlighted copy of the Concerta Authorized Generic Label Insert.

3. Distributors:

What if—despite taking the steps above—your pharmacy benefit company still says, “But we can’t find that”? or “It’s on back order”?

It might be that store or chain simply will not order it for you, under any circumstances.

To check, call the Patriot Pharmaceuticals customer service at 215-325-7676 

4. How Should The Prescription Read Exactly?

There are no ironclad answers here. Your prescriber might have a preference.  But the pharmacy might, too. If possible, try to get a straight answer from the pharmacy before speaking with your physician.

In the best of all possible worlds, the script need only contain the name of the drug!  But in the case of Concerta generics,  they are ALL called Methylphenidate Hydrochloride (HCI) Extended-release tablets. That makes it critical to establish which one.

To be crystal clear, the prescription should read something like this (for example, for the 36 mg dose):

Methylphenidate HCl Extended-release tablets, 36 mg, NDC 10147-0686-1 ONLY

The “ONLY” at the end indicates, “do not substitute with another generic.”

Note: Some readers report that their pill bottles exclude the HCl (which stands for hydrochloride). If the pills say “Alza,” don’t worry about it.

5. Pay Attention to the “No Substitutions” Box

Tricky Bit: Your prescriber must pay attention to the prescription pad checkbox that indicates “no substitutions” or “dispense as written” (it varies by state).

If that is checked, pharmacists typically take that to mean, “do not substitute a generic.”  That means you might get brand—at brand prices—or one in the clown car of new generics.

But what happens when the prescriber checks that box AND specifies a generic but uses the name of the brand (Concerta) instead of Methylphenidate HCI, etc.?

Well, anything can happen!  That’s why I think it makes sense to use my suggestion above. But again, ask your pharmacist first!

If you use a home-delivery pharmacy, consider attaching a note pointing out your request. Maybe print and include this blog post.

And yes, you can get stimulants via home-delivery pharmacy if you have that benefit. It is NOT illegal!

One problem with local pharmacies is that they often cannot fill a 30-day prescription for stimulants of any kind; the home-delivery pharmacies have larger supplies and quicker access.

See Tip: Home Delivery of Prescribed Stimulant Medications

6. What Should The Pills Look Like? Look for alza

NOTE: Look before you pay!

The pills should look exactly the same as the brand—because they are the brand.  It’s easy. Just look for the word Alza on the pill.  If it doesn’t say alza, it’s not Concerta brand or authorized generic.

authorized generic Concerta

 

 

7. Must the Pharmacy Fill the Prescription As Written?

Sorry, I cannot answer that, despite solid efforts to learn.  I suspect it’s going to vary by state.  If you are in the know, please leave a comment.

Here is an article in U.S. Pharmacist that might help:  Generic-Substitution Laws.

8. What Should The Label Look Like?

Before you leave the pharmacy or open a home-delivery bottle, look for the label.  It should say  “Patriot Pharmaceuticals.”

Do not pay for the prescription until you check the label and the pills themselves.  If you want Concerta brand/authorized-generic, they should look like the pills in the photo above.

authorized generic Concerta
This is the new label for Concerta’s authorized generic. It looks the same for all dosages. Look for “Patriot.”

If All Else Fails, Purchase the Brand

Some folks cannot wait until the last minute and roll the dice. They need continuing dependability.

If that’s you, check your pharmacy benefit’s cost for brand Concerta.  Or check out savings from GoodRx.

But Do Investigate Home-Delivery Pharmacy Benefit

Does your insurance pharmacy benefit include a home-delivery pharmacy? If so, consider using it!

If you use a home-delivery pharmacy, you might end up paying less for the brand Concerta than for generic at your storefront drugstore each month. It just depends on your policy.  If you have CVS Caremark as your home-delivery pharmacy, you might be out of luck for the authorized generic. But if you must purchase brand, home-delivery should offer a cost-savings.

Yes, this is legal!  Read more here:  Tip: Home Delivery of Prescribed Stimulant Medications

Summary

I know this is a lot to take in!  (It was a lot to research and attempt to write about clearly, too—not to mention field reader questions.)

I hope these quick points clarify things for you. If not, leave a question in the comments section.  Readers who have followed my suggestions precisely seem to have a higher success rate.

—There are two types of generics, authorized (the brand marketed as a generic) and true (what we normally think of as generics).

—Over the years, we could purchase the brand Concerta as an authorized generic, via distributors Watson (then Actavis, then sold to Teva.

—But now, Actavis/Teva has it’s own true generic, and so do six other manufacturers! Bottom line: Please stop referring to the branded/authorized-generic as “Actavis-Teva.” Unless you want a big surprise!

—None of the Concerta true generics utilizes Alza’s patented OROS delivery mechanism.

Many argue that without that delivery system, it cannot be a reasonable substitute for brand Concerta. My blog readers played a critical role in asking the FDA to reassess the first two Concerta generics (the FDA ended up downgrading them as not being close enough to Concerta). Here is my report on that issue: Consumer Q&A on Generic Concerta

—Some of the true generics utilize osmotic technology. But that is not the same as Alza’s patented OROS (osmotic-controlled release oral delivery system).  Many pharmacists do not know this! You might need to tell them!

Summary of Tips and  Strategies:

—The name for ALL the Concerta generics (the authorized-branded generic or the regular genetics) is Methylphenidate HCl Extended-release tablets.  Therefore, to specify the authorized generic, you’ll need to add something else—for example, the NDC number. This is a unique number-identifier for each medication (and even each dosage strength). See the instructions above.

—If your pharmacy says they can’t find Concerta’s authorized generic, try another pharmacy—either within the same chain or a different chain. Or even a different person at the store. Some are more willing to help than others.  If you have a Walgreen’s, you might want to make it your first stop. If your efforts run dry, call Patriot Pharmaceuticals for help in identifying a local pharmacy that might fill your prescription with the authorized generic for Concerta. 215-325-7676 

—Home delivery pharmacies have bigger inventory and greater access; that might be your best bet. NO, it’s not illegal to ship Schedule II substances, including stimulant medications.  For more info, check this link.

—If you have a choice of local pharmacies, independently owned stores typically are more service-oriented than the big chains.

But keep in mind: Pharmacies are reimbursed at a rate no higher than the cheapest generic. That means fulfilling these prescriptions can lose the pharmacy money. This can hit independents hard, big chain pharmacies less so. So, please don’t hold it against the pharmacy if they cannot help.

—So-called true generics are NOT “exactly the same as brand”—no matter what any medical professional or pharmacist tells you.

—ALWAYS ALWAYS ALWAYS check the bottle before you pay for it at the pharmacy register. If you pay only to discover that you have a generic that you do not want, you are probably stuck.

Please Consider Filing an FDA MedWatch Complaint

—If you have tried one of these true generics and found it significantly inferior to brand/authorized-generic Concerta, please consider filing a MedWatch complaint with the FDA. You can download a PDF or file directly online.

 

The first version of this post appeared 6/19/19

Thanks for reading!  Please leave a comment below. It’s easy.

I answer all questions as quickly as possible.
Gina Pera 

715 thoughts on “Authorized Generic Concerta Update”

  1. Gina, please know what a true service you are providing to so many people!

    The blogs and other information on your site are so helpful and so appreciated! Thank you!!

    I wanted to share what happened at Walgreens today when I was picking up my daughter’s prescription. After discovering your site last year, we’ve been able to get Walgreens to special order the Patriot brand of methylphenidate ER every month for the last 10 months. At pick up today, when I asked to confirm the brand was Patriot, the pharmacy tech replied, “we don’t carry Patriot. This is from Camber.”

    After conferring with a pharmacist, I was told they only had half of the number of pills needed my daughters prescription in the Patriot brand. She told me they were not allowed to order anymore as they had already met their maximum allowable order amount (overall as a pharmacy) because it is a controlled substance. I live in Virginia. Not sure if this is a Virginia state policy or federal policy. My husband experienced the same type of situation with his Adderall prescription, at another nearby pharmacy, Kroger.

    It seems ridiculous to put an ordering cap on pharmacies who serve a varying number of people and type of prescriptions every month. The tech offered to check nearby Walgreens to see if they may have any of the Patriot generic in stock. She said when she typed in the specific NDC number on the prescription it came up as Camber, which may explain why they would fill a prescription with a specific NDC code with a different manufacturer.

    Is it possible that Walgreens has it entered that way in their system? Aren’t the NDC codes specific to the manufacturer? It seems wrong for Walgreens to make that kind of replacement in the inventory search part of their system without some type of note.

    She ended up calling the stores and asking for Patriot verbally. None had it, as I expected. The main thing I want to share is that if indeed, Walgreens has a different drug manufacturer showing up in their system when a pharmacist enters the NDC code for Patriot, in addition to the NDC code we may have to insist doctors also write Patriot brand on the script.

    1. Hi Paula,

      thank you for letting me know my work has been helpful to you!

      That sounds a little dodgy….that the store had met its quota AND that they allegedly enter the Patriot NDC and it comes up Camber. Hmmmmmm.

      Another strange thing: Why would they have Patriot in stock if they don’t carry it? Because Walgreen’s doesn’t carry it; it’s available only when ordered as an “exception process.” Those are the magic words.

      If that pharmacy tech called other stores to see if they had Patriot generic in stock, it might be that person doesn’t understand much on this topic.

      I definitely would advise the prescriber specifying “Patriot” and the NDC number if there’s room. Even just “Patriot” should be enough.

      And remember…..Concerta is offering a savings card. Might be worth checking out. https://Concerta.net

      I don’t work for Janssen! Never taken a cent from any pharma company. Just offering this as a readers service.

      good luck!
      g

  2. Gina, I cannot thank you enough for this post and the difference it has made in my medication for my late-to-learn ADHD.

    I used Walgreens for nearly a year before I discovered GoodRX. The savings are substantial. It took some work to find out which pharmacies could/would get the specific NDCs in stock under GoodRX’s participating pharmacies. And I now have to go to two different pharmacies since neither can provide both of the different doses I require (in my case 45 mg: 27 + 18 daily).

    I have had to remind two different psycho-pharmacologists with every prescription they write and double check the prescriptions filled each time for the correct NDCs when I pick them up at a pharmacy. An additional benefit: I don’t have to go through the impossible pre-approval process with my insurer to get the medication I require. All of this just part of my learning curve with medication, doctors, pharmacists, and insurers.

    I doubt if I could have figured this all out and persisted in my self-advocacy without authorized-generic Concerta and your help.
    Best regards, David

    1. Dear David,

      Thanks so much for taking the time to write your comment. I deeply appreciate it.

      I won’t lie: This is hard and uncompensated work.

      The only reason I can motivate myself to invest the effort is knowing that it truly makes a difference in readers’ lives.

      It’s crazy, that we have to know more than the prescribers and the pharmacists! But it’s a reality.

      Also, FYI: Perhaps to compete with the clown-car of generics, Janssen has started a savings program for brand Concerta. Maybe if push comes to shove again, you might use it.

      It’s pretty easy. Just fill in name/contact and download the PDF.

      https://Concerta.net

      Continued good luck!

      g

  3. Hi Gina. Thank you so much for this information. My husband and son both take concerta and our lives have definitely been a roller coaster and a game of cat and mouse with this medication. Once we figure out the rules, they change.

    Here’s our newest change: filled my son’s prescription. asked for patriot manufacturer – what our Kinney Drugs pharmacy prefers to get the correct medication. they issued 3 pills, alza,as they were “out” and needed to order (which happens every single time we fill this script). went today to pick up the balance of the prescription, got home and the pills looked off. checked, and the manufacturer is Northstar RX. There is a number on the pill, 215, which resembles a generic you talk about above called camber.

    I am so disappointed and tired of this game. the doc said patriot, the first 3 of a 90 day fill were patriot “alza”, and now i have a bottle of 87 pills by northstar. does not appear to be the patented delivery system. can you comment on northstar? have you heard about any new changes on this? thanks for your help

    1. Hi Heidi,

      Sorry you didn’t catch my warnings earlier — to always check before paying for the Rx.

      I believe that pharmacy pulled one over on you.

      Depending on how exactly your doc specified Patriot (by the way, it’s the distributor, not the manufacturer….that’s an important point), you might be able to go back and say, “you gave me the wrong rx.”

      It’s very tricky, given that this is a Schedule II substance. I’m not sure what your legal recourse would be, and it probably varies by state.

      None of the generics use the Alza technology, so none act exactly like Concerta.

      But you might want to try it, if you have no other options, and see how it goes. But be prepared. 🙂

      In future, you could ask the pharmacy to specify in your “file” that you want only the authorized-generic distributed by Patriot. They should flag this so that they can be ready to order when your next scrip comes in.

      good luck!
      g

  4. First, I want to give you a huge thank you for all of the research and advice you have been giving people on this topic.

    Second,
    I have BCBS, and both my kids have been through the generic rollercoaster finding the right medication, until last fall, when we found Concerta.
    My insurance paid for it, with my standard deductible.
    In February, we tried to refill both scrips and were told our copay was now over $400, per kid. Lucky us, January was their mistake, and we should have paid $400 then.
    Went through the appeals process, and were approved, which brought our copay down to $125, per kid. That’s when I stumbled across this website.
    Thank goodness.
    A long uphill struggle with Walgreens to get them to consistently get the Patriot generic in, still struggling, and we are back down to our standard copay.
    Last month, we received another letter from BCBS stating that they will no longer cover Concerta brand, at all. No appeals process, nothing. Don’t even ask.
    It just baffles me that some BCBS branches will only pay for brand Concerta, where mine won’t pay a penny towards it.
    So, we are doubly glad to have found your website.
    Thank you, so much.

    1. Hi B,

      I’m glad you found my blog. It will save you a lot of money and consternation, I bet.

      As to your question: “some BCBS branches will only pay for brand Concerta, where mine won’t pay a penny towards it.”

      It’s not a question of branches. It’s a question of your policy’s terms.

      Even within BCBS of California, there are MANY options for employers to choose from and offer as choices to their employees — and then there are the individual policies.

      It all depends on how much you/the employer are willing to pay for your policy, the deductible options you choose, and even how policies will differ in terms of pharmacy coverage. Some have their own deductibles. The price for brand/formulary and generics are set.

      It’s up to the consumer and/or the employer.

      g

  5. Thank you SO MUCH for compiling all this in such a clear and detailed manner!
    Quick update, we were using RiteAid to fill these prescriptions and last month they switched it on us to the TriGen lab version and still call it ‘authorized generic’. We’ve now gone a month without it and will have it filled next time at a local pharmacy that we located who carries the true version.

    1. Hi Dana,

      I’m glad you found my blog — and you’re welcome!

      That’s a huge bummer.

      The pharmacy is WRONG. But they aren’t the only ones. I’ve spoken with high-level pharmacists at, for example, the big home-delivery pharmacies — and they don’t even know what is an authorized generic.

      Some have also told me that the Concerta generics that have an osmostic release system are the same as Concerta. No, Concert’a OROS patented technology is a cut above.

      But to be clear: You’re unlikely to find a pharmacy who CARRIES the authorized generic. You’re better off with Rite-Aid and Walgreen’s (which do have an agreement with Patriot) and asking them to order it. (You might have to use the term “order as an exception”.)

      You might want to re-read the first few paragraphs of the post. It lays it out.

      Good luck!
      g

    2. I experienced the same thing at my local Rite Aid. I switched to Rite Aid from Walgreens in March after Walgreens was unable to order the authorized generic. A call to Patriot Pharmaceuticals directed me to Rite Aid who we’re stocking the Patriot authorized generic. As of December 2020 the pharmacist told me they could no longer order specific manufacturers and were only stocking Trigen. I don’t know if this is a local/regional change or chain wide. Can anyone confirm?

    3. HI Lauren,

      My attempts to confirm have been unsuccessful. Getting answers from national chains on such a specific detail is nigh impossible.

      I will try Patriot again. Did you ask Patriot why the change with Walgreen’s?

      g

    4. Walgreens was willing to order it, but there was a delay in getting it back in March as my state went into lockdown. At that time, Patriot confirmed that the local Rite Aid was actually stocking their product, not just special ordering it, so I filled there instead of Walgreens. I’m waiting for a return call from Patriot and will try to get more information. Rite Aid is still listed as a distributor on Patriot’s website, but when I spoke to the pharmacist she said they had recently received the Trigen for the first time and wouldn’t be able to special order any other stimulants. I don’t know if this is accurate but I’ll report back if I learn more.

    5. Hi Lauren,

      Yes, definitely, COVID has added a huge wrench to the works.

      But also, it’s important for folks to remember…..it’s been remarkable for us to have enjoyed the authorized-generic for this many years. And still now.

      It’s a cut-throat world out there in pharmacy land. ADHD is a big “market” and the Concerta “market” is prized. Hence by last count 10 generic makers have rushed in to exploit the “market” (aka, human individuals).

      As I mentioned in the updated post, Janssen is also offering a savings program now for Concerta. So it might be worth looking into that, for the brand.

      g

    6. Hi Gina, a few updates – I spoke with a rep from Patriot who confirmed the exception process is still in place for Rite Aid & Walgreens as of 12/31/20. She promised to call the Rite Aid district manager to request “retraining” of local Rite Aid staff re. exception process. I asked my doctor to send the new prescription to Walgreens instead of Rite Aid due to numerous errors at Rite Aid. I’m still waiting on 1/12/21 to get the scrip filled that my Dr. submitted electronically to Walgreens on 12/31/20. Some of this is holiday delays, but there were a few days back & forth for Walgreens to confirm my report that I couldn’t use the Trigen filled at Rite Aid, then with BCBS to approve an override for a new fill [they have been wonderful and so helpful – called Walgreens directly and spoke to pharmacist while I waited]. Finally with all confirmations & approvals in place the Walgreens pharmacist tried to order Patriot and the order was rejected. She then had to learn about the exception process (said she had never heard of it) and has now sent a request to Walgreens district manager to approve an exception. I will call Patriot again to request they follow up with Walgreens. I report this to encourage others to stick with it, ask a lot of questions, be vigilant and prepare to advocate for yourself every step.

      In other news, Costco just announced a “new” version of its member pharmacy program with featured agreements on authorized generics. I called Costco pharmacy several weeks ago to ask if they could/would order Patriot. The said “it is not our preferred” manufacturer/brand – No we can’t order it. But they just launched a new marketing campaign on authorized generics, including Patriot Methylphenidate ER 18, 27, 36 & 54 mg. Prices for a 30 day fill of various strength are listed on the Costco website as available to Costco members ranging from $95 to $117 for a 30 day supply. This is retail with no insurance reimbursement. I’m very curious if this new agreement has any effect on availability of product and willingness/ability of Rite Aid & Walgreens to order it. I have no evidence to this effect, just curious. I’m also curious as to whether Costco would now fill a scrip with my BCBS coverage or refuse unless I paid their retail price, or whether BCBS would offer reimbursement if I paid retail at Costco and submitted a claim. Costco participates with my plan (or did) so I’m not sure if they can refuse a fill because I have coverage. I’ll update if I learn more that might be useful to other readers. Thank you again SO much for all you do, your work is so important and very appreciated!

    7. Dear Lauren,

      Thanks so very much for sharing your report with us!

      This is definitely a fast-moving target. This clown car of crappy generics has “disrupted” the “Concerta market” enormously. Janssen even launched a savings program for Concerta — the first that I know of (except maybe 20 years ago).

      I’m sure the deals will continue to change and evolve. So it’s good to stay on top of things, as you have.

      good luck!
      g

  6. Hi!

    I found this article and sent it to my prescriber, who modified my prescription to specify Patriot. Walgreens did fill the scrip, but they had to order it and don’t normally stock it. However, the pharmacist insists that the other generics are also “osmotic release” and is trying to pressure me into using their stock generics because she basically doesn’t want to order something just for me in case my dose changes or I stop going to that pharmacy and she has product left over. She said that all the Concerta generics in her stock were osmotic release and were separate from the “extended release” type. I received Actavis brand before discovering this post and talking to my prescriber.

    Is “osmotic release” different from “OSOR”?

    Can you point me to any resources that describe specifically how the true generic functions differently? I feel like I may have to “prove” my case at some point.

    Thank you for your work. I was recently diagnosed and this is my first foray into the world of prescriptions and it’s been a bit overwhelming.

    Caitlin

    1. Hi Caitlin,

      First, I removed your last name and deleted that message.

      Second, congratulations! Only recently diagnosed and you’ve found my post and thus known to be aware. Many go years….or never… so, good for you.

      Yes, I explain that issue in the blog post—that the pharmacy typically has to order the Patriot authorized-generic and it typically must be ordered as an “exception.” (It’s often important to use that word.)

      I know of no pharmacy that has it in stock. Most pharmacies keep little stimulant in stock, anyway. Fears of theft, I hear. They order stimulant medications——but from their regular supplier. Patriot might not be part of their regular supply chain.

      Some pharmacies are more willing than others to order the authorized-generic as an “exception”. My last conversation with Patriot indicates those would be Walgreen’s and Rite-Aid.

      In future, if you have trouble, I would recommend also using the NDC numbers in the blog post. “Patriot” might not be enough for most pharmacists. Both would be best, but there’s only a tiny bit of room there on the prescription. If Patriot worked for you, though, probably best to stick with that.

      To your question about “osmotic release,”—in short, that pharmacist is wrong. And she’s not the only pharmacist that doesn’t understand the difference between Alza’s patented OROS osmotic technology and regular old osmotic release. I always thought pharmacists were smarter, more educated than that. Guess I was wrong! Especially the chain-store pharmacies. But I had a “chief pharmacist” at CVS Caremark try to tell me the same thing. I’m sure he thought I was crazy. lol

      Here’s what I wrote in this post:

      In the past, the prescriber could specify on the prescription: “authorized generic Concerta/Watson, etc.”—or simply OROS.

      OROS is Concerta’s patented extended-release technology, owned by a company called Alza and used by Janssen in making Concerta. (The osmotic-controlled release oral delivery system, OROS, takes the form of a rigid tablet with a semi-permeable outer membrane and one or more small laser-drilled holes in it.)

      Since then, for a variety of reasons, it’s gotten more challenging. Pharmacies are consolidating and are less “consumer-oriented.” Some of the new generics use other osmotic technology. As a result, some pharmacists mistake “osmotic technology” for the proprietary OROS from Alza.

      That pharmacist you spoke with is also wrong in that all the Concerta generics use regular old osmotic release. To my knowledge, only Trigen’s generic does. Camber’s generic cynically replicates the “look” of the Concerta pill but any similarity ends there.

      As for other resources to offer you, I can’t think of any. I have pretty much been the exclusive investigator/reporter on this topic since 2014—and I’ve offered more details than any other outlet (most of which, if they do write about this, lift from my work) because I know how important it is.

      But maybe this will be helpful: the FDA notice when it downgraded the first two Concerta generics. I wrote about it at this post: Consumer Q&A on Generic Concerta.

      None of the generic Concerta products since then is any better. They are all cynically exploiting loopholes for generic drugs.

      Here’s the relevant excerpt:

      Q 3. What exactly did the FDA say, in downgrading the two true generics from Mallinckrodt and Kudco?
      To summarize, the FDA said the true generics might deliver the medication at a slower rate than the brand Concerta. Therefore, this can affect the effectiveness of the medication.

      Specifically, the FDA said, in part:

      “An analysis of adverse event reports, an internal FDA re-examination of previously submitted data, and FDA laboratory tests of products manufactured by Mallinckrodt and Kudco have raised concerns that the products may not produce the same therapeutic benefits for some patients as the brand-name product, Concerta, manufactured by Janssen Pharmaceuticals, Inc.

      “Methylphenidate hydrochloride extended-release products approved as generics for Concerta are intended to release the drug in the body over a period of 10 to 12 hours. This should allow for a single-dose product that is consistent with the effect of a three times per day dose of immediate-release methylphenidate hydrochloride.

      “In some individuals, the Mallinckrodt and Kudco products may deliver drug in the body at a slower rate during the 7- to 12-hour range. The diminished release rate may result in patients not having the desired effect.

      “As a result, the FDA has changed the therapeutic equivalence (TE) rating for the Mallinckrodt and Kudco products from AB to BX. This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta.”

      You can download and print the FDA safety report here

      The snag is this: The companies had 6 months to show that their generic Concerta products worked as well as Concerta. They didn’t. They couldn’t. Because they don’t.

      Instead, one of them dragged out the situation with lawsuits, trying to sue the FDA. Grandstanding all over social media—and I responded with the facts!. 🙂

      But they WERE downgraded, meaning that they could not be automatically substituted for Concerta as a generic if the doctor or insurance company specified generic.

      THEN…..we got a new White House administration that appointed a new FDA chief. That chief overrode FDA scientist concerns about generics of these “novel delivery systems” — such as Concerta’s OROS technology. He pushed through dozens of generics, including about TEN Concerta generics, before going back to the rightwing Heritage Foundation.

      The damage has been done now. I cannot imagine the FDA going back now to those 10 companies and saying, “Nope, you have to withdraw it.” That would take enormous political will and public support. And most of the public fails to understand that even though many generics are fine — and cheaper — others might truly be risking their lives.

      It took an enormous effort for me to report on this issue, open the FDA MedWatch complaint, and follow up with encouraging readers to register their complaints. A Kansas City pediatrician named Kristen Stuppy also worked on this effort.

      In the meantime, just try to get that authorized generic from Patriot (a subsidiary of Janssen, Concerta’s manufacturer). I’ve also seen that Janssen is making some moves to compete with the clown car of Concerta generics, making exclusive deals with some pharmacies.

      This is a lot to throw at you, but you seem a person who wants and appreciates the details. So there ya go!

      Good luck!

      Gina

    2. Tacking onto Gina’s reply here, I have a theory about why the pharmacist was so opposed to ordering Patriot specifically.

      My pharmacist told me they would actually *lose money* on the authorized generic. They would’ve done it for me because I’m a loyal customer and they like me (it’s an indie, I’ve never met a chain with that kind of attitude). I chose not to pursue it because I felt guilty doing something that would lose them around $100, IIRC, on every Rx they filled for me.

      I could make that choice because I have insurance that will, after a great deal of haggling, cover the brand Concerta. I pay $45 for a month of brand Concerta, vs. $10 if I got the generic. It’s annoying but not a dealbreaker for our current situation.

      TL;DR, you might (ironically) have an *easier* time getting the pharmacy to order brand for you. And that ease-of-ordering is worth something too, even if it means a slightly higher copay. The authorized generic doesn’t help if you can’t get it, and these chain pharmacies seem to have no limit to their excuses about why the order will take prohibitively long to come in, blah blah blah.

      My doc just writes “brand necessary” on my script.

      Word to the wise on that though, the insurance company can still refuse to pay. Every year now I have to go through a prior authorization process, where my doctor has to call and fight with the insurance company and tell them to let me have the brand name. This year it caught me off guard and I ended up paying cash price ($400) for my Rx for two months in a row before it got sorted. It’s reimbursable after the prior auth goes through but still. Ugh.

      But! After all the red tape I am able to get the brand, and insurance does cover it, and the pharmacy seems much happier to order brand than the Patriot authorized generic.

      ADHD meds: the LEAST ADHD-friendly process I’ve ever encountered.

    3. Hi Jaclyn,

      Yes, it’s not just a theory. It’s a reality.

      Pharmacies DEFINITELY make more money on the cheap generics. And they can LOSE money on the more expensive ones.

      You’ll find I’ve mentioned that many times in this sea of words on this issue. (So many details! All of them important!).

      And yes, that can be a good strategy — at least checking on the brand price.

      Things are always in flux. I’m seeing signs that Janssen is getting more competitive. Some BCBS plans are actually requiring that customers accept brand Concerta.

      Depends on the plan. Depends on the day. 🙂

      Thanks for weighing in with that important tip!

      g

    4. My child’s BCBS WAS only paying for brand Concerta but now that has changed as the company has deemed there are available generic equivalents. We will need to make new choices in January.

      We also had an issue with Walgreens filling her prescription recently (October) when it suddenly was filled with a generic – no notification to us when we picked it up that it was now generic and we stopped checking at pick up because it was always brand. I IMMEDIATELY complained to the pharmacist and was told it was equivalent because the FDA said so. My child’s doctor was sympathetic and called pharmacy but they “couldn’t take it back.” I complained to Walgreens corporate and used the term “compromising patient care” by changing the brand with a generic without telling the customer. THAT got a response and after fingerpointing by the pharmacy to the doctors, we got a real refill two weeks into the month (and noticeable difference in behavior in my child that soon). (As an aside, in my state, pharmacists cannot swap out brand/generics for epilepsy but can for anything else.)

      Me to Pharmacist: Yes a brand CAN cost more, but you NEEDED to tell me and give me the choice whether I wanted to pay. (Like a prior writer, I would pay $45 even $100 for a brand prescription).

      The WEEK after that struggle ended, we got the notification that BCBS has deemed the generics are equivalent, so be careful if you have BCBS. Ours allows brand at a $10 co pay but January all will change. Apparently, there is a generic equivalent that is the same (said with dripping sarcasm). My child lasted two weeks and it was horrid.

    5. Hi Monica,

      What a mess this is. So many details to track and hoops to jump through.

      Could it be that you were getting not the “brand” but the authorized-generic until now? (That is the brand sold as a generic.)

      That might explain the switch to another generic.

      I also wonder if your prescriber failed to specify “brand only” or the NDC number for the authorized generic.

      At any rate, pharmacies don’t have to tell you when they switch generic manufacturers. They switch all the time. They don’t have to tell you. Actually, that would be pretty much impossible.

      Now there are TEN generics for Concerta — and that means you could get any one of them. It’s not up to the insurer to decide what generic is bioequivalent or not; that is done by the FDA.

      But if the prescriber wrote “brand only” or the NDC # for the authorized generic, the pharmacist is obliged to do that. You might have to ask, though, for an “exception.”

      good luck,
      g

      In which case, the pharmacy will automatically substitute any Concerta generic.

    6. Additional signals to keep an ear out for… When I first had to make the change from brand to generic (due to insurance changes) and went to pick up the prescription, when the Pharmacist or tech started to tell me that the pills will look a little different, I stopped them right there and refused it and asked to have it re-filled. When the pharmacy gave me the run-around about getting the Authorized generic, I called Patriot and they helped me find another pharmacy. There were a few hiccups, but now, when they ask if I have any questions, I have them verify that the pills are printed with Alza and the dose. I had the pharmacy put a note in their system to only fill with the Patriot Authorized Generic. It took about 3 re-fills for them to finally start reading that note and this last fill, they called me after the received the prescription and verified that we would be ok waiting a day for them to get the right meds in stock. I have learned to keep about a week’s cushion available between refills in case they don’t have it in stock. Best of luck to everyone!

    7. Hi Gina,
      First, thanks for all the great info! You are one of the few educated and reliable sources on the web for Concerta generics. I truly appreciate your efforts.

      Gina wrote:
      “That pharmacist you spoke with is also wrong in that all the Concerta generics use regular old osmotic release. To my knowledge, only Trigen’s generic does. Camber’s generic cynically replicates the “look” of the Concerta pill but any similarity ends there.”

      I have been researching Camber and found this in the Camber package insert (it’s on their website). Sorry it’s lengthy:
      “11.1 System Components and Performance
      Methylphenidate hydrochloride extended-release tablets uses osmotic pressure to deliver methylphenidate HCl at a controlled rate. The system, which resembles a conventional tablet in appearance, comprises an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat. The trilayer core is composed of two drug layers containing the drug and excipients, and a push layer containing osmotically active components. There is a precision-laser drilled orifice on the drug-layer end of the tablet. In an aqueous environment, such as the gastrointestinal tract, the drug overcoat dissolves within one hour, providing an initial dose of methylphenidate. Water permeates through the membrane into the tablet core. As the osmotically active polymer excipients expand, methylphenidate is released through the orifice. The membrane controls the rate at which water enters the tablet core, which in turn controls drug delivery. Furthermore, the drug release rate from the system increases with time over a period of 6 to 7 hours due to the drug-concentration gradient incorporated into the two drug layers of methylphenidate hydrochloride extended-release tablets. The biologically inert components of the tablet remain intact during gastrointestinal transit and are eliminated in the stool as a tablet shell along with insoluble core components. It is possible that methylphenidate hydrochloride extended-release tablets may be visible on abdominal x-rays under certain circumstances, especially when digital enhancing techniques are utilized.”

      It appears that Camber (and I assume Northstar because they both come from Ascent) has an osmotic method of delivery as well as Trigen. Of course, it’s not OROS! But it might be worth a shot.

      I have tried several classes of ADHD meds and I seem to do best on methylphenidate ER. I tested 10 days of Concerta 36 … smooth as silk. All go, no side effects. I’m presently trying Trigen 36 … doesn’t suck but it isn’t as smooth as Concerta. The plan is to try the Camber product and then try Concerta again … and then decide. If it’s Concerta, I’ll go for the Patriot.

      I live in the central Rockies near Glenwood Springs, CO. Only independent pharmacies will order the Patriot product. I have to buy the whole bottle of 100 and it’s $1000.00. That’s the motivation for trying the promising generics with some form of osmotic release.

      Ironically, I worked on the marketing for Concerta back in the day. Worked on the Alza merger with J&J. Janssen, Patriot and Alza are all Johnson & Johnson companies. Hence the bottleneck on the OROS delivery system. As near as I can figure, the OROS patent, originally filed around 2003, is “abandoned”, according to Google Patents. Hopefully, someone will come close to mimicking its unique “ascending” delivery of the Methylphenidate ER. Camber/Ascent may be the closest because it is also the newest. It was released about a year ago.

      YMMV. Thanks Gina!
      Bob

    8. Hi Bob,

      Thanks for chasing down the info on Camber. I’m focusing intensively on my online training (people need it now more than ever!) and don’t have time to follow in excruciating detail the continuing saga.

      From what I understand, Alza’s OROS is technically superior — or at least it’s been for a while. And I wonder about generic companies being willing to achieve something close to Concerta’s release profile with a cheaper osmotic-release system.

      FYI — Disadvantages
      A highly effective novel drug delivery system will exhibit some negative aspects as well, of which the leading difficulties include the increased cost of such systems and the need for the meticulous design of the coating film to avoid any defects which would lead to the escape of the drug in uncontrolled doses. Also, some types require precise hole size in the membrane to achieve the desired effect and the drug release may be somewhat affected by food in the gut.

      https://www.news-medical.net/health/Osmotic-Pressure-Controlled-Drug-Delivery-Systems.aspx

      My instincts are to avoid any company that tries to fool consumers with such a visually similar tablet—aka, Camber. It just feels sneaky, and I don’t like sneaky. 🙂

      Still, I’ll be interested to learn how it works for you.

      But $1,000!!!! Have you checked Janssen’s new Concerta savings program? https://concerta.net/

      Here are the basic guidelines:

      Program description:
      Eligible patients using commercial or private insurance can save on out-of-pocket costs for CONCERTA®. Eligible patients pay an initial $4 per fill at participating retail pharmacies and receive up to $150 off their out-of-pocket prescription costs, with a maximum program benefit of $1,800 or 12 fills per calendar year, whichever comes first. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. Offer not valid in CA and MA. There is no income requirement. See program requirements below.

      Program Requirements:
      You may be eligible for the CONCERTA® Savings Program if you are age 6 to 65 and currently use private or commercial health insurance for CONCERTA®.

      Thanks for your comment!
      g

    9. Gina,

      “Thanks for chasing down the info on Camber. I’m focusing intensively on my online training (people need it now more than ever!)”
      … and thanks for keeping up the good fight!

      “My instincts are to avoid any company that tries to fool consumers with such a visually similar tablet—aka, Camber. It just feels sneaky, and I don’t like sneaky. ”
      Or … because OROS may be off-patent … they may have copied their design.

      “Still, I’ll be interested to learn how it works for you.”
      Me too! I’ll report back.

      “Have you checked Janssen’s new Concerta savings program?”
      I am on Medicare with a PDP from Humana and I’m 67yo. I’m not eligible. Bummer.

      But Thanks!
      Bob

  7. For once a good news post… It was finally time to fill my son’s Concerta (we are able to do 90 days). We have a BCBS plan that requires us to us the Branded product (as of this year), so I was excited to try that savings program on the next refill. The Tech at CVS that took the prescription persisted when trying to enter the information and it worked!! I haven’t picked it up yet, but he indicated that my 90 day refill will be… wait for it … $4! Hurrah! I feel like I’m getting something back for all the money I’ve spent over time. Know crossing my fingers that in the new year when the insurance turns over and I have to meet my deductible again, it’ll cover it then as well. Wouldn’t that be something? 🙂

    1. Deborah!!! It’s like you won the lottery! 🙂

      That’s so interesting….that your plan requires you to use the BRANDED product.

      And you can get refills at your CVS stores — not CVS-Caremark? Wow.

      Congratulations!!

      g

    2. Yes, when our insurance year rolled over in 2020 our plan switched to *requiring* the Branded product for Concerta. That’s the only thing we use where that is the case. Have no insight as to why. It just is. My son has been on Concerta for at least 6 years (ever since he learned to swallow a pill vs using liquid Methylphenidate which was a huge PITA to find, but that’s another story).

      Yes. The way our insurance is written, the best price is obtained by going to CVS *or* using the CVS Caremark mail in service. We *must* do 90 day refills on maintenance meds (cost wise, it’s 90 for 60 as far as price). My PCP refuses to include refills on meds to force me to go in every three months, so I just pick them up in person. Plus, nothing is in sync, so there is something to pick up constantly (two adults, two kids and everyone has something). No idea how you’d get things to be in sync when insurance wouldn’t pay for short supply to make that happen. I just ignore the million calls and texts I get from CVS until I have multiple things to pick up at once. Plus, it’s literally about a mile and a half from the house and it’s a 24 hr location.

      And so days it comes with bonuses… today I got 2 bags of M&Ms with my meds for $0 ($5 in Extra Care Bucks and the candy was on 2/$5 promo). I never say no to “free” 🙂

    3. Wow, Deborah. It’s your lucky year! No, wait…… lol

      I love to hear how easy it is for you now.

      We also have BCBS (California), but plans are all so different. We could not get the Concerta brand or authorized-generic via home-delivery. Or storefront. We now get monthly at Walgreen’s for $10.

      At least the doc now has electronic prescribing. For 20 years, I’ve had to send him an SASE with the requests and wait for it in the mail. The refill times never coincided with the visit times.

      Shew.

      g

    4. Most medications used to treat ADHD, including the various types of methylphenidate (such as Ritalin and Concerta) and amphetamine (such as Adderall), are considered controlled substances (stimulants). Concerta is a Schedule II controlled substance and can be habit-forming, as users may develop a tolerance to the drug over time.
      There are many regulations on controlled substances both federal and state. My doctor told me I must be seen in the office within every 90 days. I asked for three thirty-day scripts when moving and was denied. I had to wait for the doctor’s office to electronically send the Rx and then the pharmacy had to wait for a call back because the Rx was out-of-state. (The only 90-day supply I could get is crappy Trigen because that’s all CVS Caremark allows on my plan.) So I’m stuck asking every 30 days and waiting for the slow office manager to send in the Rx and return the pharmacy’s phone check . It’s very frustrating.
      I’m planning on writing to local and federal legislators to express my opinion that it shouldn’t be this difficult to get my ADHD medication.

    5. Hi Susan,

      Yes, it’s so onerous jumping through all these hoops.

      I wonder if it would work better with your doctor’s office to send an SASE. That’s what I’ve always done. As a reminder and means of expediting.

      You could just address several envelopes at once and have them at the ready. To cut down on writing, I use address labels as the “to” on the SASE.

      g

    6. Thank-you for your suggestion but the assistant at my doctor’s office says the pharmacy does not like scripts for controlled substances, especially those from out-of-state. That’s what I’m saying – what works for one person doesn’t work for another. It doesn’t seem fair.

    7. Sorry, Susan, I misunderstood.

      I thought you had office visits every 90 days but had to pick up a 30-day each month in between.

      Prescribers should have systems in place. Some do.

      g

  8. Hi,

    Just wanted to leave a note for posterity that, at least as of mid-2020, Giant Eagle in Western PA provides the authorized generic Concerta from Patriot! I overpaid for *months* from CVS for the name brand, not knowing that Giant Eagle right down the block had the authorized generic.

  9. Just wanted to provide info as this website end this loop has been tremendously helpful!! Our local Rite- Aid was using Patriot but just recently switched to Trigen. I had them put thru an Exception Process and it went through/ got approved. I am unsure if others are having an issue with Rite- Aid on this but ours did go through!

    1. Congratulations, Sarah.

      That’s what I am recommending to anyone having trouble with Rite-Aid, Walgreen’s, and perhaps some other pharmacies.

      I’m glad it worked for you!

      g

  10. Well a few positives and negatives. Husband’s new psychiatrist is fantastic and agreed that he needs the reliability of the brand name. Did the PA and they denied it basically saying “can’t you just use the generic”. I hate insurance companies, why do I pay you people anything lol

    In the positives we called a Walgreens about an hour away and they carry Patriot Concerta. Negatives it’s an hour away and still $80 since my insurance, again, sucks. So far we’ve had better luck with Walgreens that have resurrected from the remains of Rite Aid locations. The Walgreens near us was beyond unhelpful.

    1. Hi Beka,

      Did you look into Concerta’s savings program? https://Concerta.net

      And just remember, it’s not a question of a pharmacy carrying the authorized-generic. It’s a question of the pharmacy being willing to order it as an exception.

      I know…dealing with insurance issues can be frustrating. So much depends on the quality of the plan — and the employees selections among the options (if there are options).

      But, trust me, it’s much worse in other countries. At least you can get the diagnosis here and have many choices of stimulants to choose from, savings programs, etc..

      good luck,
      g

  11. So for past few months I was able to purchase the Patriot brand authorized generic 27mg from Rite-Aid, which works great and lasts long enough. Currently living in Concord, CA.

    Today the pharmacist told me this would be the last refill they can give me for this specific “Patriot” brand generic, and that next month they would be moving onto “Trigen” as their supplier.

    I’ve tried Trigen before at Walgreens (they would not order the patriot brand for me, so I moved to rite aid). Trigen should be illegal to sell, it does not work and actually does the opposite! It makes me even more tired. I’m sad that more and more pharmacies are moving to cheaper ineffective generics.

    So now, at least for my area, Walgreens and now Rite-Aid is not an option anymore. Anyone else here know any other pharmacies that are willing to order the Patriot AG in California?

    1. Hi Paolo,

      Please call the number I offered in the post:

      Update 3/9/20: Walgreen’s and Possibly Other Stores

      Walgreen’s corporate headquarters confirmed with Patriot that all Walgreen’s stores should be able to order the Concerta authorized generic for you. If you encounter resistance, ask that an Exception Process be ordered for you. Still trouble?  Call Patriot at 215-325-7676

      Allegedly, Rite-Aid also has an Exception Process as well but I have not yet been able to confirm that with the corporate headquarters.

      Other drugstores might be implementing such a policy. But no announcements have been made.

      Good luck!
      g

    2. Hi Susan,

      Yes, as I have encouraged for several years, anyone having a bad result from a generic drug should file a MedWatch complaint.

      It is important, as you suggest, to be clear that you did well on the brand but not the generic of that brand.

      Otherwise, it will be a wasted act. Nothing will be found “wrong” with the generic.

      I did succeed in leading the effort to have the first two Concerta generics downgraded. But that was under a different White House administration and FDA Chief.

      This is a complex issue, and it’s important to understand what’s happening.

      It will be very difficult for the FDA, under a new administration and FDA chief, to turn around and tell those generic manufacturers….oops, no, we shouldn’t have let those generics through. I’m not sure it can happen legally. Which is probably what was in mind.

      But still, it’s always good to collect data, and I have found the FDA scientists and other staff diligent in their duty to the public.

      thanks,
      g

  12. In August, I had the authorized generic from Patriot filled at Express Scripts, the cost was $269 for 90 days supply, the time before that, it was $239. I have BCBS. I just checked pricing at Express Scripts for brand name Concerta, and it was ~$968.80 at Express Scripts. The Patriot version, NDC 10147 0685 01, priced out at $188.61. Interesting how volatile pricing is.
    Express Scripts responds well to NDC number, my child’s pediatrician follows the recommendation to prescribe using the NDC number, and I have been able to obtain the authorized generic without any issue. Express Scripts does not participate in prescription savings programs. It might be worthwhile to try to get an initial fill for $4 at a retail pharmacy such as Walgreens, but long term, getting the Patriot product from Express Scripts seems to be the better option.

    1. Hi M,

      Thanks for your report.

      It really does depend on one’s insurance coverage, as to what’s available at what price — even at the home-delivery pharmacies.

      Not just the insurance carrier (in this case BCBS) but the details of the plan — of which there are a dizzying number.

      We also have BCBS but with CVS Caremark as the home-delivery pharmacy. Concerta brand is available to us for $100 for 90-day supply. But the AG is not available.

      We can get the month-by-month AG at the local Walgreen’s, though, at the generic price of $10/month. In the past I would not have wanted that headache 12 times a year. But now our prescriber has electronic prescriptions and has agreed to just put it on his calendar every month.

      All over the map!

      g

    2. Reading all this and it’s so sad that I’m willing to pay these prices, but they won’t even let me purchase it through my insurance at all. My husband’s psychiatrist refuses to do an authorization so we’re stuck looking at new doctors now too. It’s just so frsutrating.

      Will be checking back to hear anyone’s experience with the discount program. I’m nervous about trying it since I’ve never done anything like this before. Good luck everyone!!

    3. Hi Beka,

      I encourage you to read the post in full. It might be that authorization is not the way to go at all.

      Rather, if your husband’s MD can specify the NDC # for the authorization, that might work.

      You don’t need to be nervous about trying something. You don’t have to commit to it. Just call your pharmacy and/or pharmacy benefit to see what might be possible.

      Then just ask the MD to do it.

      good luck,
      g

  13. Gina – Have you heard from anyone about the discount program? I actually have to purchase name brand concerta through our BCBS coverage and I’m hopeful this will pick up Ane of my cost share. That’s the way it reads as far as intent. It would be amazing if it did. We’ll be up for refill in a couple weeks and I guess I’ll find out.

    1. Hi Deborah,

      I just discovered the new program last week. I’ve not had any first-hand reports.

      Note that it does not apply in CA and MA.

      The coverage seems fairly straightforward:

      Eligible patients pay an initial $4 per fill at participating retail pharmacies and receive up to $150 off their out-of-pocket prescription costs, with a maximum program benefit of $1,800 or 12 fills per calendar year, whichever comes first. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. Offer not valid in CA and MA. There is no income requirement.

      I hope it works for you! It might be worth asking ahead of time, to see if there are any hoops you need to jump through first.
      g

  14. This article is so informative and am glad I found it! It is SO ANNOYING how the generic medicine is not made well and I wish they did more research.

    I was diagnosed with ADHD in 5th grade and started taking concerta 8th grade and have been taking it since then.

    I am 21 now and still take it. Concerta is the only medicine I have found that works for me and it works perfectly for me. The only thing is that it is so so so expensive.

    I have tried the general concerta once in high-school and then again I retried it again this month to see if anything has changed and it has zero effects on me. I still get the brand concerta because it helps me so much with college but it is definitely sucks that it is a lot of money. I wish the general prescription worked on me.

    1. Hi Heather.

      I know. It does suck!

      This isn’t a matter of not doing enough research, though.

      All brand drugs have patents that expire. Concerta’s expired a long time ago. The authorized generic was available only due to a marketing deal between the Concerta manufacturer and a generic manufacturer who wanted to enter the market.

      You can still get the authorized generic (that is, the brand sold as a generic), but it can take some hoop-jumping.

      Meanwhile, I notice that Concerta now offers a savings program (not available to California or Massachusetts residents, though)

      https://Concerta.net

      good luck!
      g

    2. Walmart in Florida has filled my Rx with the Patriot NDC on it the past two months. It was around $150 but I used GoodRx and it brought it down to $66 – so I’m praying this continues. Previously in Maryland (where I just moved from) I got the same deal at Giant grocery store’s pharmacy. Good luck to all.

    3. Hi Susan,

      Are you sure you are being charged the generic price?

      It might reflect your insurance policy — some people who don’t take medications save money by choosing a policy with lower pharmacy benefits. Is that possible?

      Maybe you also have to meet a deductible?

      So many possibilities. You might want to call your insurance company and ask. Maybe you could save some money!

      g

  15. Looking for advice. My husband is currently prescribed Concerta. He got miscellaneous generics at first and did better than nothing but still not good. He managed to randomly get the Patriot branded Concerta from Kroger once then they claimed they don’t sell it after that. On the Patriot generic he was so attentive and happy, I just feel so sad that he has to go through this and I want to help him.

    We have BCBS of Arkansas with medication coverage which would make brand name Concerta possible (probably still like $140/month but I would rather my husband be happy and able to work). We’re trying to get an exception because they don’t normally cover it. If that doesn’t work where do we go from here? Does anyone have experience with Concerta’s savings program and if it works?

    1. Hi Beka,

      You are absolutely right. If your husband did well on brand/authorized-generic Concerta, he deserves to get it again.

      Your best bet is to talk with your pharmacy representative and ask if you can get the authorized-generic (Patriot).

      There seems to be a disruption currently, but no one knows why — or when it will resolve.

      You can also call the Patriot number in the post.

      Barring that, if you have to get brand, see if it would be cheaper from the home-delivery/mail-order pharmacy. If you have that benefit.

      And yes, I see that Concerta has a new savings program; that might be worth checking as it’s not dependent on income level (you can download the card at the site): https://www.concerta.net/

      I hope this helps,
      g

    2. Thanks, but the coupon is for name brand Concerta and others should know it’s limited. I used my online drug pricing tool provided my insurance. My husband’s employer only offers integrated (drug & medical combined) plans – since ACA there is very limited choice in plans. My integrated deductible is $6000 so we pretty much pay for all of our health care and prescriptions along with the astronomical premiums. We lost our plan that had $0 deductible with $0 generics.

    3. Yes, I know the coupon is for name-brand Concerta. That’s how I presented it. And yes, any assistance/savings program will be limited.

      The authorized generic IS the brand; it’s simply sold as a generic.

      If it’s possible to get the discounted brand, that solves the problem of trying to find the authorized generic. I know this is not a solution for everyone, but for some it might be helpful.

      Many people have plans that sound better than what you describe through their state’s ACA Health Insurance Marketplace. I’m sorry yours doesn’t seem to be one of them.

      g

  16. Hi folks — UPDATE 10/28/20

    A kind reader has e-mailed the following message:

    Just now heard back from Patriot. They are pretty miffed at Rite Aid and are telling the rep to go straighten things out. She also told me that Stop-n-Shop carries Patriot exclusively.

    Thank you, LJ!

    Gina

    1. I have been able to get the Patriot authorized generic from Rite Aid in Los Angeles for many months, but the pharmacist just called me to say that they can no longer get the Patriot methylphenidate HCI and wants to substitute with the Trigen generic.

      I’ll check with Walgreens and Ralph’s (Kroger) to see if they can order it. Thanks for all of your work on this!! It has been very instructive.

      Steve

    2. You’re welcome, Steve. Thanks for your comment.

      A reader e-mailed me yesterday to say she’d gotten through to Patriot’s rep (phone number in the article). She too had been getting the AG from Rite-Aid.

      The reader reports that the rep said she’d call Rite-Aid and take care of it (hopefully).

      I don’t know for sure but I suspect that these pharmacies make a LOT of money on these cheap generics — and lose money on the authorized-generic.

      Hence, the difficulty getting it.

      Concerta just put out a savings program but it’s not available in CA and MA, darn it.

      good luck!
      g

  17. My doctor was able to send an electronic rx to my usual Publix pharmacy with the NDC (thanks for that info in your post!). Even though they gave me the Patriot Alza generic a month ago just by dumb luck, they told me they aren’t able to get it any longer. The Walgreens pharmacist told me that NDC did show up in his system and that he could try ordering it, but no guarantees.

    Unfortunately I have to wait on a new rx to be sent to Walgreen’s. As if this mess with generics wasn’t enough, I’m also having to deal with pharmacists’ outdated information about Schedule II prescriptions. When those prescriptions were paper only, it was the case that they couldn’t be transferred between pharmacies. With EPCS however, DEA has explicitly said multiple times that unfilled EPCS prescriptions for schedule II-V may be transferred to another pharmacy.

    1. Dear Jordan,

      Thanks for sharing your experience with us.

      It’s just all too much, like some farcical theater, demanding that people with ADHD—who are taking medication to help with organization, initiation, follow through, etc.—jump through so many hoops to get that medication!

      I haven’t been able to uncover what is happening. My guess is that Janssen/Patriot just cannot financially compete with the slew of very cheap Concerta generics.

      The OROS system works so well for many people. But it might be that, if one cannot afford the brand Concerta, it’s time to try other choices in the methylphenidate (MPH) class of stimulants.

      Many of the newer offerings also have savings programs. Here’s the list of all MPH Rx, the newer ones in bold-face.

      Adhansia XR®
      Aptensio XR®
      Concerta®
      Cotempla® XR-ODT
      Jornay PM®
      Metadate® CD
      Metadate® ER
      Methylin®
      Methylin® ER
      Quillichew® ER
      Quillivant® XR
      Ritalin®
      Ritalin® LA
      Ritalin® SR

      Good luck,
      g

    2. We were getting the Patriot version at our Rite Aid (Concord, NH) until two days ago (10/24/20). I spoke with them and they said they are not allowed to request a different generic.
      Called Walgreens and they told me they can’t get the Patriot generic from their supplier.
      We have CIGNA / Express Scripts Home Delivery and they seem to be able to dispense the Patriot generic. We will see if this is what they do !

    3. Good luck with that, Wes!

      Sometimes an Express Scripts or other home-delivery pharmacy will have access to the authorized generic but an individual’s insurance policy does not cover it. The generics are so much cheaper.
      g

    4. Just an update – Took a few days (electronic rx with NDC sent over Saturday, prescription filled this morning), but Walgreen’s did order and fill with the Patriot generic as requested. Insurance covered it like any other generic.

  18. My daughter just started meds- on 18mg on generic Concerta. She’s not noticing much of a difference. I’m not sure if she needs to try a higher dose or if the issue is she needs to try the brand /authorized generic. (Insurance is CVS Caremark.) Any suggestions what to ask Dr. for first?

    1. Hi CL,

      There are probably many ways to go, some harder to pull off than others.

      In my opinion, I believe it’s best to start with the brand, identify an optimal dose (if that brand works well), and then, if budget dictates, try 1-2 of the generics.

      If they don’t work, you’ll know that the problem was not Concerta or methylphenidate but the generic dosage and delivery.

      g

  19. Hi, my son has concerts xr 36mg. When we started it in November 2019 it was a circular white pill. Refill in early September 2020 was white oblong with m 36 on it. Refill today was white oblong like your pictures that has alza 36 on it. The Sept ones don’t seem to be working as well as the original circular ones (we have extra pills due to not using alot during covid). Are they just less potent? Or release wrong?

    1. Hi Melissa,

      1. Your son started on one manufacturer’s generic (perhaps Trigen)
      2. Then received a refill in September is from yet another manufacturer (Mallinckrodt)

      Generics are allowed a large margin of bioavailability — so they can work very different one to the next.

      That’s why your son reacts differently to the two generics.

      You don’t mention how he is doing on the Alza (brand).

      g

      I write about the difference between authorized generics and “true” generics in this post and also more detail in this post:

      https://adhdrollercoaster.org/adhd-news-and-research/consumer-qa-on-concerta-and-generics/

    2. We haven’t started the alza since we just got it today. I hate to waste a whole bottle of the M one, but if it won’t work as good then I may have to.

    3. Hi Melissa, welcome to the struggle and so happy you found this site. As an ADD-mom with ADD-kids, I can only tell you to follow Gina’s advice to the letter.
      After years on Concerta (Alza stamp) I spent just one month on Trigen due to insurance issues. I was SICK – nausea, diarrhea, sweats, dizzy, unable to work, mixing up my words, and in a terrible mood. (I think my post is still here somewhere from July last year).
      Please don’t decide that medication won’t work for your son, until you’ve been on the brand name or authorized generic for 2-3 months. It takes time to find the right dosage and for the body to adjust. Of course, medication is only one part of the solution – incl. diet, exercise etc. But with the wrong generic, no matter what else you try… well, I can only speak from my own experience.
      It was so hard to make the choice to start medication, but honestly, our daughter is thriving, she has her confidence back, her anxiety is so much better and she is doing great at school.
      Anyway, just wanted to wish you all the best and let you know that what you read here is trusted advice.
      Vx

    4. Thanks so much, Vicky, for your testimonial.

      These stories sometimes are so “fantastical” that some people might think we’re making things up — or that people with ADHD are “hopped up on speed.”

      But your story…..a generic makes you SICK….nausea, diarrhea, etc. And that absolutely can happen, and not solely due to contamination. But because these medications affect physiology!

      So glad you and your girl are doing well.
      g

  20. Hi,

    This is a question for anyone with the CVS Mail in service through their insurance.

    Are you required to have your concerta filled at CVS (per your insurance) or can you still choose to fill it at other pharmacies?

    I currently have Express scrips and fill my prescription at Costco (they are the only ones with the Northstar generic) but my insurance is switching to the CVS mail in service 2021. I just want to be prepared for any *surprises* that might arise.

    Thanks all 🙂

    1. Hi Sara,

      It would be best for you to ask about that directly.

      Policies differ, even with the same home-delivery medication service. Moreover, having CVS Mail Service doesn’t necessarily mean your policy is exclusively CVS local pharmacies.

      In MY experience with CVS Mail and Blue Shield of California, it stinks. We can only get an inferior generic (Teva, I think, though it might have changed). So we pay $100 for 3 months Concerta. (Still a good deal compared to some policies.)

      We could also get the brand at the local CVS store but only a 30-day supply. Even with a 90-day supply, if it were available at a local pharmacy, the co-pay is $30/month.

      When we used to have ExpressScripts, I found it so much better. But that was 5 years ago.

      When CVS merged with Aetna, I think all bets were off. It seems to be the 800-pound gorilla.

      If you want to know for sure (and hope it doesn’t change soon afterward; pharmacies change generics constantly), you should call the insurance company rep. They set the policies, not CVS.

      good luck!
      g

    2. Hey Sara,

      It would have to depend on your insurance. Through my insurance, Cigna, Express scripts runs expensive, and so I fill it through the CVS pharmacy. It does really depend on your insurance. Originally I was paying 100 for 30 supply of the brand and now its 124 and I am fighting them :/. So really you’ll have to call and ask sadly.

      Shannon

    3. Sara, to answer your question, yes I did receive the authorized generic stamped ALZA through the mail from Caremark/CVS…this happened one time in August 2020 and then my insurance changed so I couldn’t celebrate for long but it did happen! Previously during the 18 months I was on CVS/Caremark insurance plan I was able to get BRAND medication from local CVS pharmacy for $20/month copay but never considered the possibility I could get it through the mail.

      Now after the change in my insurance I am on Express Scripts as of September 2020 and back to square one and am now only able to get the TRIGEN generic from CVS locally…it does not work nearly as well for me which I noticed day one after the switch. Reduced effectiveness, shorter duration, uneven results throughout the day.

    4. Hello everyone! I’m not sure how to post my own question here so please forgive me for piggybacking on someone else’s…
      Does anyone in Los Angeles have any pharmacies that will fill the Patriot authorized generic? This spring, Noreen at Patriot helped me and said that Rite Aid had a deal with Patriot that they must honor it if the Patriot NDC is requested. She called Rite Aid Corporate, sorted it out and since then, we’ve had 8 blissful months with no problems. Then, a couple of days ago when I tried to get my refill, my local Rite Aid said Corporate was telling them to give me another generic substitute (which they shouldn’t be doing). I’ve tried to reach Patriot and left messages but to no avail. They are not answering their phones.
      My children also take Methylphenidate. Their prescriptions run out next week. The other generics we’ve tried were disasters. With schools not yet open, we are all stuck in the house doing remote learning. Without this medication, our house is soon going to be BEDLAM.
      I have Motion Picture insurance. I’m sure there are PLENTY of people in the film business in Los Angeles with ADHD! Any suggestions? I’m getting very worried.
      Thank you,
      Katherine

  21. I am sort of confused. On March 13 2020, I realized that I had ADD, I was then Prescribed, Actavis Pharma version of their concerta and it worked wonderfully everything that was ever a problem for me was fixed. Then Covid- 19 hit and there was no school so we didn’t get the prescription refilled until august. The ones they gave me in august were then called teva and they did not seem to work as well. I doubt that I’ll get a response because of how old this post was made but basically I am trying to get the same prescription as the first one that I was given or something that will be similar. Idk who will see this but if I can get a email or something to see what would be the best route to take that would be nice.

    Thankyou

    1. Hi Cameron,

      I always respond to all comments — and have since 2007. No matter how old the post. 🙂

      Here’s what likely happened to you (the short version of my post):

      1. You did well on brand Concerta (which for a while Actavis was selling as an “authorized” generic, via a marketing deal with the Concerta manufacturer)
      2. You did less well on generic Concerta. (Yours was from Teva but there are a bunch others, and none uses Concerta’s proprietary delivery system, OROS; that’s the problem.)

      What to do: Try to get the brand Concerta, either sold as a brand or as the authorized generic. All the details are in the article — summarized in the info graphic.

      good luck!
      g

    2. Hi Cameron,

      In my area, Nashville, Costco pharmacy is the only location that carries the Authorized Generic Concerta that is produced by Patriot Pharmaceuticals. Teva (the original) and Trigen did not work for my son because their extended release technology is inferior/junk to the OROS technology first used in Concerta. OROS is still used by Patriot as an Authorized Generic (AG). You will pay more for an AG but it may be worth it to you. Teva has since released their own generic with a new release technology but we have not tried it.

      Recently my son tried the generic sold by Camber Pharmaceuticals and Northstar Rx, both use what looks to be a new release technology, but still not OROS. Both of these may use the same technology because they are both made by Ascent Pharmaceuticals for Camber and Northstar. However my son says this release technology is close enough to work. We are still testing it.

    3. Thanks for sharing that info, Mike.

      Yes, Camber’s design seems deceptively close to Concerta’s. But, as you say, not OROS and really nothing like the sophistication of OROS.

      g

  22. I just got the generic from Lannet as well, from a Fred Meyer (Kroger in the PNW) pharmacy. This is only my second month taking the medication, so I’m still adjusting to/figuring out if it’s right for me. The first month, I got the Patriot generic, this month Lannet (and the Lannet was more expensive!). I talked to the pharmacist who told me that they “get what they get” in terms of generics, the supplier may change from month to month, and she assured me that this was the same medication. That sounded like BS to me, but I didn’t know what else to do, so I went with it.

    Thanks for this website and all the research done; I’m glad I found it. Before next months prescription comes around, I’ll talk to the pharmacy again to request (demand?) Patriot. I’ll talk to my psychiatrist too. It’s going to be tricky to learn about the effects of medication if they keep switching between different versions of it just because they “get what they get.”

    1. Hi Scott,

      You are most welcome. I’m glad you found me.

      I would bet that 90 percent of physicians and pharmacists will confirm that the generic is exactly the same as brand.

      For some types of medications, it might not matter.

      For stimulant medications whose particular effect come from the delivery system, it definitely matters!

      The same active ingredient, methylphenidate, is in Concerta, Ritalin, and all the others. It’s only the delivery system that makes a difference.

      And you are exactly right: You cannot ever determine if Concerta is a good choice for you if you not only get the generic but also a different generic each month. That’s just crazy.

      Good luck!
      g

    2. Hi Max,

      I just responded to your e-mail. But I’ll post here, in case others have the same question.

      You ask who makes the authorized generic of IR Ritalin.

      I’m afraid there isn’t one—at least as far as I can tell. You might do better trying one of the new, brand formulations of MPH (methylphenidate, the stimulant in Ritalin).

      These companies are competitive and typically offer savings programs, even if you have insurance.

      Methylphenidate (Brand Names: Concerta, Ritalin, Daytrana, Aptensio XR, Metadate CD, Methylin, Quillivant XR, Jornay PM, Adhansia XR, Cotempla)

      Re: Concerta authorized generic

      Concerta is unusual in this regard.

      A company called Actavis challenged Janssen (Concerta developer/mfr) years before Concerta went off patent—threatening to put its own generic on the market.

      (I can’t remember the particulars of how this could legally happen.)

      Janssen struck a deal with Actavis to postpone its generic. In exchange, Janssen gave Actavis the right to market brand Concerta as a generic.

      Years pass and then Concerta is off-patent, Actavis is sold to Teva, Teva launches Actavis’s original challenger, and…..well, it all got real messy.

      A boatload of Big Generic companies exploited FDA guidelines in order to capture some of the lucrative Concerta market.

      The first two we managed to get the FDA to downgrade (I opened an FDA Medwatch case…the FDA rep was very helpful…and readers completed complaint forms).

      The FDA had been trying to develop new guidelines for generics of “novel” delivery systems (such as the highly sophisticated, patented OROS system central to Concerta). They knew the current system was not working. Technological advancement had outpaced the guidelines.

      We were almost there.

      Then a new White House administration came in and appointed a champion of generics as FDA chief. He overrode FDA scientists’ concerns, pushed through hundreds of generics, and then returned to the Heritage Foundation and the board of Pfizer.

      As a result, about 10 companies flooded the Concerta market with generics.

      It’s a mess.

      Anyway, I hope my response above is helpful.

      g

  23. Hi! Thank you for all the info- I suddenly felt like my generic stopped working…the manufacturer is Lannet Co. I asked for an AB rated version and after reading all of this info I’m beginning to think this is not equivalent. I see nothing regarding Lannet in any of your posts.

    1. Hi Jessica,

      This is a VERY complex issue. Company mergers happen. So do name changes. And then of course, the clown car of generics for Concerta keeps exploding.

      But you’ll find that I did write about Lannett (which purchased Kudco, manufacturer of one of the two very first Concerta generics, which were downgraded by the FDA) in one of my comments to this post:

      You can read my highlighted version of the FDA report here:

      https://adhdrollercoaster.org/wp-content/uploads/2015/01/Drug-Safety-and-Availability-_-Methylphenidate-Hydrochloride-Extended-Release-Tablets-generic-Concerta-made-by-Mallinckrodt-and-Kudco.pdf

      But that was a few years ago. I thought by now….surely…..

      Both those generic manufacturers (Mallinckrodt and Kremers-Urban/Lannett) were given an opportunity to present more data that might convince the FDA not to downgrade. Lannett did, but the FDA deemed it insufficient. I haven’t heard the latest about Mallinckrodt. But again, it’s not listed in the NDC directory.

      THE BOTTOM LINE:

      None of these Concerta generics will work the same as Concerta. As I’ve written, that’s because they do not use Concerta’s unique delivery system, OROS.

      Instead, they use much cheaper and simpler release systems.

      So, these generics might work well for some individuals, they don’t tend to work as well as Concerta does — and that’s important for the people who respond well to Concerta.

      I hope that’s clear.
      g

  24. I got the non-authorized generic from Actavis for the first time a few months ago before realizing what happened from reading your post. I actually like the new version more since it feels smoother and produces less of a crash than Actavis authorized generic, so will keep using it (by contrast Mylan made me feel terrible so I agree that not all generic all made equal). Only thing is that it hasn’t been added to my insurance formulary so I used GoodRx. Thank you for keeping us updated on this complicated and frustrating world of concerta.

    1. Hi Jason,

      That is always a possibility! That the generic will work better for some people. I mentioned that several times in my posts on this issue.

      The problem isn’t that these generics are inherently bad. It’s that they do not work as Concerta works—and therefore should not qualify as generics. (Because some people are forced to accept the generic version if one is available.)

      I’m glad the Trigen/Teva/Actavis generic works well for you. Now the challenge is making sure you get it instead of one of the many others in the clown car of new Concerta generics.

      take care,
      g

  25. Since this post has been such a great help and repository for information, I wanted to share that Wegmans (which this comments section led me to for ordering from Patriot) stopped ordering from Patriot this month. I was told they could fill Northstar or Trigen manufactured but not Patriot, and that it would be the same at all Wegmans. Currently waiting on local Walgreens (charlottesville, va) who has my scrip but was very cagey as to whether or not they could order it. Hoping this change is isolated to Wegmans and isn’t indicative of a wider trend. Good gravy, what a wild goose chase. Thanks again for keeping up to date with this. This post and its comments saved me in the past when I had no idea what to do and I’m so grateful for your continued advocacy.

    1. HI Matthew,

      Thanks for the update. I’m sorry that Wegman’s changed its policy — but I bet it had good reason. It might have been losing a lot of money.

      I’m eager to hear from readers who have tried other methylphenidate products. There are so many. But of course, Concerta’s is such an excellent delivery system, it’s hard to beat for the people who do well with that release profile.

      take care,
      g

    2. I was able to get Patriot from Giant grocery store pharmacy in Maryland by having my doctor write a script for me indicating the NDC number. They special ordered it for me on a Monday and it came in on Tuesday. It came to $130 with my very expensive insurance plan. I gave my GoodRx card and it brought it down to $104. But I had looked up the price on the GoodRx app and it was $56 and that’s what I wound up paying. Too bad I’m moving out of state in a couple of weeks where there are no Giants.

  26. THANK YOU! I just used this post to finally get the correct generic and stop paying for the brand name. Thank you for the information and extensive research. I spent about 6-8 hours over 2 days on the phone with my insurance company, Express Scripts, and local Walgreens pharmacy, and got no help and even less information. A few minutes on Google and this post got me everything I need, and now I will be saving about $300/month. The worst part of this is that I’m the child of one of the top doctors in this field, and know what to ask and say. It’s a struggle for me to get answers or the right information. I can’t imagine how bad it is for people that can’t advocate for themselves or know what to say/do.

    1. Hi Patrick,

      Yay! I’m so glad my work helped you. Good for you, for hunting it down!

      Yes, I know exactly what you mean….imagine how hard this is for people who cannot advocate for themselves or know what to say/do.

      Take care,
      g

  27. I can’t begin to tell you how grateful I am for this article, for all the work you did, for you sharing all these details with us. This has been driving me insane and I finally understand what’s going on, and more importantly, can get what I need!

    1. Thanks so much for letting me know, Kavita.

      It has been a lot of work, and if I didn’t know it was actually helping people, I would be very sad. 🙂

      take care,
      g

  28. Tina Marie White

    Thank you, Gina, for all of your work and information on this issue. My daughter takes Concerta (generic bc my insurance won’t cover brand name), but suddenly when she started taking a refill back in March 2020, it seemed like it stopped working. I have been going to Kroger. I am switching to a smaller regional pharmacy to see if they can get a better quality generic. Now that I understand the authorized generic situation, I will ask if they can order the authorized generic. I have felt helpless and was ready to tell her doctor to try a different medication altogether, even though it had worked for two years. I will try this exception process with the new pharmacy and hope I can get her the medicine she needs that actually works. Thank you again!

  29. Katherine Howe

    Good point Gina. I hope my daughter marries a patient person who takes over. Hahaha. Written instructions is a great idea. Definitely would help if I keel over. . Kathy

    1. Hi Katherine,

      I appreciate the sentiment!

      IN fact, I am right now creating the video for one of six case studies, of couples affected by ADHD.

      It involves a mother who “passed the torch” to her daughter’s husband. In that case, the daughter did not want to reveal to her new husband her ADHD. So, her mother stayed mum.

      At this moment, things are not going well! 🙂

      The more the adult with ADHD “owns” it—including being pro-active with doctors and prescriptions—the better for everyone.

      College can be very tricky….all that freedom, few outside rules, etc.. It’s good to prepare mindsets and habits.

      take care,
      g

    2. Michael S Boylan

      10147-0686-1 is the NDC code for 100 tablets (the “1” at the end indicates 100). Our insurance will only pay for 30 at a time.

      What is the NDC code for 30 tabs of methylphenidate 36 ER by Patriot? I’m looking but haven’t found it.

      Our child got the Teva last time and it’s useless.

      Thanks,
      Mike

    3. Hi Mike,

      In the past, I included the code I found at the NDC directory, listed for each dosage, indicated by the last two numbers (before the 1).

      10147-0685-1 – 18 mg
      10147-0688-1  – 27 mg
      10147-0686-1  – 36 mg
      10147-0687-1  – 54 mg

      Checking now, I don’t see that differentiation. Something has changed but I don’t know what or why.

      Did you try the code with your pharmacy?

      Note, as in the post:

      Note: If your pharmacy says that number is not coming up in their database, they might instead find the 11-digit billing code.  For example, the 36 mg replaces one hyphen with a zero.  That is, NDC 10147-0686-1 has a billing code of NDC 10147068601. For the full details, click here: NDC 10147-0686-1 METHYLPHENIDATE HYDROCHLORIDE.

      If all else fails, I’d call Patriot for guidance.

      Good luck!
      g

    4. John David Kay

      Did MICHAEL S BOYLAN get his questions from JULY 5, 2020 AT 4:50 AM answered? If not, let me try to assist. I use Walgreens. To obtain Patriot Pharmaceuticals’ generic Concerta, 36MG, I had my shrink add the following words to his electronically delivered prescription: “Methylphenidate HCl Extended-release Tablets, 36MG NDC: 10147068601 – ONLY MFG PATRIOT – Generic for CONCERTA 36MG ER TABLETS” I check the pills to be certain I’m getting my “generic” Concerta 36MG white tabs before I leave the counter.

    5. Hi John,

      Yes, I responded to Michael. But if he subscribed to responses, he’ll see yours, too.

      You’re using the NDC billing code. Some pharmacies use that rather than the straight NDC code.

      I provided that code to him below — and it’s in the post.

      thanks for pitching in!

      g

  30. Katherine Howe

    Yes, we get most of our prescriptions as 90 days. My daughter is 18 and still sees a pediatrician for her Concerta. She really wants a new doctor. I’m also considering sending her to a mental health associate for her ADD. Maybe someday I’ll look into a 90 day prescription for her. For now I have the monthly routine down… We have CVS Caremark too. I wonder when I’ll let go and have her manage her own meds? (Probably never, lol) She is starting college this fall but will be close by. And also we don’t know the dorming situation. But the plan is she’ll dorm there. God willing.

    1. Hi Katherine,

      I have been in charge of procuring my husband’s RX, for many years. Home delivery. 90 days.

      With all the changes in insurance, pharmacy coverage, getting the paper scrip in hand, mailing it in on time, it’s just not “playing to his strengths.” 🙂

      It’s sort of a self-defense move on my part. lol

      But as for your daughter…you might want to at least draw up some instructions….step by step….in case of an emergency but also just preparing her for adulthood.

      She’ll have to take care of it sooner or later.

      I should probably do that for my husband, in case I keel over. Written instructions — and a timeline. 🙂

      g

    2. So, do you realize if you filled for 90 days instead you’d save 1/3? Caremark operates on a 3 for 2 when you fill for 90 days at a time (get 90, pay for 60).

    3. Hi Deborah,

      Guidelines really vary policy to policy.

      We also have CVS/Caremark, and we would pay $30 per month even for a 90-day prescription. Instead, I’ve always used home-delivery (four times a year hassle versus 12 times a year!). With our policy, it’s $100/90 days.

      But that’s an important benefit to look for if one has it!

      g

  31. Katherine Howe

    I used to get the authorized generic from Walgreens and paid with GoodRx because it was cheaper than using my insurance. (CVS Caremark). More recently I’ve been able to get the authorized generic at an independent pharmacy. They have run it through my insurance and I pay generally the same as I did with GoodRx. About $100 to $120 for 30 day supply of Patriot 27 mg. Just the other day I procured the next 30 day supply. Patriot as usual and it went through my insurance for $28. This seems so crazy to me. I double checked that I did indeed have the ALZA imprinted 27 mg which I did. What’s going on????? That cannot be right.

    1. Hi Katherine,

      These situations change constantly as deals are struck——or dissolve.

      Between insurer and pharmacy. Between pharmacy and manufacturer/distributor. Between and among all of them!

      I’d say you lucked out. Good for you!

      g

    2. Another thought… Do you have insurance that includes prescriptions in your deductible? Ours is like that. I pay about $150/30 days until we meet our deductible. We’ve met ours, so now I pay 20% or roughly $30/30 days. The two amounts you quoted sound kind of like that. -Deborah

    3. Katherine Howe

      Well I’ll be darned. Deborah you are right. Our family deductible has been met (and it includes prescriptions). First time that has happened! I didn’t realize our medical costs had added up to so much and we are only in June. Guess we are getting old and require more care. Lol. The Concerta is for my daughter. She always costs us an arm and a leg, too! Well the good news is her Concerta (authorized generic) will be affordable for the rest of this year. Woop woop. Now just need to play the game each month hoping we can obtain it. Kathy

    4. Katherine-

      I’m glad I could help you figure it out. A lot of plans changed this year to include prescriptions in the deductible if they weren’t before. (Ours was one) Here’s another thing to check in to. Does your pharmacy benefit have a 90 day prescription benefit in it for “regular” prescriptions (things you take all the time)? We have Caremark and we are required to fill for 90 days for all things like blood pressure, cholesterol, etc. When we do, we get 3 for 2 (90 days for the price of 60). It’s not required for the Concerta, but it does apply if the Dr is willing to write for 90 days which ours is. That means instead of $450 for 90 days, it’s $300 which is a huge difference. Now that we’ve met our deductible, it should be 90 days for about $65. Worth checking.

    5. Hi Katherine,
      Maybe you just hit the point during the year where your insurance deductible was met? With my policy, once the deductible has been met, insurance pays more (therefore I pay less) for the cost of prescription meds. Just a thought.

  32. Thank you so much for making all of this information available. I have 2 children with adhd both taking concerta. One of them had done quite well on the Amneal generic, but the other had horrible side effects
    After the chasing the last available authorized generic in our area during late 2019, we were able to use your recommendation for including the # on the prescription. Our local Walgreens in Southern California had no problem ordering them for us.

    Our newest problem started this month when my other son taking the Amneal was given the Mallinckrodt generic. After searching for info on this product I found that these are not actually approved for submission. Does anyone know if something has changed? I can’t find any information on this supplier after 2016. We are worried again about possibly side effects and inconsistencies. And will probably ask for the authorized generic on his next prescription just to get some consistency.

    1. Hi Amber,

      Yes, I helped to lead the effort to have those first two inferior Concerta generics downgraded by the FDA.

      The truth is, all of these generics should be downgraded—or never approved.

      But with the change in White House occupant, there’s been a huge windfall for “Big Generic” — and dismissal of FDA scientist concerns about bioequivalence with novel delivery system drugs (like Concerta).

      The fact remains, though, the Mallinckrodt and Kremers-Urban generics that were downgraded….your pharmacy should not be substituting them for brand (if your doc allows generic substitution). That is illegal.

      https://adhdrollercoaster.org/tools-and-strategies/victory-concerta-generics-downgraded/

      It’s not that these downgraded generics are defective or dangerous; they are simply not anything close to Concerta in how they work. That’s why they were downgraded, because otherwise pharmacies would keep substituting them for brand when the doc allows substitution (or the insurance company requires generic when one is available).

      I hope this helps!
      g

  33. Thank you Gina for your detailed information on Authorized Genetic for Concerta. My son has taken Amneal in the past and it just did not work on him. I was not about to pay $800/mo on Med or $400 even with the GoodRx coupon, so this time when it was again Amneal at Walgreens I was looking for some advice and came across your article. After following the specific wordings for the prescription and going through two pharmacies, I was able to get the Authorized Genetic so I want to share.

    Walgreens near our area in CA do not carry Authorized Genetic but true genetic by AMNEAL and did not want to help me with Exception Process or request for one from Patriot Pharmaceutical. So I checked Patriot’s website and found Rite Aid as one of their distributor. I called one near our area and they said that was what they got last time. So with that, I then asked my son’s physician to re-write a new prescription with the NDC number and submitted to Rite Aid. Took few days for Insurance to go through but just picked up the Concerta 54mg by Patriot Pharm. Authorized Genetic was more expensive than true genetic Concerta but it was well worth the process. Thank you so much!

  34. Just called Walgreens and asked if they would be willing to order the specific NDC number outlined in the article. They said they would, but that it would take two days to get it in.

    No fuss, no arguing, just very easy.

  35. Gina,

    Thought I’d pass along that the Aptensio copay program expired at the end of May. Rhodes told me the reason is that there is an approved generic (TE AB3) made by Actavis (and their patent expires this month!).

    From drugs.com (https://www.drugs.com/availability/generic-aptensio-xr.html), the name of this generic is “methylphenidate hydrochloride capsule, extended release;oral”.

    When I look it up in CVS Caremark, it lists Aptensio as “Aptensio Xr 50mg Csbp 40-60” and it lists a generic as “Methylphenidate Er 50mg Csbp 40-60”.

    On GoodRx, they list the generic of Aptensio as “Methylphenidate XR”.

    What I don’t know is whether this is really supposed to be an actual equivalent or the typical shell game. I also am unable so far to find a pharmacy, including CVS, that actually has it.

    If you find anything out about it, please pass it along to all of us…

    Thanks!

    1. Hi Don,

      Thanks for the heads up. There has been a slew of new stimulants over the past 5+ years. I haven’t been able to keep up with them all—much less get first-person reports.

      I assume that Aptensio worked well for you?

      From the website, I see that the manufacturer claims there’s a 40% immediate-release MPH (Methylphenidate) layer and a 60% extended-release MPH layer.

      The new generic is a “true” generic, but that doesn’t always mean it’s “truly” bioequivalent. In fact, by law, “true” generics’ bioequivalence can be 20% higher/lower than the brand.

      This is why generics in general typically don’t work for people with ADHD. The dosage and “profile” (the rate at which the MPH is released) can make a huge difference in how the medication works for an individual. There can be a small “window of effectiveness”. Get much outside that window (over or under) and the effect might be poor.

      I found this from 2016. where Rhodes took Actavis to court for copyright infringement. (I believe this is also what Actavis did with Janssen/Concerta years ago; a deal was struck whereby Actavis would postpone introducing its generic and Janssen would allow Actavis to market the brand as a generic — i.e. authorized generic.) Seems Rhodes lost.

      https://insight.rpxcorp.com/litigation_documents/12023511

      Here is the FDA approval letter, from 2018: https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2018/208861Orig1s000TAltr.pdf

      Here is an article I wrote for CHADD about brand vs. generics:

      https://chadd.org/wp-content/uploads/2017/02/ATTN_Winter_17_Generics.pdf

      We can assume that Actavis exploited loopholes with this generic as they have with their Concerta generic. It’s what “Big Generic” tends to do.

      The best I can say….speak with your doc about this. Maybe try it, in a limited supply (10 or so). But be ready beforehand with the Rx to fill with brand if the generic is sending your life off the rails.

      Or to try another MPH product.

      good luck!
      g

  36. Update: IngenioRX mail delivery is a nightmare. They said they can fill with trigen or actavis. They are filling concerta 54 mg generic with the teva generic, also marked as teva/actavis, looks like the teva pill with numbers 727 on the 54 mg strength. Make sure to ask a pharmacist what exactly the pill looks like (should say Alza, be the shape of a tic tac and specify the dose mg strength on it) with the NDC number.

    I called patriots manufacturer and they are contracted with rite aid, Walgreens and a few others. Some insurance plans allow for a 90 day fill if at Walgreens (for some anthem insurance plans), so call your insurance to find out where a 90 day fill if it is one of the pharmacies that are contracted with patriots generic. Patriots the manufacturer said even if Walgreens/preferred pharmacy who works with patriots, does not have it in stock, to call the patriots manufacturer and they will make sure that Walgreens gets the patriots generic.

    Be careful when they say actavis, because they are likely referring to actavis/teva generic that is not the “Alza” pill now distributed by patriots.

    1. Hi Michele,

      Yes, as I’ve written repeatedly (including in this post): ACTAVIS is NO LONGER the distributor of the authorized generic. That stopped a long time ago.

      Teva purchased Actavis, which now peddles its own Concerta generic (without Alza).

      FYI Patriot is not the manufacturer. Patriot is the distributor.

      I know it’s a pain to have to deal in these details, but they often prove important. (As with those believing that Actavis is the manufacturer of the authorized generic.)

      And yes, I provided in the blog post the contact for Patriot.

      tx
      g

  37. Gina,

    Thank you so much for this post. I appreciate the information, which explains a lot of my experience. It’s my introduction to your website, and from what I can tell, I will be returning.

    I had undiagnosed ADHD until the summer after I graduated from high school. A few years earlier, a psychotherapist had suggested to me that I had it, but my parents denied it. I finally convinced my parents to have the neuropsychiatric institute at UCLA evaluate me, and they diagnosed me with it. They happened to be doing a research study on Concerta in adults. I participated. They titrated my dosage and settled on the 72 mg I have been taking since. That was almost 14 years ago. Since then, I have taken the drug with great success. I did better in college and better still in law school than I ever did at earlier stages of my education, despite them being harder. The medication helped me do that.

    I had health insurance through the Kaiser Permanente HMO from birth through 2014, which included the first eight years I took Concerta/methylphenidate ER. I recall getting pills with different shapes, so I probably had some true/non-authorized generics. I didn’t know the difference at the time.

    In 2015, I got a job that didn’t offer Kaiser, so I started with PPO insurance. I had prescriptions filled at CVS then at Walgreens for the last five years. By blind luck, I got the authorized generic most of the time. When they could no longer get it after it switched from Actavis to Patriot, I got the brand. I could afford the copayment, so I was happy. I was fired last March, and I kept the insurance I had through COBRA, so I continued going to the same pharmacy and getting the drug.

    This January, I started working as an independent contractor, and I got insurance through Kaiser due to its lower cost. I didn’t think to ask which generic methylphenidate–or the brand–they stocked. They only stock the Ascent/Camber generic. I notice a 20-30% difference in its efficacy versus the brand. My attention wanders more, and the drug seems to last for fewer hours than the brand does. Kaiser won’t order the authorized generic. The brand is not covered, so I’d have to pay the full price of over $800 for it. Do you or anyone you know have any experience getting the authorized generic or brand name drug from Kaiser as a covered benefit? I’m going to use their dispute resolution/review procedures to see if I can get what I need.

    My psychiatrist at Kaiser suggested I try another drug that is covered, such as Adderall or Metadate. I have a competitive sports background. One key point in sports is not to change a winning strategy. I am not excited about starting over in the process of finding an effective treatment. I realize you don’t know me, and you are probably reluctant about giving advice online, but do you think it’s worth switching drugs after 14 years of success with what I’ve taken? I’m more inclined to switch insurance than to switch drugs. You can email me if you’d prefer.

    By the way, they won’t mail me the drug. I noticed your post on that but haven’t read it yet.

    Thanks so much again for providing us all this useful information.

    Will

    1. Hi Will,

      I’m happy to know my work has been validating to you.

      You ask very good questions. In fact, your logic seems impeccable—so I encourage you to trust your judgment.

      Kaiser can be a real problem when it comes to Adult ADHD treatment.

      It’s going to be difficult to make a case, that the Concerta generics don’t work as well for. Because we have this overwhelming institutional “gaslighting” happening….”generic is exactly these same as brand.” No. No, it is not.

      Did I mention no? 🙂

      I hope you can convince the Powers that Be at KP. I’ll share some suggestions below.

      First, I want to address your question…that is, if you should try Adderall or Metadate.

      Excuse me while I go pound sand. 🙂

      1. Read this: https://adhdrollercoaster.org/adhd-news-and-research/the-tragic-truth-of-prescription-adderal-or-madderall/

      2. Metadate? Seriously? Sure, you could try it. Miracles happen. But Concerta is so popular because it marked an enormous leap forward—a smooth and sustained delivery system with a slow taper-off.

      And I don’t know one person taking Metadate, for what that’s worth.

      3. Stick to your winning strategy.

      My husband has taken Concerta for 15 years (maybe longer). We went through hell before I figured it out. If I ask him now, “There are a lot of new stimulants out now. Would you want to try a new one,” he would say….

      “Are you INSANE”? 🙂

      He loves his work. He doesn’t want to derail himself. Why should he?

      The larger question is, why should KP want you to?

      Stick to your guns!

      Now for appealing to KP:

      You might start by documenting that you’ve taken the same medication to good effect for years — just as you’ve stated here. But maybe with clear bullet points. The Cliff Notes version. 🙂

      Note when you started the Camber knock-offs and how you felt. Be specific as to how your judgment, focus, driving, etc. were adversely affected.

      FYI – this post might provide validation as to what you’re experiencing:

      https://adhdrollercoaster.org/tools-and-strategies/sound-off-downgraded-generic-concerta-users/

      I write all the nitty-gritty details here. It might be that you could print the FDA’s original statement on the downgrading of the first two inferior generics. (We worked hard on that one, and won! Then we had an election and soon, there were NINE inferior Concerta generics.)

      —-
      excerpt:

      Q 3. What exactly did the FDA say, in downgrading the two true generics from Mallinckrodt and Kudco?

      To summarize, the FDA said the true generics might deliver the medication at a slower rate than the brand Concerta. Therefore, this can affect the effectiveness of the medication.

      Specifically, the FDA said, in part:

      “An analysis of adverse event reports, an internal FDA re-examination of previously submitted data, and FDA laboratory tests of products manufactured by Mallinckrodt and Kudco have raised concerns that the products may not produce the same therapeutic benefits for some patients as the brand-name product, Concerta, manufactured by Janssen Pharmaceuticals, Inc.

      “Methylphenidate hydrochloride extended-release products approved as generics for Concerta are intended to release the drug in the body over a period of 10 to 12 hours. This should allow for a single-dose product that is consistent with the effect of a three times per day dose of immediate-release methylphenidate hydrochloride.

      “In some individuals, the Mallinckrodt and Kudco products may deliver drug in the body at a slower rate during the 7- to 12-hour range. The diminished release rate may result in patients not having the desired effect.

      “As a result, the FDA has changed the therapeutic equivalence (TE) rating for the Mallinckrodt and Kudco products from AB to BX. This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta.”

      Q 4. Is this downgrade permanent?

      The downgrade remains in effect. But the companies are countering the FDA’s decision.

      Let’s back up a bit.

      Consider this, from the original FDA statement:

      “Consequently, FDA has revised its draft guidance for industry for bioequivalence testing for methylphenidate hydrochloride extended-release tablets (Concerta). FDA has asked that within six months, Mallinckrodt and Kudco confirm the bioequivalence of their products using the revised bioequivalence standards, or voluntarily withdraw their products from the market.

      “FDA has changed the therapeutic equivalence (TE) rating for the Mallinckrodt and Kudco products in Approved Drug Products with Therapeutic Equivalence Evaluations (commonly referred to as the “Orange Book”) from AB to BX.  This means that the data are insufficient to show that the Mallinckrodt and Kudco provide the same therapeutic effect as Concerta (or the authorized generic marketed by Actavis).  A drug with a BX rating is still approved and can be prescribed, but is not recommended as automatically substitutable at the pharmacy (or by a pharmacist) for the brand-name drug.

      “FDA will continue to evaluate its testing and approval standards and bioequivalence guidance for other generic methylphenidate hydrochloride extended-release products and revise as needed.”

      https://wp.me/p5Ilzb-10w

      Good luck!
      g

    2. John David Kay

      Gina, your information is brilliant! I called (215) 325-7676 and Patriot Pharma representative Noreen immediately helped me set-up my acquisition of the ALZA 36mg Authorized Generic they distribute. I use Walgreens. It’s outrageous, but the pharmacist at Walgreens Vienna, VA store refused to just help me with the Walgreens Exception Process. The KNOWN PROCESS at Walgreens. Just call (215) 325-7676 to get your real generic Concerta!!!! Gina, thank you for your time and energy and caring and help!!

  38. I almost had the Patriot methylphenidate generic from Walgreens and at the last minute they said it was against the law (Maryland) to fill a controlled substance prescription that orders the specific NDC. Nireen from Patriot has called Walgreens corporate about this issue but I have not heard back.

  39. Getting this medication is a huge PITA. I am going to attach a long (but not even complete) story because I would like to know if this is happening to anyone else. I believe we need to take action about this, and I’m willing to help.

    I am currently on medicaid. When the authorized generic became unavailable here in NM last fall, I had to go through the entire appeal and fair hearing process to get the name brand covered. During the appeal process, the MCO insurance company changed dates on faxes from my Dr so that their version of events made sense (but you could still see the real date under it?). Despite their fraud, the state ruled that they had to give me the name brand. A little over a month later, the insurance company’s appeal dept put a note on my file saying that the decision in my favor had been a “mistake” and they weren’t to cover the name brand.

    I spoke with the woman who put the note on my file, she lied directly to me, telling me that I just didn’t understand the fair hearing opinion and I really didn’t win it. She asked if I had the form in front of me, and I didn’t (I had just cleaned my desk when she called and was trying to go through the stacks of paper to find it) She told me it clearly said that the state sided with them, and that only the judge had sided with me, so I didn’t get the name brand. I asked her if I was going to have to go to Court to appeal this. She gave me some smug answer about how if I wanted to waste all that money on legal fees to try to do that, it was up to me.

    This is the point where I told her that I was an attorney and taking them to court would cost me almost nothing. At that moment, the entire conversation changed. I asked her to read me exactly what it said when it was denying me this medication. She told me she couldn’t because she had “put it away” already. I told her to take it back out and read it to me. She refused. She then put me on a long hold so she could “find it to take it back out” I found my copy of the decision while I was on hold, and as I already knew, it didn’t say any of the stuff she was claiming.

    She came back and said she was just confused, and of course I had won that appeal and she had made sure everyone knew it. She claimed to have never put a note on my file.

    Last month Walgreens gave me the generic anyway. They wouldn’t take it back once I realized and I couldn’t cover the nearly 500 out of pocket. I was told it was the “law” that they HAD to give me the generic. I told the pharmacist as an attorney I assured her that was NOT the law. She assured me this would never happen again, it was all over my file to only give me the name brand. A couple of days ago, I dropped my prescription back off and made sure to be clear it should be name brand only. When I picked it up, this time I opened it right there. It was the generic again. I gave it back. The pharmacist on duty came and told me that she couldn’t give the name brand to me because despite the prescription being for Concerta, the fact it allowed substitutions meant that they couldn’t give me the name brand. Instead of the brand vs generic being a COST issue, she was claiming that there was some legality that forced them to deny you a name brand medication EVEN IF YOU WANTED TO PAY EXTRA. Walgreens lost my business that day. I am considering action or going to the board of pharmacy because it’s utterly ridiculous to have this happen.

    I took my prescription to CVS who told me that the insurance company was STILL denying the name brand. They ended up covering it the next morning when I told them that as soon as I paid out of pocket I would file a lawsuit the same day.

    I have been taking Concerta for about 12 or so years. I have been taking medication for ADD for 33 or so years. (Cylert was way better for me, but the FDA pulled approval while I was preg with my daughter, and so I ended up with Concerta) It should not be this hard to get these medications. It should not be hard to ensure that generics are quality replacements.

    I propose we start to think about taking legal action, perhaps as a group, either as stronger legislative advocacy or in the courts. (obviously the advocacy of this website alone is amazing, Gina!)

    1. Hi Heather,

      I definitely understand your frustration.

      One thing: Walgreen’s is really the good actor through all this. CVS is the dog.

      I think it is “the law” that generics are substituted if the MD does not stipulate “no substitutions” or “dispense as written.”

      How that dovetails with what your insurer, Medicaid, will pay, I have no idea. Medicaid has its own set of rules.

      Maybe you should try a little harder to get the authorized generic instead of the brand. That might be a more winnable battle.

      But if you can pull if off as you describe again……

      It’s not hard to ensure that generics are bioequivalent. We were on our way to doing that when a kleptocracy swept into the White House.

      Until we fix that, there is no hope, imho.

      good luck!
      g

    2. Something I’ve learned recently: sometimes the pharmacist’s response varies widely with very small differences in word choice. Asking to pay extra or pay the difference didn’t get me anywhere because the pharmacy was bound to what the insurance would allow them to fill. Insurance said no name brand, they couldn’t fill name brand — even with my doc writing “brand necessary” on the script.

      However, when I went back in and asked for the *cash price*, I got a different answer. I told them I wanted the cash price, for someone walking in off the street with *zero health coverage*. In other words, I asked them to behave as though my health insurance didn’t exist.

      That got me somewhere. I was afforded the privilege (ha!) of paying $450 out of pocket for a one-month supply of Concerta while I continued hashing things out with the insurance carrier. But with my insurer in the mix, I wasn’t allowed to fill it at all.

      Now, that is with a prescription that says “brand necessary.” Not sure what they would’ve said if that hadn’t been on there. I have a theory I still could’ve done it, though, because I almost did it for my kiddo’s meds last month. They thought they were out of stock on the generic and I asked for the cash price on the brand. They were about to sell the brand to me to the tune of $375 or something like that until they found some of the generic after all.

      So, just food for thought — but expensive food for thought. I was, fortunately, able to get my insurance carrier to relent after that one month paying out of pocket.

      Re: Gina’s recommendation below about trying for the authorized generic vs. the brand, it may depend who’s the real roadblock. My pharmacist told me they could get me the authorized generic, but they’d be losing significant $$$ on me every month. This is not the case with the brand — so for them it makes more sense to give me the brand over the authorized generic even if it costs me more (this is assuming I’m going through insurance). They seemed willing to do it, but they’re an indie business that’s more customer-focused and maybe willing to take a hit for a loyal customer. I suspect a big chain pharmacy would be less accommodating, and might throw up enough barriers to the authorized generic that it ceases to be feasible for a patient to get it.

      Anyway, I’m by no means a trained expert, just a veteran of many years of medication battles. For what it’s worth, I’ve had much better luck with our local pharmacy. CVS, Rite Aid, and Target — the most accessible ones around here — all have a corporate mindset and bureaucracy that really wore me down. I suspect that’s part of the point.

    3. Hi Jaclyn,

      Thanks for the tips!

      Yes, that’s a great reminder about the “cash price.”

      Some pharmacies (the corporate ones) won’t play ball with cash price.

      But I remember once getting some B12 (injectable) at a drugsstore. The co-pay was more than the little bottle was worth. I asked for the cash price– and paid $5.

      Years ago, when we had a very high deductible, I also asked for the cash price on a mammogram. It was a fraction of the base insurance price.

      re: independent pharmacies

      Yes, I’ve noted a few times that they are often the best bet. But also: They might lose money filling the authorized-generic Rx.

      Now, if I understand your point, they will make out better if you get brand, not authorized generic. Good to know!

      And yes, word choice matters!

      Thanks!
      g

    4. I got a fill of generic Methylphenidate ER from CVS in March. It says it’s from Trigen Laboratories. It does nothing whatsoever for me. About $75 wasted – I used GoodRx to get that price because my $800/mo premium with $6000 deductible CareFirst coverage priced the drug around $125. Looking up options now for 30 day generic Methylphenidate and GoodRx is now $316 at Walgreens and $211 at Walmart – What the heck?
      Anyway, I made the FDA report saying the generic had no therapeutic effect for me. I urge others to do the same for all inferior generics. I will call Trigen as well – they only show phone contact.

    5. Hi again, Susan,

      Good for you, for filing the report.

      I suspect these complaints will go nowhere until we get an administration that respects science. But at least they might remain on file.

      It’s going to take a LOT of filing complaints to cover this clown car of Big Generic bad actors.

      g

  40. From what I am hearing there are many pharmacies that aren’t filling the authorized generic of Concerta unless you specifically ask for it. I just had that happen with my pharmacy. I was going to get the brand name Concerta, but the pharmacy called my mom and told her the medication would be over $400 (even with my insurance). The pharmacy I use had to order the Patriot Pharmaceuticals generic for me, and I will be getting the authorized generic tomorrow.

    1. Hi Aaron,

      Yes, in the last 6 months or so, some invisible-to-consumers change happened. It’s made the authorized generic harder to get — but not impossible, at least for some.

      I’m glad you get get the authorized generic.
      g

    2. We are on pharmacy number 4 trying to chase the authorized generic. I had good luck with Walgreens for several years but when Patriot became the distributor my Walgreens stopped carrying it and would not follow the exception process for me or order it. The pharmacist was actually really condescending and told me that their corporate office negotiates deals with regional distributors and that she cannot do anything about it. Costco also told me they would not order it as did CVS. I called Patriot and was told that is incorrect and that an inquiry would be started but in the meantime Patriot walked me through a list of pharmacies they had as carrying the authorized generic and I called around until I found one that would fill with Patriot. That has been working for some time now. And this month out of the blue the price dropped. I use good rx because my deductible is over $6k and usually pay around $125 but only paid $68 this month.

    3. Hi Micahlh,

      Thanks for sharing your experience. I’m glad that my suggestion to call Patriot helped. And, wow, a price drop.

      The reason things changed when Patriot became the distributor is detailed in the post.

      (Short version: the marketing deal Actavis had to sell Janssen’s brand Concerta as an “authorized generic” expired — and Actavis introduced its own generic. So did about 9 other generic companies.)

      tx
      g

  41. I gratefully found your site after receiving a couple of poor generic versions of Concerta. I managed to find my husband the authorized generic,and then suddenly even our own doesn’t carry it. Sigh, I’ve got a new script for one made by Camber pharmaceuticals, imprint 214. We’ll see how bad it is.

    1. HI Michele,

      I’m sorry you had to learn about this mess the hard way.

      I’ve been advocating on this since 2015. 🙂

      We managed to get the first two inferior generics downgraded by the FDA. Then the White House got a new occupant. Soon a boatload of inferior Concerta generics flooded the market.

      I hope that the Camber sneaky-snake look-alike works for you. I find it diabolical—that Indian company trying to fool consumers with a Concerta-shaped pill.

      If not, document the problem and lobby your insurer. Check with your local Walgreen’s — follow the information in the post’s introductory paragraphs.

      good luck!
      g

    2. I had that generic and I don’t like it. What you need to do is ask the pharmacy to order the authorized generic. I’m going back on the authorized generic on Friday.

  42. Well it’s time for a refill…so i called my docs office this morning and requested he prescribe the “authorized generic.” Long story short, the nurse called back and said the best they can do is make sure the Rx is for name brand only ??? They’ve never heard of an authorized generic before. 🙁 Is there something else similar that I know I can get that won’t cost an arm & a leg? Or do I call Walgreens next? 🙁

    1. Hi Jessica,

      Unfortunately, we often have to educate our physicians about this. You can’t depend on them to know.

      Whether you can get help through Walgreen’s or not, your physician needs to know how to write the prescription.

      You might want to check the post again — and download it for your physician as a PDF. Or send the link.

      good luck,
      g

  43. I am so furious!!! Now the family owned pharmacy we’ve been using will not order from Patriot anymore because apparently the prices have skyrocketed and all they will get now is NorthStar. The NDC doesn’t even matter now, they won’t order it. They put in the NDC for Patriot and both pharmacies were sent NorthStar as “equivalent substitutes”. Since my primary insurance only covers the brand now I’m hoping my son’s dr can send through a authorization for Caresource to pick up the cost since it’s now offered at the generic price. I really need that to happen so we can be done with this nightmare. If not, then no more Concerta.

    1. Hi Kristin,

      Frustrating indeed! I can understand why the family-owned pharmacy doesn’t want to lose more money.

      The problem is, these inferior generics. And so many of them.

      If you can get the brand at a generic cost (which isn’t the same as the authorized-generic…ach, all of this is so confusing), go for it!

      good luck!
      g

    2. My Family Pharmacy who has been excellent getting us the authorized generic told me today that it was unavailable from their supplier. So instead we got what they had remaining of the AG and then 10 Camber pills. Not holding out high hopes for the Camber. We’ll see. The Teva pill definitely did not work for my daughter. The pharmacy told me to try again next month. I hope they are being truthful and have not decided just to cease getting it for me. I realize they could be losing money. With my insurance I pay around $113 for 30 pills of 27 mg.

      Best to everyone on this journey.

      Kathy

    3. I ended up getting the Northstar RX generic last month, and I don’t like it. Luckily, my pharmacy will order the authorized generic for me.

  44. So I called Kroger today to see if my sons Patriot had come in yet and I am being told it’s been ordered but because it’s back ordered they aren’t sure when it will come in. He only has two pills left. Does anyone know if this backorder business is true or if I am getting the run around? And if it is true, does ANYONE have a date.

    1. Hi Leslie,

      Unfortunately, we cannot help you with that.

      Different Kroger stores in different regions operate on different schedules. And obviously deliveries are being delayed by COVID-19.

      good luck,
      g

  45. Yep, that was a fluke! They didn’t even have ALZA printed on them!! I even asked beforehand if they did. Here we go again with this nightmare. Glad I asked to see them before taking them.

    1. Yes, the fact that she was unclear about “bioequivalent” gave me doubts. 🙂

      I imagine people working in stores, with the public, are pretty anxious right now. Maybe she was tired.

      g

  46. She described the pill to me over the phone and I specifically asked if it was printed with ALZA and she said yes. So when I go there I’m going to have her open it for me so I can be sure. If it does then I’ll let you know. She was very specific in saying only this one AND Patriot are the only 2 bio equivalent ones. So I guess we will see!

    1. Hi Kristin,

      If it says Alza, that’s the brand/authorized-generic.

      But please know these are not the “bioequivalent ones.”

      Bioequivalence refers to the other kind of generics—that so-called “true” generics. They are similar to but NOT the brand.

      So if that’s the word she used, she is mistaken. No matter. If it says Alza, that’s all you need to know.

      Good luck!
      g

  47. Gina,

    I just got off the phone with my pharmacy who could not get Patriot but they got Northstar and it’s the same pill. Are you aware of this manufacturer now making the bio equivalent of Concerta as well? I apologize if I missed this information already.

    1. Hi Kristin,

      As far as I know, only Patriot is the distributor for the authorized generic.

      I’ve seen no mention of Northstar. It’s probably just another generic. A so-called “bio-equivalent” that most people find does not work as well as Concerta.

      You might want to call Patriot and ask, to be sure. The number is in the first few paragraphs of the post.

      Good luck!
      g

  48. Gina, thank you so much for your comprehensive post on this topic. I shared the pdf with my son’s pediatrician, and requested that she write the script with the NDC number, per the recommendation. I was not able to fill the script via Walgreen’s, as the Patriot medication was on backorder, and they weren’t sure when it would be available. I then contacted Express Scripts, which I usually don’t use, mostly because it’s difficult to arrange delivery of a controlled substance. But hey, we’re all staying at home these days, so thought i would give it a chance. Express Scripts said they could get the medication, and it just arrived today. It took about 10 days. The pills look like the Concerta brand, with Alza on the capsule. It’s a miracle! And, the price is comparable to what I would pay for the Teva generic. I am paying **so** much less than i was previously, for the Concerta. Thank you, thank you, thank you for the information that helped me navigate this confusing area that even the medical professionals don’t understand!

    1. Dear Melanie,

      Thanks for the kind words. They mean a lot to me.

      I’m thrilled that ExpressScripts came through for you. You are fortunate to have ExpressScripts instead of CVSCaremark home-delivery.

      And yes, that’s a bright spot of having to stay home — you’re there for deliveries!

      You might want to check now to see when you can re-order. Different companies, different rules. For some it’s 15 days before you can send in the Rx. For others it’s 30 days.

      take care!
      g

    2. A little late here, but please tell me your secrets! I also have ExpressScripts and they won’t budge on home delivery of any form of Concerta. I have been on the generic from Northstar for only 2 WEEKS, and let me tell you, it’s dog poop. (Never in my life have I ever felt this much weighted sadness with death as my only salvation, and I’m 24!) ( do not fret, I consulted my doc. And we agreed I should stop taking that particular generic). I was also on Trigen at 54mg earlier this year, and that was also doodoo. I’m really holding out that expresscripts will pull through, or I’m going to have to look into a different medication altogether

    3. Hi Sara,

      Everything depends on your particular insurance coverage — and the agreements that your insurer has with pharmacy managers.

      Have you tried calling the number I listed in the article for Patriot (the distributor of the authorized generic)?

      You can’t get brand, either? That be more a limitation of your insurance coverage than of Express Scripts.

      good luck!
      g

    4. Thanks Gina,

      I have not called yet. Its on my list of things to do.

      My insurance (have 14 months left to be on my mothers plan before I have to get my own) is tricky. All generics (even the good one) only cost me $10 a month for one 30 pill prescription. But I can only fill once a month. If I want brand, with insurance, it would cost me $450.

      My Jewel pharm. was telling me that they would order directly from Patriot if I requested it, but if for any reason they could not get a hold of it, they would just simply substitute it with some other generic.

    5. Hi Sara,

      Your prescriber could write “do not substitute” — and then it just won’t be filled. They should return it to you.

      You might want to check out some of the newer methylphenidate stimulants. They are brand but they typically have savings programs, which limit your co-pay to a certain amount (e.g. $30).

      Here are a few. Just Google search one by one, using just the name, and you should be taken to the company website. You should see any savings program there.

      Daytrana, Aptensio XR, Quillivant XR, Jornay PM, Adhansia XR, Cotempla

      good luck!
      g

  49. Hi Gina,
    Back again, just like “Groundhog Day” or a bad penny. Now my Shoprite pharmacist tells me they have a new “preferred generic” from North Star. I was so happy to get Patriot here but no more…their “hands are tied” by the distributor contract. So I am right back where I started last July. My local Walgreens is NOT interested in or able to order Patriot. My mail order rx (Optum RX) can’t guarantee a specific generic, so that isn’t an option.

    I just don’t know if I have the energy to go through this again. We are moving three hours away in three months when my husband retires. And (like all of us) now is when I need these meds the most.

    In which direction do you think I should spend my time going next?

    1. Lori, sorry that you have to go through this. I think everyone on here has experienced the desperate, powerless feeling.

      As Gina said, I can confirm that Walgreens are able to order Patriot. I gave them the NDC number per this post before they were able to look it up – shocking, I know – when I said “Patriot” they just said no and no.
      Also, I needed to ask a few times and it helped telling them my side-effects on the generic so they took me seriously. Try to go outside of rush-hour when they have more time to help; and ask for a consult with the pharmacist right off (don’t even try speaking to the person at the counter).

      Per Gina’s instructions, here is what I tell my doctor to put on the Rx (this is for my 36mg): “Methylphenidate HCl ER 36 mg NDC 10147-0686-1 Brand or Patriot only”. For my daughter’s 18mg its “Methylphenidate HCl ER 18mg, NDC 10147-0685-1 Brand or Patriot only”.

      Best of luck and don’t give up!

      Gina – thanks again for this life-saving post!!

    2. Hi Vicky,

      You are most welcome. Thanks for the acknowledgment.

      Google is down-ranking me because I get so much traffic for this post. According to Google search, non-MDs should not be writing about medical subjects!

      Never mind that ADHD specialists teaching at medical schools tell me they refer students to my blog! Especially for the ongoing info on these generics.

      Never mind that most MDs and pharmacists remain clueless on this topic.

      Crazy. 🙂

      BTW, maybe you missed the post update — you might need better tactics the next time.

      https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update-6-1-19/

      take care,
      g

    3. My local Walgreens was not any help. At. All. Everything I asked I was shot down. I did not try calling corporate yet. But Kroger is actually ordering it for me. At least they are trying – no promises. When I called today to check if it had come in I got the “it’s on backorder” excuse. We only have three pills left, so crossing everything on my body that I can.
      The last manufacturer they switched to – Alvogen – was a bit better than some of the others behavior wise. But we have A LOT of sleepless nights on this one.

      ALL GENERICS ARE NOT CREATED EQUAL

      I am having a hard time getting my son’s pediatrician to understand this as well.

    4. Call Patriot, Leslie. Read the updated part of the post at the beginning.

      With the quarantining, all businesses will be slow to respond or deliver, I imagine.

      Your son’s pediatrician should know that professors at medical schools refer med students to my blog so they can understand.

      I just created a PDF of this post, so you can print for your doctor.

      https://adhdrollercoaster.org/wp-content/uploads/2020/03/Authorized-Generic-Concerta-Update.pdf

      good luck,
      Gina

  50. The pharmacist at CVS says the Trigen manufactured methylphenidate ER is the AB rated generic (and authorized generic). Any suggestions on this? Because the Trigen methylphenidate is ineffective and not even close- it’s a round circular tablet which that alone is one of the first signs it’s not the same.

    1. Hi Ashley,

      The pharmacist is WRONG. Trigen’s generic is not the authorized generic.

      The authorized generic is the BRAND — it’s only sold as a generic.

      I have written several posts detailing all you need to know. You can add search terms to the box in the right column. For example, Trigen.

      This from 2017:

      1. Trigen
      Reports so far are not good on the Trigen generic:

      One month of my son being on the Trigen generic made me want to lose my mind, and now we’ve had two glorious weeks back on the authorized generic. [NOTE: this is the brand sold as a generic.] This is so depressing.
      One month of Trigen generic was no good! CVS insisted that it was equivalent and that’s all they stock now, so I had to switch to Walgreens this month since they still carry Actavis generic. [NOTE: this is the brand sold as a generic.) The time release mechanism [Alza’s OROS] is what it’s all about!
      I’m finding the Trigen generic is horrible.
      UPDATE 3/27/2018 : Trigen recalled their 36 mg. generic Concerta because it was considered sub-potent (27 mg). Generics are allowed a 20% window up or down, compared to brand; 20% would be 28.8, and this generic was 1.8 mg short. It might not seem like much, but typically people with ADHD have a very narrow window of effective dosage; the 20 percent variability is risk enough. More about generics and “bioequivalence” below.

      https://adhdrollercoaster.org/adhd-medications/7977/

      g

    2. We also HATE these! They are colored identical to the Alza ones but they don’t do crap!! As a matter of fact, they are worse than nothing. They seem to release too much Meds at one time and then drops to zero before the next wave! So multiple “sundowners” syndrome during the day! My twin sons both developed tics DAY 1 when we got switched to this brand.

  51. Nerine from Patriot called me this morning. The number does not show up in my caller ID, and I am so grateful that I did not ignore her. She was amazing and supportive. She said that Walgreens does have an exception policy, and if you run into any issues to give them a call at 215-325-7676. She said they check the messages every hour and when you call to provide your time zone as well, so they can return their call. She didn’t seem familiar with AllianceRX mail order pharmacy, and I told her I was not going to mess w/ them for now as my local Walgreens already agreed to fill it for me. I have to pay more OOP, and Walgreens has to lose money too, but I don’t want to bother them again.

  52. According to the local Walgreens, it is available, but they are trying to restrict access b/c it is 4x the cost of the other generics, and they are losing money on it. I was able to convince them to get it for me because I work in healthcare and it is a critical time when I must function at my best. She was able to get it approved. It will be more expensive than mail order pharmacy, but it is still better than paying for brand name. Thank you for your help and being such a useful resource.

    1. HI Yaolin,

      I’m glad Walgreen’s is helping you.

      Yes, I’ve written many times here that the stores who help customers get the authorized generic often take a financial hit in doing so.

      It’s a good idea to do our regular drugstore shopping there, too.

      g

  53. Gina, I just tried calling Alliance RX (Walgreens mail order pharmacy), and I was told that as of yesterday, Patriot has “disabled” this medication? Do you know what that means? I tried calling Patriot and got a voice message and haven’t checked my local Walgreens yet.

    1. HI Yaolin,

      I don’t know if the “exception process” works with Walgreen’s mail-order phamarcy. Those are typically different entities (storefront and mail order)

      Best to check your local Walgreen’s.

      Remember: the country is now on “lockdown”. We cannot expect universal success when calling businesses.

      Good luck,
      g

  54. Kroger is going to “TRY” to order the Patriot for me. I am getting his doctor to put the NDC on the prescription. She said they can’t promise anything, but they seem to be the only ones willing to help at the moment. Walgreens was a no go. I kept getting NO across the board. I’m at the point of almost wanting to switch his medicine all together, even though when he gets the ALZA pills – it works sooo good.
    My heart broke last month when I got his prescription and they had switched to Ascent? But I will say – that of the other generics we’ve tried – this one is a bit better than say, Trigen or TEVA. He might as well not be taking ANY medicine that take those again. Wish we could order straight from the pharmaceutical company ourselves. Will this ever get any better.

    1. Hi Leslie,

      Did you follow the instructions in the first few paragraphs of my post?

      If not, you might want to try it.

      As far as “will this ever get any better,” no one can say.

      This White House named a kleptocrat as FDA chief. In 2014, we were able to get the inferior Concerta generics downgraded.

      The new chief scoffed at FDA scientists’ concerns about generics for novel delivery-system medications (as with Concerta).

      In a giant gift to “Big Generic,” he pushed through several hundred questionable generics.

      Elections have consequences. That’s the bottom line.

      Good luck!
      g

    2. I got as far as calling Patriot.. If this doesn’t work with Kroger – then next month that’s my next step.

    3. Hi Leslie – we had the same results that you saw. The Ascent/Camber generic worked better than Trigen (waste of money) but still not quite as good as Concerta. Luckily for my son it seems to be close enough to not matter.

      It is very frustrating having to assess a new generics effectiveness to determine if it is therapeutically equivalent every time a pharmacy/insurance company wishes to save money. The FDA should require that generics use the same excipients as the branded drug for any non-immediate release drug (i.e. modified release, sustained release, etc.) especially those that have a neurological effect, because clearly not all excipients are the same. Ridiculous!

    4. Hi Mike,

      FYI — The FDA was in the process of updating generic guidelines in light of the sophisticated delivery systems (e.g. Concerta’s OROS). Those delivery systems can make all the difference in how the drug performs.

      But then the White House Administration changed, and the appointed FDA chief discounted FDA scientists’ concerns and pushed through dozens of generics — before going back to the Heritage Foundation.

      I think it’s always important to understand the story behind the story. This is not the FDA’s fault, insofar as the scientists and staffers who oversee these things. The FDA was very helpful when I started the campaign to downgrade the first two inferior generics.

      g

  55. Last month I decided to refill my Rx at Walgreens instead of picking it up from the clinic pharmacy. I was surprised when I saw it looked completely different! I was given a new white oval tablet with a 726 logo on it. Within the first hour of taking it I could tell it was off. Felt like I forgot to take it, or it wasn’t working etc. So I hit the web and found this info. Thank you for all of your research, this is incredible! Anyhoo, I thought maybe going back to the clinic pharmacy again to pick up my Rx would provide me with the original alza36 I was used to instead of what Walgreens gave me. So yesterday I picked up my refill from the clinic and I’m saddened to say that this time I was given a white cylindrical tablet with 214 on it. It definitely looks more like the original alza36 SHAPE, but after rereading through this site again I see you have it pictured as another false copy cat. I guess I’ll find out tomorrow when I start taking it. I am feeling very apprehensive at this point. Ugh!

    1. Hi Jessica,

      I’m glad you found my blog.

      Please read the post and use that information to try again at Walgreen’s.

      Good luck!

      Gina

  56. Update from Gina Pera 3/4/20: Walgreen’s and Possibly Other Stores 

    For the first few many months I’d called, the person answering didn’t even know what is an authorized generic. That seems to have improved recently. Patriot reached out to me last week to update me on the situation

    Mayor points:

    —There Is An “Exception Process” at Walgreen’s, possibly Kroger and others. This means that if the store initially tells you it cannot get the authorized generic for Concerta, ask the pharmacist to file an exception process.

    —Walgreen’s corporate headquarters confirmed with Patriot that all Walgreen’s stores should be able to order the Concerta authorized generic for you.

    If you encounter resistance with Walgreen’s, ask that an Exception Process be ordered for you.

    Still trouble?  Call Patriot at 215-325-7676 

    —Allegedly, Kroger has an Exception Process as well but I have not yet been able to confirm that with the corporate headquarters.

    —Other drugstores might be implementing such a policy. But no announcements have been made.

    —CVS has chosen not to participate.

    —Walgreen’s Is Your Best Bet Now—and Has Been Since This Issue Began, in 2014

    I have no business interests with Walgreen’s.  I can simply confirm that, since I first started to report on the Concerta generics issue (2014), Walgreen’s has been the most customer-focused chain. (Wegman’s, too, though Wegman’s stores are much smaller in number and regional.)

    Walgreen’s must be taking a financial hit on this, so what’s the decent thing to do? Do your drugstore-sundry shopping at Walgreen’s, too.

  57. Francis Williot

    Anybody familiar with the Medicaid or Medicare laws regarding covering the Brand Name Concerta? Mine is through Caresource and they now specify on the “PREFERRED DRUG LIST” the NDC of Patriot Brand only. I assume that means they would cover Jannsen Concerta as well right? Other question – who in the state of Ohio carries Patriot Pharmaceuticals Methylphenidate ER ? Surely somebody reading this blog lives in Ohio right? The biggest problem with this blog is the excuse that “Insurance Insurance insurance its all different ..… ” That’s not the issue at all. People simply CAN NOT FIND A PHARMACY THAT CARRIES PATRIOT BRAND ON A REGULAR BASIS! That I think is what most readers want to know – who carries it and is it a guarantee they will be carrying it? ITs not realistic to call every pharmacy in a state – in fact it will land you on a government watch list if you even tried it. DO NOT DO THIS. I have first hand knowledge of being profiled for this kind of thing. Walmart told me that the doc should write the RX as “Concerta” (NO SUBSTITUTIONS or DAW) and it would automatically order the Patriot Pharma authorized generic if Caresource rejected the brand name. She said it would take 2 days. Has anybody else had Walmart pharmacy order the Patriot auth generic ?

    1. Hi Francis,
      I’m in Ohio and have Caresource for my children. As far as I know Caresource still will not cover the brand Concerta, but my primary insurance will..of course not at 100% so it’s still cheaper for me to get the authorized generic for my son and have Caresource pick up the bill. The only place I’ve had luck finding the authorized generic is through a local family owned pharmacy, Whitacres. I’ve had no luck at chain retail pharmacies..but others have. I think anymore it’s really just hit and miss unfortunately.

    2. Hi Francis,
      Where are you in Ohio? Just call the number provided by Zach above for the Patriot Rep (215-325-7676) and she can let you know what pharmacies have ordered within the last 60 days. I am in NE Ohio and was told that my local Discount Drug Mart and Acme had ordered and Walgreens and Kroger (if you are almost anywhere else but NE Ohio) can order it through an exception process. Scroll up and Find the comments from Zach. He does mention talking to a Walmart pharmacist directly to get them to order it.
      Good luck!
      Kathy

    3. Hi Francis,

      Sorry, I’m not familiar with Medicaid or Medicare drug laws. But you seem to be confused about the difference between the Concerta authorized-generic and the brand.

      I’ll make it easy: There is no difference. Concerta brand = Concerta authorized generic.

      That’s what an authorized generic is: the brand sold as a generic.

      Now, you say that Caresource specifies the authorized generic on their preferred drug list. Then you ask if that means they would cover Janssen Concerta as well.

      That’s why I emphasize: the authorized generic IS the brand.

      So, it seems you needn’t trouble yourself further.

      I recommend that you read the blog post for the full details about generics-authorized generics.

      And please remember: the details have been changing month by month since I first wrote about this. In 2014!

      To add another layer of details: Patriot distributes (not makes) the Concerta authorized generic, which is made by Concerta manufacturer Janssen. It is only sold as a generic (making it an authorized generic, sometimes called a branded-generic).

      By getting the authorized generic distributed (not made) by Patriot, you ARE GETTING THE BRAND.

      I know this is confusing. And, honestly, that is not my fault. In fact, I am exhausted from repeatedly attempting to explain this simple fact to readers — for many years now.

      Your second question: about the “biggest problem with this blog.”

      Actually, the biggest problem with this blog is that I have been the only person writing about this with such details. And I am unpaid.

      I have provided ample information, information that no one else has provided. I am not a miracle worker and your frustrations, while I sympathize with them, are not my fault.

      I’ve been the only person covering this issue for years — and it takes a lot of time and hard work. Researching and writing — and then fielding the various questions from readers.

      You are welcome to look for the information I provide from an “ADHD magazine” that takes massive amounts of money from pharma. Instead, you will only find insufficient summaries taken from my reporting.

      Whether you like it or not, the type of insurance coverage you have can make a difference. So can where you live and the type of pharmacies you have access to.

      There is no law that says you should have the authorized generic—or that there should even be one.

      If you want to find it, you’ll either have to ask local pharmacies or call the Patriot number that I shared in the blog post: 215-325-7676

      I understand that you are frustrated — and perhaps not taking medication. But please calm down and try to get the facts instead of shooting the messenger.

      Good luck in finding the medication you need.

      Gina

  58. Laurie Bussard

    Hi again. Just wanted to update on my experience with the pharmacy and asking for the “Authorized Generic” even after telling the pediatrician I needed the brand name for now and didn’t care if I had to pay out of pocket (SMH) He didn’t fill the info out correctly so I was left to deal with the independent pharmacy I’ve been using for 5+ years.

    They ordered a different generic (it’s Actavis Pharm. white oblong with 726 on it) unfortunately it isn’t the right one.
    They couldn’t order the authorized generic due to the cost being so high they’d lose money and I was frustrated by the end of the conversation.

    I DID find out the switch from ALZA 36 began in October of 2019 and that IS when my son’s problems started. So, hormonal or not the cause of his issues are most definitely the medication not working at all! It’s so like he didn’t take ANYTHING. (so happy I’m not going crazy after all),

    I hope next month we can get the brand until I find a pharmacy with the ALZA (Jannsen?)

    Thank you so much for all your hard work again and I’m filing a report regarding the medication issue because at this point I’ve removed him from public school and I’m homeschooling.

    God bless!!!

    1. Hi Laurie,

      That’s a shame about your trouble. So frustrating.

      I’m not sure what you mean bout the “switch from Alza 36.”

      Last June, Actavis-Teva no longer was the distributor for the authorized generic (made by Janssen).

      Supplies might have lasted longer but the deal stopped earlier.

      Actavis-Teva issued its own generic (NOT an authorized generic but a “bioequivalent” — the standard way we think of generics).

      Janssen’s subsidiary, Patriot, took over distribution for the authorized generic.

      Please read the post — the beginning info about Walgreen’s and Wal-mart. Might be worth a shot.

      g

  59. Michelle- Was it $330 for the Concerta? or is $330 now your cost for generic that you used to be able to get for $8? Seems to be a lot of change in the pharm coverage this insurance year. Ugh!

  60. Thank you thank you! A few days ago I went to fill my daughter’s prescription which I had figured out last year needed to be run as a DAW9 to pay $8. Yay me! Crisis averted….until a few days ago. DAW9 not working -REJECTED at CVS. I called our insurance company Medco Express Scripts and spoke to a lady who had no knowledge whatsoever on this stuff. On hold for 30 min only to find out. We don’t cover DAW9 anymore. Duh? I realize that but why. So once again my detective skills are put to work. Call the doctor’s office. It took a day to get a call back from a nurse. Insert your website. Thank you thank you! I should note that my prior work experience was in the Pharmaceutical field but even with this experience and understanding of the generic market it was all overwhelming.

    Went back to CVS paid $330 for the script for my daughter because she was out. They could not order the AG. They only carried what was contracted with CVS. The pharmacist gave her 30 second formed response, but indicated some people don’t do as well on this generic formulation. Went to Walgreens armed with the NDC and as of now they are able to order it. That this is still the case in 30 days.

    Has anyone had any experience getting the remaining refills switched from CVS to Walgreens? That’s my next ride on this rollercoaster.

    I also want to note that this is so frustrating to think that in my case my child has to be a guinea pig with the generic formulation. It was bad enough finding the drug that works for her in the first place. I’m so grateful for people like you that are driven to find answers. I have saved this page in my favorites.

    1. Hi Michelle,

      It all depends on your specific insurance-plan coverage. Has your insurer said that you must get your Rx filled only at CVS?

      I’m hearing more reports of having no success now at Walgreen’s, despite previous success. So, at least you found a Walgreen’s that will fill it. That’s good.

      Yes, it’s frustrating alright. This is an unpaid service — and moreover, Google’s search engine penalizes me for writing about Rx when I am not an MD. (Never mind that I inform the MDs.)

      I do it because I appreciate the consequences. Often dire ones.

      It’s nothing short of unconscionable—sociopathic even—that Big Generic and the kleptocrat named by this administration as FDA chief greedily performed this uncontrolled experiment on vulnerable people.

      This cannot stand. As a nation, we better focus this time and think of consequences.

      Good luck!!
      g

  61. I am so grateful I found this. I was having all kinds of issues with different generics in 2018. The good news was my insurance started covering Concerta brand name at generic cost. Now I’ve changed jobs and am having horrible problems with prior auths and generics. Walgreens is saying that the generic for Concerta is Methylphenidate ER OSM-not Methylphenidate ER. So I have paid for this horrible generic for 3 months. My psychiatrist wrote a prescription for Methylphenidate ER last month. I got the exact same generic manufactured by Amneal. It doesn’t work. I’m shaky and anxious and really foggy. I amactually in danger of losing my new job because I can’t remember anything or settle down. I glad to know I’m not crazy. Thank you.

  62. My heart just broke into a million pieces. We had been so successful getting the Patriot At Kroger for my son. My dad picked up the prescription for me yesterday and I didn’t even look at it until this morning. It’s a round BRIGHT neon orange pill from Alvogen. We are in a very rural area and I honestly don’t see what other options I have now. Already traveling 40 miles to the Kroger. CVS and Walgreens both tell me that they can’t “special order”. I’m almost at the point of talking to his doctor to see about switching medicines so I we can stop dealing with this every few months it seems.

    1. I am so sorry, Leslie.i understand completely.

      If you can’t get brand, then yes, it might be time to try another option.

      You might try calling Patriot to see if they know of another pharmacy in your area.

      This is all so very wrong.

      Good luck.
      G

  63. I have been taking Concerta or the authorized generic since I was 10, I am now 29 and am in the second year of my health professions program (I prefer not to say medical or veterinary school for anonymity).

    I was perfectly balanced on my medications, excelled in school and had no trouble focusing. I have never known in my adult life what it was like to not be able to focus.

    I was tested numerous times and officially diagnosed as a child and it took a while to find the right balance according to my parents. It was night and day for me when my psychiatrist worked with me in combination with the proper medication. I excelled in high school, undergrad and graduate school, sure I had the occasional inability to focus after a long day, but my ADHD was medically managed.

    Having been on Concerta for so long, I built up a tolerance and was maintained at a higher dose that required prior-authorization and quantity override time and time again with a new insurance policy. But everything was working, I was a perfectly functioning contributing member of society thriving in my academic pursuits and work.

    That was until a terrible mistake happened in the September of last year when a joke of a pharmacist at a Walgreen’s told me that the new TEVA generic was the same as the authorized generic I had been getting (which in September of 2019 was the Actavis formulary). I had already had so much trouble finding the authorized generic at a pharmacy and Walgreen’s was the ONLY PLACE that carried it, so I figured suck it up, it’s the generic it will be the same. Heading out of town for a conference the next day, without an option to find another pharmacy in such short notice, and most certainly not able to stop my prescription abruptly (I had to do that once when I was 22 when there was a lapse in insurance and it delayed my ability to fill my prescription for 48 hours. I was almost hospitalized because of the side effects, but luckily on the second day of the 48 hour hell, my doctor told me to increase my afternoon ritalin dose and take that in the morning to supplement until I could get my prescription. This was one of the scariest moments in my life). I had no other option.

    Getting back to last year, I became sick with walking pneumonia at the conference at the same time I started the knock-off should be illegal generic (in my opinion). I had brain fog, was tired all of the time, and my short term memory was affected. I thought that it was just my overly stressed body trying to recover from a nasty bug. But this went on for 2.5 weeks. I couldn’t pay attention in class, I would come home and fall asleep at 5 in the evening, sleep through my next morning classes. I would write 15 pages of notes and 2 hours later not remember one word of it. I had stored one of my credit cards somewhere prior to traveling, and I have a clean apartment, for weeks I could not remember where I put it, this had never happened. I worked so hard for so long to get to where I am and when my friends started noticing I was acting strange and I wasn’t coughing as much but just seemed out of it, not able to focus, not remembering what we talked about the day before, or even able to converse like the professional student I was, I called my doctor and said something was terribly wrong. I didn’t know if I had had a stroke, or a tumor or something, but I said I was not myself and for the first time in my life I didn’t know what was wrong, but I did not have control of my own mind and body.

    It was through this website and contacting my old pharmacist of 15 years that I learned that the authorized generic was made by Patriot. My doctor wrote another prescription but my insurance refused to cover it until the month ran out. I had my current Walgreen’s Pharmacist contact other pharmacies in search of anyone who carried the authorized generic. By the time I could get my prescription filled I was mentally exhausted, crying many days, working ten times harder than I ever had to just get through the volume of material thrown at us on a daily basis in medical and veterinary schools. When I arrived at the pharmacy that had the authorized generic, the pharmacist told me, he had never seen someone on such a high dose, and that it wasn’t appropriate or safe, he said because the address on my prescription was from out of state (because I attend school out of state but was always told to have your driver’s license address match your prescription), that he would not fill it. I had never encountered anything like this. I told him to call the Walgreen’s and talk to the pharmacist that REFERRED me to his pharmacy, that I had been going to Walgreen’s for over a year and a half and I had been on that dose, covered by insurance for the last 10 years. I asked him to call my doctor. It was obscene how hard it was, to get my legally prescribed, medically necessary medication in a college town. Thankfully after 20 minutes on the phone with the Walgreen’s and my insurance company the man had the nerve to tell me my “everything checks out, but you shouldn’t be on such a high dose for your heart.” I told him that is why I see the doctors that I do and I am aware of all health risks and side effects of the medication I have been on since I was child, and I appreciated his concern.

    I finally had the appropriate authorized generic. I am on 108 mg of Concerta, this is a lot compared to most people but it is not unheard of. The problem was going from 108 mg of the unauthorized generic that I had been on for several weeks, to the generic I had been on for more than a decade, the transition was not as smooth as my doctor had expected.

    I experienced hyper-agitation and mood swings when I went back to the original dose I was on of the proper medication. It took weeks of finding the right balance of the Authorized generic and my ritalin to get my brain to re-adjust to who I was. Within 10 days of being back on the right medication, I remembered where I placed my credit card, I was waking up on time for class, able to focus, and could recall things with minimal difficulty. My memory was working again. My doctors still can’t explain the readjustment period and I honestly can’t recall and don’t recognize any of the study guides/ lectures during those 4 weeks when I was on the wrong medication, it was as though my memory was gone. Thankfully much of medical and veterinary school builds on clinical experiences, integration and repetition and my performance in my program was not compromised, and I am doing well. I struggled daily being so frustrated with myself for not having control of my mind or my body and months later I am about 95 percent myself, but I have to work a bit harder than before in my program and how I study and learn in school has changed somewhat, I have to take breaks and I have to be more hands on with my learning.

    In the first week of February, the other pharmacy could no longer get the authorized generic and said it was on back order for them. I was terrified that something like last fall may happen again, but thankfully found a local family run drug store (not restricted by the ridiculous corporate decisions and red tape that Walgreen’s, CVS, and Kroger are experiencing related to this drug). I was nervous getting my prescription filled, afraid I would be profiled, and scolded for my prescription, my dosage and essentially accused of being suspicious because I had my prescription that matched my DL out of state home address. The most amazing thing happened. The new small town pharmacy welcomed me with open arms and ordered the authorized generic from patriot the next day. I felt valued and respected as a patient/client. I have been on this generic that says alza, is from patriot and has the little lazer drilled hole my doctor said to check for. I have been tired this last week, struggling to wake up and focus in the morning but I think it has to be something related to school, exhaustion, test after test, the miserable rainy weather etc. But I will be looking on this blog monthly to keep track of the latest updates because the information I learned on this site, in combination with my childhood pharmacist and doctors, I honestly believed saved my life and professional career.

    I would not trade what I went through, although it was one of the most terrifying and frustrating things that I have experienced. I learned to have so much compassion for other people who have never been properly medicated and struggle with their ADHD, I learned how incredibly strong and resilient and unique people with ADHD are, that if given the chance to become medically managed we are capable of anything.

    I was hesitant to post on this site but so many stories I read on here, made me see that I was not insane, that I was not broken and that I can do this. I wanted to thank all of you for sharing the troubles you have experienced and I hope that if my story can help any of you, please know that you are not alone. Please know that what the pharmaceutical companies are doing is not your fault, and please please make sure you never stop advocating for yourself, your loved one, your child.

    1. Hi Sam,

      That’s quite a testimonial.

      Thank you for taking the time to write it.

      I’m glad you found my blog and that my work and the comments of others saved your life. It still astounds me that I was the first to write about this — and the only to consistently report on it.

      An unpaid advocate on a blog. A blog that Google penalizes because I dare to write about medications when I don’t have an MD.

      The 21st Century is a weird place. 🙂

      People scream about Big Pharma. I say the one to watch is Big Generic. They are bloodless in their exploitation of FDA guidelines on bioequivalence.

      The Obama administration FDA chief was very responsive to MedWatch complaints. And the FDA scientist I spoke to, when successfully leading the campaign to get the FDA to downgrade the first two inferior generics, was very helpful.

      We won. Those two generic manufacturers had to withdraw their products. One complied. The other, Mallinckrodt, tried to sue the FDA.

      The FDA scientists said, “we need to develop guidelines for medications with complex delivery systems.”

      Then this current administration appointed a venture capitalist who overrode (and scoffed at) the FDA scientist concerns and pushed through MANY generics.

      Then he went back to venture capital.

      People with ADHD should never assume that they will always have a right to treatment. Look at the UK, where adults often wait 4-5 years for an evaluation– and treatment, if it ever happens, is pretty sad.

      Wishing you continued success in your studies,
      g

    2. Hi Gina, it has been a while since I posted. Something is very wrong and I am hoping you can provide me with guidance.

      After returning to school after having been back in my home state over the summer, I went to the pharmacy I use while I am away at college. It is the only pharmacy in the tri-county area that carries the patriot authorized generic of Concerta. This is the same pharmacy that had been filling it prior to me leaving for the summer (I had my prescription filled at a chain pharmacy back home during break).

      I had called the pharmacy on the 27th and the Pharmacist said she didn’t have enough to fill my prescription and their system said that it was unavailable to order but she would try to place an order anyway. She offered to do a partial refill if she could not get it in stock. She called me the next day saying the order she put through worked and it should arrive “tomorrow.” I thought it was strange how it was unavailable but then the order went through, but that is beside the point. I picked up my prescription on 9/29.

      I had been doing so well and excelling in school and everything had been normal. Had been normal being the key phrase….

      Since the beginning of October, I have had a lot of trouble sleeping and waking up, trouble focusing, trouble getting through a long day, trouble paying attention to friends, and just an overall irritability and a need to randomly get up and clean the evening before an exam or when something else is due. It almost feels like last year when the pharmacy had filled an un-authorized generic.

      I really thought it was just the stress of my professional program as I am on the authorized generic and had no problems in August or September, and this semester is notorious for being hard let alone during a global pandemic, but last week during an exam I could not tune out my neighbors music, I had ear plugs, and it was unbearable, I failed my exam and I have never, ever failed an exam. Something happened last night and I just can’t shake the feeling that it may be related to the exact timeline of when I picked up my prescription, and when all the problems started happening.

      I went to fill my weekly pill case last night and when I poured some of the pills in my hand, from the bottle to transfer them, I noticed on three of the pills (they were all next to each other), the word alza was very bold, the text being almost double in width compared to the others in my hand.

      I decided to pour the rest of the bottle out to look at all of them because I have never in almost 2 decades of taking Concerta seen that. I found other pills where the normally crisp margins of the letters, instead looked fuzzy almost like they hadn’t dried is the best way to describe them. This made me look even closer at the remaining pills. Some of the pills looked normal with normal text.

      I decided to separate them out. I looked at the ones with normal “alza” and the red brown color was uniform smooth, but the ones with the weird bold or fuzzy alza were a faded red brown color almost looked mottled with white; it was extremely subtle. The texture looks like a sponge dabbing on paint if that makes sense.

      The last thing I noticed is on some of the pills with fuzzy/non crisp margins, and the mottled faded color, the ends of the pills looked like they were melted or an extra coating was put on them. I guess the best way to describe it is how if you paint your nails and you bump into something before they are dry, they smudge/ripple. The pills that have the normal alza and uniform non-mottled red brown color do not have this on the ends or near the “drill hole/divet.”

      That was when I remembered something that happened a few weeks ago when I was setting up my weekly pill case after picking up my prescription. The first pill I picked up was chipped around the “drill hole/divet” I thought that was odd but the bottle was very full and difficult to open so I attributed that to damage from the lid. I thought nothing of it but kept it in the back of my mind.

      I know me, I know my body and I just don’t know what to do about this or who to call or ask or what any of it means? After looking at every single pill last night something is wrong, This seems like an issue with the pharmacy or the pills, and my doctor is not available this weekend so I am just looking for guidance because I don’t even know if he can help me with this…

      Is it possible there was an error at the facility that manufactures them? Such as a bad/contaminated lot/(batch??)? Could these be tampered with, is that even a thing? Have you ever heard of this happening before? Has Patriot changed anything recently? I really appreciate any and all advice that you may have or anyone on this post may have….

    3. Dear Sam,

      That’s awful! I have no idea.

      The FDA has very strict guidelines for brand medication productions. So, if the pills are as you describe, it seems unlikely they are Concerta brand/authorized-generic.

      Though it might be that Janssen could provide some answers as to what it might be. Perhaps from an online pharmacy selling counterfeits.

      Do you still have the bottle? What does it say as the supplier?

      You could call the pharmacy but that will probably be unsatisfying.

      Here is the contact info for Janssen:

      For any questions regarding treatment with CONCERTA®, please call

      1-800-JANSSEN (1-800-526-7736)

      Monday through Friday from 9:00 AM to 8:00 PM ET

      Saturday/Sunday from 9:00 AM to 5:00 PM ET.

      Can you send a photo to me?

      g

  64. Hello all,

    Just want to thank Gina so much for everything. I have been taking Concerta since I was 8. I am now 26. Before switching to my own insurance and moving to GA, I never had trouble getting my prescription filled. (In terms of the correct Concerta medication with the OROS delivery system). I am from NY and Wegmans always was able to fill it with absolutely no fuss.

    Once moving to GA I used CVS Caremark for a little, and with not being knowledgeable got a 90 day supply of Trigen. My thought was “oh, it must do the same thing as the other pill.” SUPER INTOLERABLE. Was able to void the prescription by talking to a CVS Caremark Pharmacist and they were able to help me get the Alza pill going forward. Then they started to make it difficult for me to get it. As well as a lot of the pharmacies around here were also making it difficult.

    In my experience a 90 day supply through mail order services are the best option to ensure you get the right prescription filled (Correct NDC for your dosage of Concerta.) I used Express Scripts in late 2019, made sure I spoke to one of their pharmacists to ensure they could fill my NDC at an authorized generic price for a 90 day supply. They did and they were super helpful. Anthem, my insurance provider, switched to Ingenio RX as of Jan 1st 2020. I went through the same process with them on the phone just now. At first the pharmacy tech said she couldn’t find the NDC in their system for the 27mg. But she was able to find it and then said she’d make a note on my file.

    I then went the extra mile and called Patriot myself (2/19/20) The customer service line was super helpful. I verified the NDC, availability, etc just to make sure there’s nothing sketchy going on. She said they realize this drug means a lot to people and if there is any pushback in terms of being able to get Concerta in my area, to call back in and she will get me in touch with a Patriot rep to help me find a pharmacy or even talk to the mail order supply companies to get it.

    I do realize most of the issue is peoples ability to get the generic coverage of Concerta but also the availability is as well. I My best advice, if you’re able to do so through your insurance company, is talk to the mail order company they use directly. As far as I know Express Scripts for sure will help, and Ingenio said they will be able to as well (my first prescription through Ingenio has yet to be filled but they did say it wouldn’t be an issue)

    I’ve tried cold-turkey, I’ve tried different medicines, but Concerta is the only thing that has truly worked for me. I know ADHD is something some people will act like everyone has and almost look down on it as not a big deal but I know for sure without these meds I don’t know where I would be.. I feel for anyone going through the struggle of trying to get the right medication and at times feeling helpless. Just want everyone to know who is dealing with ADHD and the struggle to get the right meds that you’re not alone. Thank you Gina for bringing us all together and doing the research. With your help I have finally taken responsibility into my own hands to truly know about the drug I’ve been taking for so long and how to go about getting it when there is obstacles in the way.

    1. Dear Zach,

      Thanks so much for writing! You are a model of self-advocacy! 🙂

      I appreciate the kind words—especially since the Google search algorithm is docking me for daring to write about stimulant medication, especially since I am not an MD.

      Oh that more people could Express Scripts instead of CVS Caremark home-delivery. The latter simply won’t carry the authorized generic.

      I wish more people had a Wegman’s, too!

      I feel for the pharmacists at these big store-front chains who have to give the bad news all the time. They are being hamstrung by their company’s executives and their profit model.

      And, of course, these chains are being squeezed by the megillah of CVS Caremark and it’s purchase of Aetna.

      Keep up the great work in taking care of yourself!

      g

    2. Good to hear. I am using Costco and the can get the authorized generic but 1/2 the time They have tried to give me another generic, even though my provider specified the NDC number. I called express scripts, also in December 2019, and was told they couldn’t get it. I’ll have to talk to them again. Mine is 36 mg. Hopefully it is available with less hassle than Costco. Thanks for your footwork and info.

    3. UPDATE!!!

      INGENIO RX is a NO GO. They’re under the umbrella of CVS CareMark. They told me via phone they could fill my 90 day mail order and then called 1 week later saying they couldn’t and there is nothing they do.

      I finally got ahold of the Patriot Rep who was beyond helpful!! She gave me her direct number and said I could post it on here for you all. She will help you find pharmacies in your area who have recently filled the Patriot prescription. If for some reason her and her team do not answer, leave a voicemail!

      You no longer have to call Patriot Pharmaceuticals customer service line which will tell you they will forward your info to a Patriot Rep, this is the direct line for support!!

      —-> Her number is 215-325-7676 <———-

      She mentioned some amazing information. Walgreens Corporate and Patriot have an understanding that all Walgreens should have an Exception Process in order to fill the Patriot prescription. I went to a Walgreens earlier today that said they couldn't and the Patriot Rep asked for the exact address because she was sending that to Walgreens corporate so they could speak with that pharmacist to make sure it doesn't happen. Sounded like she was ready to give Walgreens a earful lol

      Basically when it comes to Walgreens do not let them say they cannot do it, they have an Exception Process and there is no reason for them not to fill it. If you cannot fill it at your Walgreens call the number above and tell them!!

      Also I was told as of March 9th, 2020 Kroger will have an Exception Process as well. Kroger told me today that as of Jan 1st they have a specific contract with another generic and no longer able to order NDC specific. I do not know if the gentleman at that pharmacy knew about the Exception Process effective March 9th but that is what the Patriot Rep told e=me.

      Please call that number!! I live in Atlanta, which I know is a big city but she gave me almost 12 Pharmacies (a couple who were independent pharmacies) and was beyond helpful. She really cares and I could genuinely feel that. She made it very clear to me that they have plenty of product and open to do business with anyone.

      I hope this helps you!!!! Don't take no for an answer. I know some of us are limited to where we live (smaller rural cities/towns) and have difficult insurance but Patriot is here to help!!

      Call that number! Love to all.

    4. Dude! You’re the best!

      Thanks, Zach!! I called Patriot many times since I first published this article (June 2019). It seems only now that the company is being responsive.

      g

    5. Also she mentioned WalMart works well with Patriot and has some sort of an exception process but to make sure you actually talk to a WalMart Pharmacist to ensure they know if they order this product for you that you will indeed be back to buy it. I guess WalMart just doesn’t want to get burned and have product on the shelf that was for a special order and have it sit there.

    6. For Zach on the update March 4… A huge Thanks!
      We just got a letter from our Anthem plan that they are no longer covering the brand at generic prices starting in May, so I was about to re-start my search for the authorized generic. We were coming up short in our search last fall when we first started having the pharmacy trying to give us an alternate generic and just had the doc switch the prescription to brand. Now, to get brand covered, will be full of hoops to jump through. So, thank you again 🙂

    7. Update 3/5. Walgreens ordered it with absolutely no hassle. They mentioned Tevia was on the shelf and I said I would like for them to start the exception process for the Patriot order as I was intolerant to anything but the Patriot. Called to confirm and my prescription should be in tomorrow. No reason for Walgreens not to fill the Patriot authorized generic for you!!

  65. My son was doing fine on the generic with Alza 36 and in the past 3-6 months the pharmacy switched to a round tablet that has TL 708 listed MFG on bottle is Act. He’s been having some really bad side effects with the tablet versus the cylinder ones he used to get and I’m just trying to figure out if this change is the problem or if it’s because he’s almost 13 and having hormonal changes? I thoroughly enjoyed your article btw. I hope you can shed some light on this for me. God bless you!

    1. Hi Laurie,

      I completely understand your two alternative explanations. In fact, that’s why I have worked so hard to educate the public on this issue.

      Because with the pharmacist and sometimes the physician tut-tutting that “generics are exactly the same” — the risk is blaming other factors. And that means not continuing to function as well as possible.

      I would say, yes, hormonal changes can make a difference in how well the medication works. But usually, it’s not so abrupt as I bet it was when trying the new rx.

      Before deciding which is the case, I’d get him back on real Concerta.

      good luck!
      g

  66. I’m just frustrated. We never had to meet a deductible on pharmacy before, so it was $30/month based on a 20% copay for generic (whatever brand CVS was carrying at the time). The Concerta prescription I picked up this week was $215 (30 days) and will continue at that price until we meet a $3400 family combined medical/pharmacy deductible. Only then will the 25% copay for name brands kick in ($53.75). Not seeing how that is “paying the same as the generic”. Even once we meet the deductible, that’s still almost 2x what the deductible cost before. If someone who is also fighting the CVS Caremark change finds a way to get the Concerta billed at the generic copay, I would love to know how.

    1. Hi DS,

      I share in your frustration.

      I always avoid those high-deductible policies, precisely because they often don’t cover Rx. I think they are designed more for people who don’t take Rx.

      Or maybe yours would cover regular genetics more cheaply.

      There are so many variations on health insurance — selections made by the employer and then selections made by the consumer to fit their needs.

      And things constantly change.

      I hope it improves for you. Meanwhile, just think about the cost to your child’s life if he didn’t have access to an Rx that works well for him.

      best,
      g

    2. I completely get your frustration, and commented a few weeks ago on being in the same boat as you. In our case it was only $5 each month for generic Concerta until this change happened. Thanks for CVS Caremark for screwing those us stuck with plans that require deductibles for name brand prescriptions. Normally our prescription coverage is awesome.

      My son’s now switched to (generic) Ritalin LA because of this. We’re still assessing what we think of it.

    3. Heather — if you’re trying alternate methylphenidate products, you might want to check out some of the newer ones. They typically have savings cards.

      e.g. Quillivant XR, Aptensio XR, QuilliChew ER, Cotempla XR-ODT

      good luck!
      g

  67. I will chime in as far as giving a field report. My son has been taking generic Methylphenidate ER for years. We have CVS Caremark coverage and received the dreaded letter in December. I’ll be honest that I didn’t really pay close enough attention to verify that it said anything regarding price not changing. Under our previous coverage, a 90 supply cost on average $90 (slight fluctuations occurred from time to time based on what CVS paid for the meds… we have a percentage based copay). When filling my son’s prescription this week I was faced with the “only name brand Concerta” and a rather harsh reality that we now have a substantial deductible before I am able to get the copay rate on the Concerta (which will be about $150 for 90 days… close, but not exactly the same). In the meantime, we are looking at an increase of approximately 700% while having to pay the full contracted amount. Ouch! Considering that literally everything else that we get filled for our family has copays of less than $20 for a 90 supply, this smacks of some sort of conspiracy. No joke, the day before filling the Concerta, I had picked up *2* prescriptions for myself for a total of $12 for both (and that was 90 days for each). About the only up side to our situation is that my son does report that the new prescription (both a dosage increase and branded) seems to make a significant difference for him.

    1. Hi DS

      When you say your son was taking “generic” Methylphenidate, I assume you mean the authorized generic (the brand marketed as a generic).

      It sounds like you will be getting the generic price on Concerta after you meet your deductible? That’s a good deal.

      There is no conspiracy. Concerta uses expensive proprietary technology.

      It’s Big Generic that has “conspired” to flood the Concerta market with cheap and ineffective knock-offs.

      The generics use the cheapest most basic pills, etc. Then they exploit FDA guidelines.

      If your son feels a “significant difference,” that seems like a big upside to me.

      Hang in there
      g

  68. I figured I’d chime in. I’ve had the circular generic for the last year when I got a letter stating it would no longer be covered (didn’t specify about brand being the same price). My doc sent in a new prescription to CVS (CVS caremark/BCBS) anyways so I figured I’d try it. to my disbelief, it rang up for the same price I always paid. Bottle is labeled “concerta ER” mfg is “Janssen” but it’s the brand pill pictured with “Alza 36” written on it. I’m not quite sure what’s going on but I’m not complaining. I’m currently at work and would be crashing right about now with the generic. It’s also a much more “calming” feeling where the generic felt a bit more like vyvanse and that made me irritable.

    1. Hi DF,

      Thanks for that field report. Lucky you!

      You have the brand at a generic price — without it being the difficult-to-get authorized generic.

      Pretty much a dream situation.

      I’m glad it’s working better for you.

      g

  69. I wish I could report the same info as FNP. Every pharmacy in our town only carries the circular generic now, currently have Alvogen (Round White AL). We have noticed a definite deference from the Patriot/Alza generic. My daughter can even feel the difference, says she feels like she never took her pill. My only choice to get the OROS tech again is to buy brand. I did file a report to the FDA from your link. Have you heard anything new about being able to get a true authorized generic? I;m really glad I found this site. I couldn’t figure out what was going on with the sudden change until I read all your information. Thanks for your help!

    1. Hi KP,

      I’m glad you found my blog, too. Thanks for filing the MedWatch complaint.

      I can’t imagine that we’ll get the critical mass we did last time (when the FDA downgraded the two inferior generics) — because now there are NINE.

      The outgoing FDA Chief, appointed in 2017, gave many gifts to Big Generic — and much damage has been done.

      I do hear that Patriot is still making available the authorized generic. You might try calling them.

      But, honestly, it’s so variable, depending on your type of insurance coverage, it’s hard to find any blanket statements. About anything.

      Best of luck,
      Gina

  70. I was nervous, but picked up Rx from local Walgreens. No longer reads Patriot; instead Janssen. Still has ALZA on tablet with a different NDC#. I still paid the same Rx copay, but the Retail $ listed is more than doubled; more than $1000!

    1. Hi FNP,

      You have the brand Concerta.

      All NDC #s are specific to the company and dosage.

      So, the NDC # for the Concerta brand and the Patriot authorized generic will differ—even though the Patriot is simply re-labeled brand.

      Even 18 mg, 36 mg, and 54 mg within the brand have different NDC#s.
      g

  71. Update: Was able to fill Brand Name Concerta for generic pricing. Caremark CVS insurance using Abbie Pharmacy (Smaller chain) with my DR writing D.A.W as mentioned somewhere in your blog, I think. lol.. Live in Rosevile, MI

  72. Suzanne K Tyler Stock

    Just letting you know I had success at Costco. I live in Durham, NC. I was using Kroger pharmacy but our Krogers all closed and reopened as Harris Teeters. For a few months everything went fine. In mid December, 2019, I was told that Harris Teeter could no longer get the authorized generic. I called Express Scripts, who my insurance prefers we use. I talked to a pharmacist on the phone and she searched but could not get the authorized generic, either. Next I tried Costco pharmacy. When I called I was told that the one distributed by Patriot was all they had, but when I got that scrip filled the next day, it was 3 pills of alza and the rest something else, so took the 3 (I was already a week behind without my medication during the holiday crazies) and refused the rest. In a few days they had the right medication and I got the rest. Early January I had my 3 month doctor’s appointment and took your suggestions with me. The doctor wrote the script with the NDC number on it. I filled it at Costco with no problems and got the correct authorized generic. Thanks for your help.

  73. Just wanted to add my data point.

    I also have CVS/Caremark through GEHA in Texas. The online pricing tool showed our generic price for the brand and no generics being available similar to others.

    Had my doctor’s visit today and asked to be swapped back to, specifically, Concerta. Not long after I left, I got a call from my pharmacy at Sam’s Club. I thought, ‘uhh oh,’ but they were calling to tell me the doctor was requesting the brand and that they’d need to order the Concerta. While I had her on the line I had her verify the price since she seemed skeptical it would be generic pricing. Luckily she said it indeed came back as my generic price. Lol I had started to get nervous.

    Anyway, I decided to share for what it’s worth.

  74. Hi- A Walgreens near me has been able to special order the authorized generic from Patriot for the last two refills. I also called the Patriot customer service line, which when it picked up referred to itself as the Jannsen customer service line. I selected whole sale retailer option instead of patient option and was able to talk to someone. I left a message for the rep who deals with these meds. It took about three weeks, but I got a call back today.

    She said that they have plenty of product available for wholesale, and all a pharmacy has to do is special order it from them. She said if a CVS or Walgreens or any pharmacy says Patriot is not longer available, that’s not accurate and to special order. She then gave me a list of some more pharmacies in my area that either have it in stock or have special ordered it recently. Most of them were Safeway. I’m in Colorado.

    Of course I don’t know how truthful any of this is, since it hasn’t been this simple so far. But that’s the message they gave me. Fingers crossed my Walgreens can keep special ordering it.

    1. Hi Brittany,

      Great scouting! Thanks for reporting your findings.

      It’s good to know that Concerta manufacturer Janssen and its authorized-generic subsidiary, Patriot Pharmaceuticals, have not made an exclusive deal with CVS Caremark. It was sure sounding like a possibility.

      And yes, we, unfortunately, might want to take a sales rep’s advice with a grain of salt. For example, perhaps CVS or Walgreen’s don’t allow special orders; if the Rx doesn’t come through their existing suppliers, that’s the end of it.

      Good to know about Safeway. Here, only a few mega-Safeways have pharmacies.

      Good luck with future attempts!
      g

  75. Thank you! As a parent and as a physician, I found this incredibly helpful!! Following your directions, I have been able to get the EXACT medication my child needs.

    One small issue came up when my child’s doctor entered “Methylphenidate ER” and the electronic system automatically entered, “Methylphenidate ER (Concerta)”.

    Just as you have said, my pharmacy explained that the prescription must NOT have the word “Concerta” on it. The doctor re-wrote the prescription WITH the NDC and WITHOUT “Concerta”.

    1. Hi Jonathan,

      Thanks for writing.

      I’m glad that the “method” worke3d for you. Many readers are reporting a new lack of access….unless they have a certain CVS Caremark plan.

      (I’ve tried to get the details, but companies currently seem to feel no need to inform the public about new marketing deals.)

      cheers,
      Gina

  76. This is for Linda: it’s Carefirst “Blue Preferred PPO” in the state of Massachusetts where they just filled Concerta 36mg today with the actual name brand at generic prices. My plan uses Caremark. I actually have the name brand in hand right now and it only cost me 10 bucks. Good luck figuring this out.

  77. Hi Gina,
    I’m glad I found your blog post. It actually did come up when I did a search because I’m concerned that my Trigen manufactured generic for Concerta isn’t working (FYI, I searched “Trigen Laboratories”). I’ve felt that it hasn’t been working well for a couple months and, to put it most delicately, recently realized that it is passing through me with only the pink coating missing. I called CVS early this afternoon to ask them for a replacement and was told by the pharmacist, “I will have to call you back after I research the side effects. I can’t do it right now because there are a lot of people waiting.” Needless to say, I have not received that call. It’s 10:30 p.m.

    It’s disheartening to read the issues that so many people are having just getting a drug that works for them. I guess I’m now joining that group. But I wanted to tell you that I appreciate the time, effort, and valuable information represented in your posts. I feel at least a little bit “armed” for the coming battle 🙂 Now I need to find your link for MedWatch…

    1. Hi Joanne,

      Thanks so much for your kind words.

      I tell you what…it’s been disheartening. For 20 years, I’ve worked so hard and plow through so many obstacles. Tirelessly. But this has gotten me down.

      No one knows how the algorithm works, exactly. But definitely, my blog’s traffic has been cut by half. It might be that “Concerta generics” is so specific a search term as to not get caught in the algorithm’s broad net.

      Definitely, self-education and self-advocacy is a must. Otherwise, the consequences are just too costly.

      Here is the FDA Medwatch complaint form: https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1

      take care,
      g

  78. I’m also in the boat of dealing with the letter that came from CVS Caremark in November about only being able to get the brand name. At first it looked like it was going to be great, and I even had a feeling it was too good to be true. I tried to fill my son’s Concerta yesterday, and after a lot of phone calls and confusion, have figured out today that we have to pay a large deductible first before our old co-pay amount kicks in. That’s the catch. So much for the “same amount” as before the letter stated.

    I may try and have my sons ADHD prescription changed completely. Are there other ADHD medicines that are going under the same process with CVS Caremark? I need to know what possibly to avoid.

    1. Hi Heather,

      Once a medication patent expires, the generics enter the market. That is the major issue.

      There are generic versions of Ritalin, Adderall, etc.

      As far as what’s happening with CVS Caremark, it’s apparently on a high-security need-to-know basis. 😉

      So much depends on one’s individual policy, the deductible, the pharmacy benefit. With so much variability, it’s impossible to make any blanket statements.

      There are other MPH medications that aren’t yet off patent. e.g. Daytrana, Jornay PM, Metadate CD, Quillivant XR, Quillichew ER, etc.

      It depends on the individual as to how well one of these works, in comparison to Concerta.

      Good luck,
      g

  79. Hello and thank you for your in-depth analysis. I never thought I would have to be an expert in big pharma supply chain management!!! (Disgusted). I’m an academic researcher so I really fell down the rabbit hole with this:)!!!

    So we had CVS, but my new insurance doesn’t have a contract with then (sigh), so we switched everything to Walgreens. As people have found out, Walgreens stopped their contract with anyone but Mylan.

    So I spent one whole day on the phone with various local pharmacies. I found one without our health care clinic (Aurora in Wisconsin). Last month they did not have a contract with anyone but Mylan, the pharmacist however could track down generics that had a pinhole in them. Apparently the pinhole allows that gastric acid to enter and release the first dose. More similar to the delivery system of Concerta.
    I sent her the link to this site, she and I were reading it together over the phone:) I was able to get 20 of the slow release technology. I called today; she had been researching on my behalf (I think she enjoyed it) some big wig must have had a good golf game because this month Aurora Health Care now has a contract with Patriot!!!!! So she’s ordering me 100 pills just in case some other suit get a better deal with someone else (eye roll). Thank you so much!! I feel empowered!

    1. Hi Johanna,

      I love empowering academic researchers—and everyone else. 🙂

      This is definitely a moving target.

      FYI — the “generic with a pinhole” is probably Trigen. It has an older, simpler osmostic release system—NOT the same as Alza’s OROS system. (But many pharmacists remain confused….or deceptive.)

      I wrote about it in 2017: https://adhdrollercoaster.org/adhd-medications/7977/

      But now it seems you have access to the authorized generic via Patriot. Let’s hear it for golf games!

      Best of new years to you!
      g

  80. I would like to thank you for this blog post. It helped confirm that I wasn’t going crazy with the different pill. As others have noted it felt like I was getting a single large dose of ritalin, which I’d then come down off of.

    I got really lucky in that when Kroger gave me the ‘new generic’ I was able to call a local pharmacy (they’re a tiny chain with three local buildings), and get the authorized generic. I spent a week fighting with insurance, but I was able to get it, and have a regularly scheduled appointment early in January. I’m certainly going to get it for the authorized generic or the name brand – and with a conversation about what to switch to if I can’t keep getting it.

    Thank you again so much for this informative blog post. I had gone off of the meds for a while when the earlier issues with the generics happened several years back so I didn’t know what I was going to be in for, and knowing that I wasn’t alone in this was so very beneficial.

    1. Hi Timothy,

      I am so grateful for your note. It means a lot to me, to know that my work has made a difference in your life.

      It’s sort of crazy that I was the only person reporting on it.

      It’s also crazy that Google’s new algorithm has cut my blog traffic in half, because I dare to write about medical issues despite not having an MD.

      Algorithms don’t know that ADHD specialists at major medical schools tell me they refer their medical students here. 🙂

      Thanks so much and have a great 2020!
      g

    1. Hi Kim,

      Maybe it’s just not the right stimulant for her?

      If she also has anxiety (not solely “cognitive anxiety” from ADHD), it might be that she needs a second medication to counteract the stimulant exacerbating the anxiety. This is quite common.

      But it might be too high a dose, wrong stimulant for her….many possibilities.

      good luck sorting it out.
      g

  81. I live in Massachusetts and just did “price out a drug” (or whatever it’s called) using the Caremark app. I have Caremark through carefirst. Before the new year, the price of brand name concerta 36mg was about 300 a month out of pocket with my insurance at nearby pharmacies. The generic grab-bag of “equivalent” medications was only 8 bucks a month. After the new year, just like magic, concerta was 8 bucks and generic not covered.

    Hooray!

    Let this serve as one Caremark data point. Concerta is now super cheap with my insurance. Generic not covered.

    I’ll let you all know if I can actually get them to fill it now.

    Thanks,
    Steven

    1. Wow, Steven, it’s like you won the lottery!

      Caremark has many different plans, hammered out with insurance companies. Unfortunately, we have one of the lousy ones. Because, no such luck for us.
      g

    2. Can you please let me know which Care First Plan You have. I called carefirst before I had to choose a new insurance company that the authorized generic would be covered under my plan. They assured me it would be. Accordingly, I believe I should be able to get Patriot, or any other authorized generic, or the brand concerta. Because I was told the above by Care First/CarMark…. I am going to try and switch insurance coverage plans if there is one that covers Brand Concerta at a lower price.

      Thanks
      Linda

    3. I hope Steven will reply, Linda.

      Meanwhile, it might be that it was true when you selected the policy but has since changed. Things seem to change quickly with these deals between pharma companies, pharmacies, and insurers.
      good luck,
      g

  82. With my new concerta working about 1/2 as well as it used to, this article is so overwhelming. I am glad to find it, as it tells me that I am not crazy when I kept thinking my meds weren’t working right. Still……….this mom needs this to get cleared up. 🙁

    1. Hi Tracy,

      I’m glad you found me!

      Google, in all its wisdom, has created an algorithm that reduces search results for sites such as mine….medical+ topics not written by an MD.

      My website traffic is down 50% because of this. Yet, I am the one doing a better job than most MDs of informing and educating the ADHD community. In fact, I pick up many of their pieces.

      Good luck sorting it.
      g

    2. Yay! My old meds came today! I am so glad I had this info to help me advocate for myself!! Thanks so much!!!

    1. Hi Steven,

      Sorry, I don’t have time to dig into this.

      One thing is clear: The Concerta patent already expired. The deal with Actavis only forestalled its entry with a generic.

      Janssen will still keep making brand Concerta. But with the patent expiration, Big Generic is free to exploit the market under the lax guidelines this White House administration has insisted remain.

      g

  83. Argh! No ALZA at either Kroger, CVS, or Target here in Georgia after having it filled correctly at Kroger last month. Used every tip and strategy recommended. No other authorized distributors in the area. Have been without medication for a week now. This appears to be a case of butting my head up against a wall. If the authorized distributors are not going to carry it the only recourse seems to be moving to another drug (FYI – standard generic tried barely worked for 8 hours, then dropped me into a post medication hole like coming off a sugar high). Anyone have a comment on using Vyvanse instead? It’s monstrously expensive but at least available.

    1. Hi Michele,

      Yes, something seems to be in the works. But unlike in recent years, businesses seem to think public announcements are not necessary.

      My suspicion is that CVS Caremark cooked up some deal with Janssen-Patriot, to exclusively distribute the authorized generic.

      Another possibility: At the year’s end, some stimulant medications are in short supply. The U.S. DEA allows only X amount of the raw materials each year. It has not kept up with the diagnosis/treatment rates, especially with adults.

      Have you checked the brand price?

      re: Vyvanse, no one can predict which class of stimulants will work best for an individual. It just depends on your neurochemistry.

      If you do best on an MPH medication (not an amphetamine, as Vyvanse is), you might want to look into the bevy of new MPH medications. They tend to have savings cards/coupons, trying to get market share.

      They include (some newer than others): Daytrana, Aptensio XR, Quillivant XR, Jornay PM, Adhansia XR, Cotempla

      g

  84. Gina, thanks for all of your work on this issue. I also received a letter from BCBS of Minnesota that indicates starting 1/1/20 they will only cover brand name Concerta. I haven’t explored this issue further, so I don’t know what will happen when we go to refill in January. Also, we live in the western suburbs of Chicago, and for now we are only able to get the Patriot version at Costco. Walgreens stopped carrying it around June, and Kroger stopped in October. I haven’t followed up with Target, CVS, or Osco since mid-summer, but none was carrying it at that time.

    1. Thanks, John!! Very useful.

      Something is shifting.

      It used to be that companies made announcements. But now, it seems on a “Need to Know” basis (and then even insufficient).

      I have tried to contact CVS Caremark corporate headquarters many times. No response.

      I’m wondering if CVS didn’t anticipate the uproar (and loss of business)—and then moved swiftly to cut a deal with Patriot or Janssen.

      g

  85. Hi Gina,

    My letter actually does not specify storefront pick up or mail. It simply says the generic will no longer be covered and the brand will be offered at the same price as the generic. I assume per the lack of details in this letter that goes for both storefront and mail. We’ve actually never used the mail service, only storefront, which is why I’m assuming it affects both for us.

    1. Ah, now the full details. Thank you, Kristin!

      Perhaps we did not get such a letter because we sprang for the brand the last few refills, rather than get stuck with the Teva inferior generic.

      g

  86. Success and failure in NJ. One wall greens that used to be able to order for me said they can no longer do that but I tried another and they were able to order both 27 and 36 mg. This is for December prescriptions. I might suggest checking more than one walgreens. The CVS in my area said they absolutely couldn’t order it and they didn’t mention anything about switching it for the generic for Concerta prescriptions.

    For people that did receive that letter what did your prescription say concert a generic or was it Concerta please advise.

    I wish I knew a good lawyer or reporter because the Teva application for their generic actually goes back almost 15 years which means they held onto it until the smoke cleared from the downgrade and then inserted it into the market that has to be an illegal activity or at least unethical. Anyone know a good reporter?

    1. My letter stated Caremark would no longer cover the generic Concerta starting at the first of the year. They will only cover brand name Concerta. I do believe this is a Caremark pharmacy coverage thing only and not an actual CVS pharmacy thing. If you do not have Caremark has your prescription coverage then this may not affect you depending on your insurance. As for reporters or lawyers, no. But I did file a report with medwatch. You can at least start there. 🙂

    2. Thanks, Kristin.

      It’s been hard for me to get a bead on the facts because terms are often used imprecisely.

      You are distinguishing CVS storefront pharmacies from CVS Caremark home-delivery pharmacy. Is that right?

      That’s been my understanding.

      It’s not happening for everyone with CVS Caremark pharmacy coverage, though. I’ve called several times and no one knows anything.

      Guess we have a cheap policy. My husband works at a startup.

      g

    3. Yes, that’s what I’ve been advising….check at different stores (e.g. Walgreen’s, Costco, Wal-Mart).

      Yes, I happen to be a good reporter. That’s why you’re learning about this here and virtually nowhere else. That’s why my readership and I got the first two inferior generics downgraded. 🙂

      1. CVS
      It’s not the CVS storefront pharmacies that have issued the letter — it’s CVS Caremark, the home-delivery pharmacy. (At least that’s my understanding from reader comments.)

      2.

      I’m afraid you are misinformed of the facts about the Teva generic.

      Teva’s generic came from its purchase of Actavis.

      Actavis tried to introduce its generic years ago. That was delayed by Actavis and Janssen entering a marketing deal — where Actavis could sell Janssen’s brand Concerta as a generic.

      That Actavis/Teva generic is why Concerta users have been able to buy brand at generic prices for so many years.

      That marketing deal ran out several times, each time re-negotiated. That stopped when Teva bought Actavis — though there might have been other reasons.

      g

  87. I wonder if it is health plan specific and STATE specific. As I wrote a couple of weeks ago, my daughter’s Blue Cross only covers the name brand (under Dad’s Blue Cross out of Illinois) while my Blue Cross (out of Idaho) which covered her previously, made me pay more for the generic (after paying the $150 deductible for January). We filled the prescription in the same place (Walgreens) in Idaho (but his company is out of Illinois), but when the insurance changed (from Mom’s to Dad’s mid year for a job change), the same bottle of pills (marked Alza) got a new label to say it was Concerta and what shows for the insurance’s portion of the bill is ASTOUNDING considering it is the same bottle of pills. It would be interesting to know WHERE Michelle’s insurance is located in or the other locations where this change is noted. Is it possible that state insurance laws drive the same company to cover prescription drugs differently?

    When renewal time happened, I read Dad’s insurance carefully and for the Blue Cross plan (still out of Illinois) only the Concerta is listed…no generic. We’ll see what the cost is in January.

    1. Hi Monica,

      Maybe it is state-specific, but I doubt it.

      It seems the first place to start is with the immense variety of health plans.

      Even within the same company, employees can choose among options that have vastly different Rx benefits

      g

  88. I just got a letter from CVS Caremark saying that starting Jan 1, we can no longer get the generic Concerta covered and will have to get the brand name. However, it says this will not cost us any more than the generic currently does. I find this hard to believe as we only pay $10 for the generic. Anyone have any more info about this? I haven’t had a chance to call yet.

    1. Hi Michelle,

      Yes, other readers have reported this. It remains a mystery to me. Perhaps CVS struck a deal with Janssen/Patriot.

      We also have CVS Caremark and I’ve not received such a letter — and when I call, no info.

      Obviously, we have the wrong health plan!

      good luck!
      g

  89. Thank you so much for keeping this page updated. I’ve been following for at least the last two years. Walgreens had been great (in Ohio, anyways) about getting the authorized generic from Patriot (I specified Patriot at the time last year when we moved here). However, I just got a letter saying that starting in 2020, Walgreens would no longer be in our pharmacy network!

    So, I tried to get the authorized generic from Kroger’s this weekend. The pharmacist tried to order the Patriot (before I came here and saw that I should specific NDC) and she said Cardinal Health ended up ignoring her request and subbed their own preferred generic brand despite her notes. Seems strange considering that Cardinal Health is on Patriot’s website as a distributor. Not sure if I should try again at Kroger with the NDC # strategy, or if I should try to go to CVS at Target and get the name brand?

    1. Hi Batya,

      I’m glad my work has been helpful to you.

      Please disregard Patriot’s website vis a vis distributors. It might be a starting point but it has not been accurate, for the most part.

      It seems your insurance policy might be cutting back on pharmacy benefits. This might also come about due to how cheap these (inferior) generics are.

      As for what to do next, hard to say. I would exhaust all options unless the brand is not very expensive for you.

      Personally, I would not give CVS any of my business (in any way) given how badly CVS Caremark (parent company) has treated its customers with ADHD.

      good luck,
      g

  90. Just thought I’d add in case anyone can help. Been following these posts for awhile and was hoping things might get better. Still can’t find the AG anywhere around here (suburban Philly area). CVS “cannot get,” nor can small local pharmacy although their pharmacist is lovely and tries to help. So frustrating!! Have not had success with home delivery.

    1. Hi Beth,

      Sorry to hear of your plight.

      Maybe your insurance plan is the problem. Maybe it has very tight cost restrictions on pharmacy benefits.

      Do you have Wegman’s there? If so, might be worth a try.

      Good luck,
      G

    2. Just to update – I was able to find authorized generic at a local pharmacy and I received a 3 month supply. I sure hope they still have it when it’s time to renew. Prior to that I had called my insurance company to begin a formulary tier 2 generic exception which may not have helped much anyway. We’ll see what happens in three months.

  91. Hi Gina,

    Kroger here unfortunately cannot order it for me anymore. Neither can Walgreens, CVS or Rite Aid. None of who I’ve talked to can or will order it with the manufacturer or NDC and I don’t know why. They give me no reason other than they can no longer get it. There is an independent pharmacy here, Whitacre’s, and they can order it for me so we’re switching to them. Hopefully they will continue to get it. Since beginning next year my insurance will no longer cover the generic and my secondary insurance is cutting their contract with Walgreens so no prescription there will be covered by them, it seems the insurance companies, pharmacies and manufacturers are in a battle!! I sure hope this ends soon, this is doing no one any favors.

    1. Ach, so frustrating, Kristin. I hope it settles down.

      The hard truth is that popular brand medications reach the end of their patents. That’s when generics can enter the market. That’s just a fact of life.

      The problem, though, is that Concerta is very difficult to approximate in a simple generic (without the OROS technology).

      The FDA chief appointed by this White House really made a mess of things. He came in from venture capital (not medicine or science), ran roughshod over FDA scientists’ concerns about generics that were not truly substitutable, ushered in hundreds of very cheaply made generics (many made in China or India to lower standards) — and then went back to venture capital.

      This was truly destabilizing to all concerned—pharmacies, insurance companies, etc.. I imagine the aftershocks will continue to ripple through.

      This mess comes directly from this administration, and that’s not a political statement. That is just fact. I hope we can correct the course soon.

      In the previous administration, we were able to lobby the FDA (via MedWatch complaints) to downgrade the first three generics for Concerta. But now there are at least NINE companies—and counting.

      g

  92. Hi Gina,
    I’m not sure why this won’t let me reply directly to the previous comment but I meant AG (authorized generic). I had authorized brand in my head. It’s been a very long day with trying to figure all of this out. These other pharmacies are not giving me any reason as to why they can’t get the authorized generic anymore and now this new pharmacy is telling me they can’t guarantee they will continue to get the authorized generic. I’d hate to have to find a new medication for my son when Concerta has worked so well for him all this time. But these other generics are garbage and it’d be absolute waste to get any of them.

    1. Hi Kristin — I think some in the industry do call it a “branded generic.” But the FDA uses “authorized generic”.

      https://www.fda.gov/drugs/abbreviated-new-drug-application-anda/fda-list-authorized-generic-drugs

      I know. It is absolutely crazy-making. I’ve been through it myself. But unfortunately, our Blue Shield plan does not include that sweet deal some are reporting.

      You read the post, right? You know that the NDC has changed, right?

      If Kroger is working for you, maybe stick with it. Then you’ll have a history. That might make a difference if they have to make a decision as to filling it or not.

      I agree. Concerta represents an amazing breakthrough. It’s a huge market. Which is why Big Generic is horning in with its cruddy approximation.

      g

  93. Super super bummed and stressed. Our local Kroger just informed me today that they can no longer get the AB. I am having to yet again switch pharmacies. If this last pharmacy stops getting the AB too then we may just have to be done with Concerta altogether and find a different medication. Insurance will not cover the brand and I can’t afford it out of pocket. 🙁

    1. Hi Kristin,

      I’m confused! Why do you want the AB generic?

      Did you ask about availability for the authorized generic?

      g

  94. Christine L. Cook

    This is additional information concerning a pharmacy in Middlesex County/New Jersey.

    WEGMANS has successfully filled my script for the Patriot Pharmaceuticals 36mg product. In fact they indicated that Patriot was their preferred supplier for that product.

    I’ve not outlined the travail involved to get this final solution, as it mirrors other’s experience.

    Gina, thank you for your doggedness, this site, and the regular communications. You are a Godsend!

    1. Thanks for noticing, Christine. 🙂 I’m happy to help.

      I’ve heard so many good things about Wegman’s! Including it carrying the AG.

      Walgreen’s, too.

      I made a point of getting my flu shot and shopping at Walgreen’s yesterday—and letting the pharmacist know why.

      Happy Thanksgiving!
      g

  95. I just remembered also that the full name brand instead of any generic had something to do with the fact that our cvs caremark insurance came from a very large fortune 500 company that was “self insured”. Meaning they were not part of any other negotiating groups and funded their insurance program themselves. This allowed them to negotiate their own payment tiers and programs with cvs seperate from their health care at UHC. I was the only person experiencing this at our local cvs and had to work with the pharmacy mgr to get it clarified. I wonder if this is the same with rhose of you who got the letter?

    1. Hi Kathy,

      Another reader has pointed me to a recent announcement. I will be following up tomorrow — to decipher it.

      Prices, formularies, Tier 1-2 medications are really all over the map when it comes to insurance plans. No cookie cutter info applies.

      g

  96. CVS Caremark (the home-delivery pharmacy) sent me a letter stating that only brand name would be covered and any generic would be denied in the Calendar year of 2020. Maybe I am interpreting that wrong but I would think any generic, including authorized generic, would not be covered. I’ve been using the generic for the last few months as I was getting the run-around on the patriot ones but happy to be back on ALZA 36. Best wishes to you and anyone else on the roller coaster.

    1. Ah! Thanks, Scott. Now I’m understanding.

      As another reader just pointed out, there was a recent press release about this.

      It’s a big change from just three weeks ago, when I spoke with CVS-Caremark Corporate.

      Sorry to misunderstand.

      g

  97. Hi Gina,

    CVS Caremark will not cover Trigen or any Authorized generic in 2020 per a letter I received a few days back. So anyone that likes the authentic original and has Caremark CVS will get the original but at a higher copay for some with deductibles. There are deals being negotiated with CVS Caremark and the original maker of Concerta to use brand name only. And anyone that has adjusted to any generic will no longer be able to get it unless they pay 100%. And I can still fill it at Walgreens or my other local abbeys pharmacy. Hope that clears up any confusion.

    1. Hi Lisa,

      But are you sure the letter says that — that you will get the brand Concerta at the generic cost?

      I cannot imagine that is the case. But I will check tomorrow.

      g

    2. Lisa,
      Info I found online which supports and explains info contained in letters you guys are receiving.
      “CVS expands brand-over-generic
      CVS will implement a Tier 1 approach to deliver lowest net cost. This move will allow coverage of a brand drug on the first tier if the brand is the lowest-net-cost option. The brand will process with a generic copay, and the generic will be excluded from coverage. Adderall XR, Concerta and Advair will be the first three drugs in this new program.

      All patients utilizing those medications will be transitioned to the brand-name drugs at the beginning of the year. While members will benefit from the Tier 1 copay, it is unclear if plan designs for all plan sponsors can support generic copays for brand-name drugs. In addition, with the longevity of the program unknown, there is a risk of member disruption if, and when, covering the brands no longer makes financial sense.”
      This is unfortunate for me however as my PBM for 2020 will no longer be Caremark:(
      Jess

    3. Thank you, Jess!

      This is indeed new information. I spoke to CVS Caremark management only 3 weeks ago.

      Now, I have no idea what it means. The language is imprecise. I will try to decipher tomorrow.

      It seems to say, from the way I read it, that if there is not a cheaper option available, brand will be delivered at a generic price.

      For example, there is no generic for Vyvanse, so maybe that would be cheaper.

      But there are MANY cheaper generics for Concerta.

      Thanks so much,

      Gina

  98. Hi Kristen,

    Yes, the folks with deductibles, let alone high ones, will suffer greatly, eating those costs before their insurance will start picking it up. When I first got the Caremark CVS letter I assumed it wasn’t covering Concerta at all anymore! I read deeper and found they would cover it but only the authentic name brand (original company with the original patent)! Then read some blogs and found out that the company must be cutting side deals to get business back but at the cost of folks deductibles. Total shame! Then what about those folks that are used to the generic and happy with it?!? They’ll be forced with the original ALZA 36, possibly experiencing opposite of what we reported years ago on this blog.

  99. Hi Scott,

    Ive talked with CVS and felt as you did, it’s all ironic after all the struggles. I was told in 2020, Concerta Brand is all that will be covered. Other generics authorized/or not, would not.

  100. Hi Lisa,

    I got the same letter from CVS Caremark indicating I must use Concerta name brand in the new year of 2020 otherwise I would foot the entire bill. Been fighting for the real deal so long this is so darn ironic.

    1. Hi Scott,

      Yes, CVS Caremark (by that I mean, the home-delivery pharmacy) carries ONE Concerta generic, and it’s NOT the authorized generic.

      You’ll have to go to a storefront CVS for that (and not all will oblige) or another pharmacy.
      Good luck,

      G

    2. I also received the same letter. Doesn’t help me any because my insurance doesn’t cover any of the cost until my deductible is met so it’s cheaper for me to get the authorized generic and just pay it all out of pocket still.

    3. Hi Gina,

      I actually do not go through CVS for my son’s prescription. I get the authorized generic from Kroger. Per my insurance I am not required to use CVS for any prescriptions, that is just who our insurance has partnered with for the prescription plan. We would get reduced rates going through CVS, but we aren’t required to use them as long as the pharmacy we choose is in network. Prescriptions filled elsewhere are still accepted and covered..if my deductible is paid in full. Right now it would cost me less money for the whole coming year to pay out of pocket for the authorized generic than it would be to pay off my deductible to have the brand covered and still having to pay 20% of that cost. So this change doesn’t really help me because it’s never helped cover any of the cost for two years because of my deductible status. Unfortunate.

    4. Ahhhhh I see. Unfortunately we cannot get mail delivery for his prescription anyways either. His pediatrician will not write more than 30 days at a time. I guess this whole thing does not change my situation one bit! For better or for worse. 🙁

    5. Hi Kristin,

      Your pediatrician has no reason not to write 90-days prescriptions. Unless he or she wants your child to make an office visit every month.

      But if that’s the policy, that’s the policy. Sure does make it harder on a parent, though.

      g

    6. Hi Gina,

      I think it’s actually just the pediatricians preference. Not sure if it’s because my son is only 7 right now or if he himself only likes to write it for 30 days at a time. I did have to end up signing a form stating I would not sell his medication so not sure if it’s also an office thing for his practice there. We only have to go in every 3-4 months and still he writes it for 30 days at a time…no idea. I have to submit a refill request every single month. Unfortunately our CVS stores here do not carry nor will they order the authorized generic. I’ve only been able to get it here locally at Kroger. I sure wish a prescription could be sent out of state because I’ve come to find out the authorized generic and brand are much much cheaper in some other states. Even free in Canada!! The pharmaceutical companies sure are a mess!

    7. Hi Kristen,

      First, ADHD medications are NOT free in Canada. Many types of medications are not covered, for the most part, by the Canadian health system.

      re: “selling the Rx” — I wondered if that might be the concern, but that is a concern mostly with college students, away from home and getting pestered to “share.” It should not be the case with a pediatrician. It can really add to parents’ stress.

      It’s really not an issue of state prices. It is an issue of 1) the particular pharmacy or chain, 2) the location (higher-cost area might charge more), 3) one’s insurance plan, if that is part of the equation.

      g

    8. Hmmmm…. in this support group I’m in on Facebook for parents of kids with ADHD, those who live in British Columbia are stating they pay nothing for these medications for children under the age of 18 beginning last year. Either way I am living in the totally wrong state compared to these other state prices!! I am going to ask his pediatrician if there’s a specific reason he doesn’t write 90 days scripts. Because if he can, that will save me a little bit in the long run for sure. I will stick with the authorized generic as long as it’s available!

    9. Medication coverage/cost varies by province.
      Canadians can buy insurance coverage for medications.

      Under the Canada Health Act, prescription drugs administered in Canadian hospitals are provided at no cost to the patient. Outside of the hospital setting, provincial and territorial governments are responsible for the administration of their own publicly-funded drug plans. The public drug plans determine what prescriptions drugs are listed and under what conditions for their eligible recipients.

      Most Canadians have some access to insurance coverage for prescription drugs through a patchwork of public and/or private insurance plans. The federal, provincial and territorial governments offer varying levels of coverage and decide who is covered and what the patient and plan pays.The publicly-funded drug programs generally provide drug plan coverage for those most in need, based on age, income, and medical condition. Many Canadians and their family members have drug coverage linked to employment and some Canadians may have no effective drug coverage and pay the full cost of prescription drugs.

      https://www.canada.ca/en/health-canada/services/health-care-system/pharmaceuticals/access-insurance-coverage-prescription-medicines.html

  101. I also have CVS Caremark and UHC. I did not receive that letter. But that is probably because I never got my daughter’s authorized generic through my plan. I always filled that particular script at Walgreens and used GoodRx because it was a better price than through my plan. Since this fiasco I go to an independent pharmacy in my town. They have been able to get the authorized generic and I’ve noticed they don’t put it through my insurance. They charge me $107 for a 30 count of 27 mg which is what I was paying with GoodRx. I have to call them each month to give them lead time to get it as they don’t stock a large amount. If you can find the authorized generic anywhere I suggest you give GoodRx a try and ignore CVS Caremark. I feel bad that my pharmacy might be losing money giving me this service and I worry that they won’t want to see me monthly.

    1. It really depends on your insurance plan.

      For example, with our policy, we can get the authorized generic or brand at the local CVS store for $30/month. (With GoodRX, we’d pay $92, ($62 more) at CVS.

      I opted for brand via home delivery for $100/90 days. $10 more but much less hassle. Four times annually instead of 12.

    2. We have UHC and CVS/Caremark too, but luckily the way it works with our pharmacy plan is that we can get a 30-day supply filled at any participating (ie., non-CVS) pharmacy for 2 prescriptions, but then we have to get a 90-day prescription that can only be filled at CVS/Caremark otherwise the plan will not cover the cost. However, because the authorized Concerta generic is a controlled substance, you can only get 30-day prescriptions here, not 90-day ones (I live in NJ, I don’t know if this is true elsewhere). As a result, we fall into a loophole where we can always get our 30-day prescription filled anywhere that is a participating pharmacy, we never eventually get forced to CVS/Caremark like we do for other long-term prescriptions. After hunting around (because Walgreens stopped carrying the authorized generic, and of course CVS doesn’t carry it), I discovered that our local Wegman’s grocery pharmacy department DOES use the authorized generic, so that’s where we get it now.

      Like you said, it all depends upon your insurance plan. I guess we are lucky, both in the plan and that Wegman’s uses the authorized generic. I am very grateful for that.

    3. HI Patrick,

      Wegman’s and Walgreen’s have been reliably helpful with the authorized generic.

      I’m not sure what you mean about New Jersey laws. You mean that you cannot get a 90-day prescription at the storefront pharmacy? Or that you cannot get the home-delivery. As far as I’ve been able to determine, there are no state restrictions on that. Last I checked, anyway: