Authorized Generic Concerta Update

Generic Concerta update

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

As the first to cover this issue, from the beginning, I will be clear: It’s a rapidly changing story. What was true yesterday might not be true tomorrow.  These cheap (in price and content) generics have pharmacies and insurance companies scrambling.

Briefly, the new  2017 White House administration named a a new FDA chief, Scott Gottlieb, a fellow at the American Enterprise Institute. He over-rode FDA scientists’ concerns about bioequivalence. That is, do they work as well as the brand? Next thing we know: a clown car of non-bioequivalent Concerta generics.   Pharmacies and insurance companies have no doubt been scrambling to adapt to this enormous and unexpected change.

This came as a huge disappointment to Concerta users but also to me and others, who worked hard to lobby the FDA to downgrade the first two inferior generics — successfully. We thought that war was over.

Adding to the complexity: Much depends on your particular insurance pharmacy benefit. Some people seem unaware that different policies from, for example, Blue Shield, have different benefits.

Much also depends on your willingness to self-advocate.

Please note:   For 20 years, I’ve accepted no pharmaceutical funding or support of any type, and that includes from the makers/sellers of Concerta!  That makes me one of the very few ADHD “names” online who has rejected this type of funding. It’s called a conflict of interest.

Current Summary:

Several years ago, many Concerta users became accustomed to receiving the authorized generic (the brand marketed at a generic, at generic pricing) through a company called Actavis.  That is no more.

That marketing agreement expired. Then, Actavis was purchased by Teva.  And, the company released its own Concerta generic.

Shortly after, Concerta manufacturer Janssen made the authorized generic available through a subsidiary, Patriot Pharmaceuticals. For more than a year, Concerta users were able to ask their pharmacy to order the Patriot authorized generic via an “exception process” (explained below). A few drugstores reliably honored the request. Now, fewer do.

I suspect it’s because the clown car of Concerta generics keeps expanding. The Concerta market is now flooded with these very cheap-to-make generics.

For the most part, these generics resemble generics of Ritalin or Ritalin LA —and perhaps cost pennies to make, in China or India. By contrast, brand Concerta uses a proprietary technology, OROS™, from a company called Alza.  This makes Concerta a very sophisticated delivery system.  The medication (methylphenidate) is released at a steady rate. With the generics, it tends to be uneven, in jumps, starts, and stalls—with a fast drop-off.

Your Options Now:

1. Try to get the authorized generic (from Patriot Pharmaceuticals) from your local or mail-order pharmacy.

This involves your prescribers cooperation in specifying using the information near the end of this post. Look for this subhead: **This is it!!!  How to Specify the Authorized Generic Concerta**

Tips:

  • Do not ask the store if it carries the authorized generic. Keeping a medication in stock and ordering it are two very different things.
  • If the pharmacy says it cannot fill your prescription, ask that an Exception Process be ordered for you.
  • Still trouble?  Call Patriot at 215-325-7676 

Please know that this process worked for about a year. It is getting harder and harder to find success that way.

2. Check out the new Concerta savings card

Check the terms at the link.  It works with your insurance.  Does not apply in MA or CA.

3. Try another stimulant option

Background Information:

If you remain confused about generic vs. authorized generic and the historical changes, you might find the following information useful. Also, at the end are details on trying to procure the Patriot Pharmaceuticals authorized generic for Concerta.

Would you like to support my work —at no cost to you? 

Simply  begin your Amazon shopping expeditions in the box to right. Just bookmark it as “Amazon” and a small portion of your purchases will help to defray my costs. Thank you!

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 (check out new savings program at Concerta’s website). Or, one of the other methylphenidate medications  (Ritalin, Daytrana, Aptensio XR, Metadate CD, Methylin, Quillivant XR, Jornay PM, Adhansia XR, Cotempla, etc.)
  8. Know to always look before you pay!  Readers report not realizing they have one of the clown-car generics—despite the prescription specifying the Patriot authorized-generic—until they get home.
  9. Please….If you participate in an ADHD-related forum or another type of group,  share the link to this blog post.  I’m seeing  sites repeat tidbits from this post but out of context and without updates—and therefore unhelpful and also violating copyright.

First, some background and context.

 

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

Gina Pera authorized generic Concerta how-to

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 [Note: there are even more now, in 2021]:

  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 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.

Patriot Pharmaceuticals — The New Distributor

In fact, Patriot Pharmaceuticals is a subsidiary of Concerta maker Janssen.  It sells only authorized generics for Janssen brand drugs.

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

**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.

How long will this remain useful?  It’s anybody’s guess.

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.

 

 

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.

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!

Home delivery pharmacies typically have bigger inventory. NO, it’s not illegal to ship Schedule II substances, including stimulant medications.  For more info, check this link.

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 at least 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! (But don’t count on them believing you.)

Please Consider Filing an FDA MedWatch Complaint

To be frank, I cannot see any hope of reversing this horribly decision by FDA Chief Gottlieb (he left after about 17 months, back to the Heritage Foundation).  We are stuck.

Still, it’s worth putting it on record. As I mentioned, the FDA was incredibly responsive to our complaints about the first two Concerta generics, but that was a different White House administration.

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.

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Simply  begin your Amazon shopping expeditions in the box to the right. Just bookmark it as “Amazon” and a small portion of your purchases will help to defray my costs. Thank you!
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842 thoughts on “Authorized Generic Concerta Update”

  1. Walgreens just called me and said the request for Patriot got kicked back. Don’t know if it’s because they aren’t allowed to order it anymore or if it’s not available, but could be at some unknown future date. School starts Monday. My son runs out of meds then. And if he can’t get his filled, I can’t get mine. So grateful for the NDC’s here! Then all the pharmacies can more quickly tell me they can’t order it. Grrrr!!!! Fry’s (part of Kroger) said not only do they carry Patriot, they have it on the shelves! Even better than Walgreens!

    1. Hi Erinn,

      I imagine Walgreen’s has taken an enormous financial hit, serving its customers with the authorized-generic. Probably can’t keep it up for ever, especially the least profitable stores.

      But glad you found another source!

      g

  2. I have posted here before and continue to cross my fingers every single month when I go to the pharmacy. (My mom’s insurance will only give her 30 days at a time, although I am able to get 60 days at a time myself.) It is getting increasingly difficult to get the Patriot manufacturer as everyone here has been experiencing.

    I urge you to do what Gina says and file a complaint with the FDA. https://www.accessdata.fda.gov/scripts/medwatch/. There is a new chief of the FDA under Biden and I am hoping that decisions made by Scott Gottlieb regarding generic ratings will be reversed if enough attention is brought to the issue.

    For those of you who live in Massachusetts like I do, you are ineligible for the Concerta savings card. Are there any MA (or CA) people who have had luck getting the card accepted using a mail order pharmacy in another state? My insurance uses CVS Caremark but only their “special order” medications can be used with manufacturer savings cards. Unfortunately the brand name of Concerta is not considered “special order.” However, I did call Janssen and learned about the MA law that prohibits the use of the Concerta savings program. https://www.mass.gov/info-details/mass-general-laws-c175h-ss-3#updates-
    I am working on finding out who to file a complaint with regarding this law, which prohibits savings programs when there is an AB rated generic available. When I find out, I will share it here.

    1. Thanks, Emily. Good point on the savings card. Good for you, for taking action.

      As the lead person in successfully getting the first two generics downgraded, I’m all for consumer action.

      Truthfully, though, I cannot see how the FDA can — after such a long time and with almost 2 dozen Concerta generics — reverse this. There would be all kinds of hell to pay.

      I’m willing to let somebody else lead that fight. As a non-compensated advocate, I’ve definitely done my time! 🙂

      g

  3. I just found your site today but have leaned pretty much ALL that I’ve read so far the hard way firsthand. I take 2 36mg (72mg) and only the Alza 36 works for attention. The others all work for appetite suppression and other side benefits, but only the OROS works on me for attention!

    So my pharmacist (Walmart through McKesson as a distributor) hooked me up with Patriot when it came available and I was special ordering it. But then last winter they implemented a new “system” that now prohibits special orders of controlled substances for some unknown reason. So the pharmacy’s special orders are now just systematically ignored.

    So then I go to Walgreens and after some initial resistance agree to special order the Patriot. However I work for Walmart and so my insurance has been difficult to use a non-Walmart pharmacy. In MayI paid $36 for 60 36’s. In June $46; July $60 and a note in the system for Walgreens to see saying I’m SUPPOSED to pay full price of some $600+. So now it appears there’s nothing but artificial barriers on all directions to getting Patriot!

    Talked to my Dr, who has said that “only osmotics work” (not mentioning OROS specifically), so he’s at least amenable to my requests. But he suggested going to a fairly new single 72mg osmotic; a big blue round tablet. I’ve taken it for a week… seems a no-go; appetite suppression: yes; attention: seems a no!

    So like all the rest, I’m just looking for a way to get the 2 36mg “Alza 36” tablet I need a day just to do my job effectively and live life normally (not “shut down”; I’m “primarily inattentive”).

    I look forward to digesting your info if I can get my focus to hold long enough! 😉 Cheers and thanks for what you’re doing!

    1. Hey Darren,

      You’re doing fine as far as being on top of it!

      This is a complex phenomenon, and it boggles the minds of some — especially when they’re taking a Rx that doesn’t work for them. What a double-bind mess!

      Did you see the Concerta savings program? It’s not valid in MA or CA, but if you don’t live in either of those two states, it might be an option?

      https://Concerta.net

      good luck!

      g

  4. Gina – Thank you so much for this post, it has been so incredibly helpful.

    Like others, I’ve been stuck with the Trigen (Osmotica) and Camber (Ascent) generics and felt terrible in comparison to the Patriot product. I called 16+ pharmacies in the St. Louis area and all of them told me they’re no longer contracted with Patriot, so I wouldn’t even be able to go through any form of exception process to order it (shame on you Costco for having the ability to order authorized generics specifically highlighted on your webpage but then refuse to do it). I called a Patriot representative as noted on this page and she was so kind & provided the names of pharmacies that have ordered in the last month in the STL area (which was not very many). Thankfully she said Express Scripts can process these requests – as long as you request it specifically! Luckily they are my pharmacy benefit manager so fingers crossed this process works. She stated she anticipates it becoming more and more difficult to find Patriot Concerta in the upcoming future as many contracts between wholesalers/pharmacies were just carried out and Patriot is no longer a preferred brand anywhere with all of the other generics flooding the market. Good luck to everyone in the same position!

    1. Hi Claire,

      Thanks for the field report.

      Did you check out the savings program? https://Concerta.net

      It’s a real shame. And really a disgrace.

      In these pharmacies’ defense, I’m sure ordering patriot is a big money loser. Patriot/Janssen just can’t compete with this bevvy of cheapo inferior generics on the price point.

      good luck,
      g

    2. Claire,

      If you haven’t called a CVS pharmacy, I would recommend you do that or try a local pharmacy. The CVS nearest where I live will order the Patriot generic, while Walgreens and Walmart will not. This means I have to have health insurance next year (luckily my health insurance from last year rolled over to this year and I’m covered despite not signing up for health insurance through my employer back in December). I have to insist I get the Patriot Pharmaceuticals generic every time I call my psychiatrist.

    3. Claire- will your insurance cover the Brand if your Dr requests it? If this is an option for you with your insurance, the Concerta coupon program from the manufacturer pays $150 of what your insurance doesn’t cover. If your copay on brand is less than $150, you pay $4. Just putting it out there in case you missed the posts where Gina mentioned it.

    4. I just called the Costco in Tukwila, Washington, and they said they keep the Patriot brand in stock routinely as their preferred generic. So maybe it varies by Costco location? I have not actually filled a prescription there, but that was what they said on the phone for what it’s worth. Good luck to everyone (and let’s never again make the mistake this country made in 2016).

    5. Thanks, Pam — and Tukwila Costco!

      Best I can figure, it’s regional. But also sub-regional sometimes, depending on store customer base maybe?

      g

  5. Wanted to share my story in case it helps anyone.
    1. I actually started on Camber generic way back when, before I knew anything about generics. It worked decent for me.
    2. I moved and ended up getting the authorized generic from the local grocery chain’s pharmacy (Hannaford – they’re lovely). I ended up having to increase the dosage, because the AG seems to dispense more smoothly and/or over a longer time frame for me. (At the time, I did not know that it was because of the different brand of generic.)
    3. Now, I’ve moved again and chose Costco because they claimed to have an authorized generic program, listing Patriot specifically in their documentation. I was aware of this post, yet was really thrown off because they filled Camber instead (it looks so similar). They say they are absolutely unable to order Patriot.
    4. I’ve now called a half dozen other pharmacies in the KC, MO area (including Walgreens) and everyone has said something to the effect of “we cannot order anything other than our preferred brand of generics.” Given other posters, I think some of that might be bull$*!#, but things change.
    5. I’m going to call Patriot and see if they identify an actual distributor or help me figure out an exception process, I’ll check in if I can figure anything out.

    Side note on compromise/relative effects: I might end up just accepting the Camber, since I’m only here for a few months – but if so, I will be getting it at a lower dose than the AG. I’ve now (accidentally) tried Camber, Trigen, and Patriot generics. Trigen was horrible and I submitted a medwatch report for it, but Camber is… fine. The AG (for me) was a very smooth experience, while I can feel Camber “kicking in” and “wearing off”, but otherwise it is not the worst.

    1. Thanks, Zane, for that report.

      In the pharmacies’ defense, this slew of non-bioequivalent generics knocked everyone for a loop.

      Walgreen’s couldn’t keep taking the hit forever, I imagine, and well-served the ADHD community for a long time.

      The brand now has a savings program.

      Things change.

      At least the Camber worked okay for you. I won’t give that company any credit, given that it obviously sought to deceived customers that a produced that superficially looked like Concerta, was.

      g

    2. My local Harris Teeter, a Kroger company, carries Patriot. Perhaps you have a local Kroger store (City Market, Harris Teeter, King Soopers + others) where you live that would carry it.

  6. Thanks so much for this. I was about ready to quit Concerta and then found your article. Switching to Patriot made a big difference for my daughter. For the St. Louis area I’ve had success with Mercy pharmacies filling the prescription.

  7. Hi,
    I am experiencing a reverse “issue”. Im on a new insurance that will only allow me to have the brand name version of concerta. I have previously been taking the Camber generic. I take my first dose tomorrow and am having a hard time finding information on how exactly the two differ. Do you have any information on this?
    I am nervous about taking my first dose of the brand name, fearing that it is going to hit more intensely in a way that is more harmful than helpful.

    1. Hi A,

      It’s impossible to predict how you will do on the brand Concerta.

      You might do better. You might do worse. It all depends on your neurochemistry.

      The medication is the same — methylphenidate. The difference comes with the delivery system — how fast, how much is released into the blood stream, how quickly and at what rate does it wear off, etc.?

      The only way to know is to try.

      good luck,
      g

    2. I have switched from the Brand to the Camber generic and do not notice a difference. Hopefully you won’t either. If anything I would think the Brand would be “smoother” because of it’s delivery design.

      When you put the Brand in a glass of water, the medication squirts out one end of the plastic capsule as if squeezing toothpaste out of the tube. It squirts out slowly over time.

      When I get my next refill of the Camber, I’ll drop one in a glass of water and we can see if it delivers the medication in the same fashion. I’ll post a picture here.

    3. Hi Tom,

      That’s great, you don’t notice a difference. But in either case, is it working? 😉

      Concerta’s OROS is very sophisticated. It’s not just that it “squirts out slowly over time.” It does so at a steadily ascending and descending rate.

      Camber lacks the mechanism to do that.

      g

  8. Thank you for telling me what to look for with the Concerta generic. My insurance company quit paying for brand name Concerta at the beginning of the year. Since I have a high deductible Health plan, my cost was about $250/bottle even with the coupon from Janssen. Wanted to let your readers know that I found the Patriot Pharma generic at my local Harris Teeter pharmacy (a Kroger company). The GoodRx price for 30 was about $67 (compared to my insurance price of $150)

  9. Hi Gina,
    Can’t thank-you enough for all you’ve done on this topic, truly amazing.

    I’ve been taking Concerta for close to 20 years and now my daughter is also on it, its been a life saver in so many respects. It’s truly unbelievable how this saga with trying to obtain the authorized generic of Concerta has been unfolding. I live in south Florida and one by one, the major pharmacies have been “phasing out” and refusing to order Patriot Authorized Generic Concerta.

    In fact Costco, one of the last to join the ranks started about two months ago by refusing to accept GoodRx for Concerta, and then flat out refused to order Patriot brand Concerta, claiming that they have now committed to Camber as their supplier.

    At some point I expect something will snap and perhaps the pendulum will swing back the other way, but until then, it is near impossible to obtain Patriot brand Concerta, and if you can its obscenely expensive. I’ve taken and continue to take the good old generic instant release Methylphenidate (10mg) as an “extender” and frankly, I’m considering utilizing it 3x/day in place of Concerta, at a cost of under $20/month. And this brings me to…. my question, So much of your attention has focused on Concerta (and for good reason) but if you had to “rate” the next two or three best options in the Methylphenidate class… could you…

    For instance, I’ve noticed that just based on the little I’ve read that “theoretically” Focalin seems like it “should” be a great alternative, but I’ve seen little discussion of it. Perhaps taking 2x/day extended Ritalin? or is that also plagued with the same cluster in the generic space as Concerta. I ask because my daughter and I have to face reality and come up with a plan B to address the immediate term while fighting the long term battle to get access to the Authorized Generic of Concerta.

    Thanks-again!

    My question is,

    1. Hi Michael,

      I’m glad my work has helped you.

      One thing to understand about me: I am entirely self-supported. No pharma funding ever — and you might be surprised how much one pharma “owns” so many of the “thought leaders” on ADHD online. That company determines way too much.

      I do this as a public service, and it can be exhausting. There’s no way I can be a medication analyst. 🙂

      I focused on Concerta only because it is so popular among millions of people with ADHD. I was around when it entered the market — and it was a real game changer. The OROS delivery system is unique, and that is why the generics are so different — they don’t use it.

      In truth, we are lucky to have had the authorized-generic as long as we have. It’s an anomaly.

      But with the Trump-appointed FDA chief, rules about generic bioequivalence to novel delivery system drugs (e.g. Concerta) were a non-existent issue.

      I and others succeeded in getting the first two “cynical” generics downgraded by the FDA. But then ….. well, elections have consequences.

      There is no way this is ever going back. Once approved….and that many approved….not happening.

      Pharmacies would lose money selling the AG, and pharmacies, especially now, aren’t in the business of losing money.

      BUT, did you notice in the story that Concerta now offers a discount card?

      https://Concerta.net

      As to your question, there is really no way to make comparisons among the MPH products. It depends on the individual. It’s possible that one of them would work better for you. But I wouldn’t bet the house on it.

      The IR and the rudimentary sustained-release tend to have an up-and-down roller coaster effect. Yet, for some, it might work better.

      Human genetics…all over the map. The only way you can know is try it. But preferably on a weekend when you can be, as my mother would say, “good for nothing.” 🙂
      best,
      g

    2. For the past 9 months here in Florida, I was fortunate to get Patriot from Walmart and use GoodRx at around $68. This month they said they could no longer order it at all. I’ll see what else my doctor can prescribe for me. I’ll call Patriot again. Vyvanse is too expensive, Adhansia XR might have a coupon, Dexedrine is affordable. We’ll see…

    3. Yes there is a coupon that pays up to $150 toward the 30 day supply of Concerta which costs $370. So $220 is just more than I can afford. My deductible is $6000. So basically I pay $800 a month premium for a plan that makes me pay for all my Healthcare anyway. Thanks for the info though. Some people are benefiting from the ACA, but I don’t personally know of any.

    4. Okay, just checking. 🙂

      My understanding is that these discount programs are meant to work with insurance — to offset the brand fee, etc.

      Janssen also has a patience-assistance program, on a financial needs basis; you can take a short quiz to see if you qualify BUT one stipulation is not having insurance:

      https://www.jjpaf.org/eligibility/?medication=CONCERTA%C2%AE#step1

      Yes, those high-deductible plans seem more designed for people who aren’t sick or taking medication.

      You’ve probably penciled it out but for us, it made more sense to pay a little higher premium for a lower deductible.

      good luck
      g

  10. I’m just putting in my two cents on the Northstar generic. I got switcherooed by my long term pharmacy without knowing and got to try this generic. It was awful. Diarrhea, headaches, more emotional, it all released very quickly, etc. I tried for 10 days to make it work but had to discontinue it due to building symptoms experienced as days passed. Went back to Patriot, no side effects, worked same as last long while. I was just shocked they can say these meds are the same and so sad for people who end up with inferior generic and it ‘doesn’t work out for them’. I did report these issues to medwatch etc.

    1. Yep, Cat. It’s a farce.

      When I was researching this back when the first two generics came on the market, I called an attorney specializing in pharma.

      I asked him about the obvious false equivalency.

      He said, “Oh, Mallinckrodt had a brilliant strategy, finding the legal loophole. It was genius, really.”

      Shocked at the callousness regarding millions of lives on the line, I just blurted, “Yeah, genius, for a sociopath.”

      It’s truly evil.

      Unfortunately, elections have consequences. And we’ll be stuck with these consequences for a very long time.

      Think of how many people with ADHD will be prescribed this, have bad results, and they/their prescribers opt for non-stimulants.

      Disheartening,
      g

    2. Oh lordie. I was diagnosed just 3 months ago (29F) with ADHD-C, and today I received my 3rd month of methylphenidate ER, now at 27mg. I noticed the tabs were different (not cylindrical, now caplet shaped). It turns out the “Concerta” I’ve taken the first 2 months was manufactured by Northstar Rx, and this new month’s round is made by Actavis. So my only experience has been with Northstar, no true Concerta/authorized gen as a baseline.

      Huh. No wonder I mentioned to my PCP that I don’t feel like it’s doing a ton and I have all these other gastro issues plaguing me the last few months (constant diarrhea, which I had some before I started the med, but really rough lately). We’ve been thinking I’m developing lactose intolerance, but your and everyone’s feedback is really making me question it. Hopefully the Actavis is better; if not, I’m hoping my pharmacy will accept authorized generic request. It’s ridiculous that there can be so much inconsistency and unpredictability with these supposed bioequivalents!

    3. Hi Beekah,

      Congrats on the diagnosis! How smart of you, right off the bat, to question and then to find my blog post. Well done! 🙂

      Yes, I would not be surprised if that Northstar generic is exacerbating, if not outright causing, your GI issues.

      The “real” Concerta still might present problematic issues in that regard but the fact that it is a smoother, more sustained delivery might reduce the odds.

      I encourage you to educate your PCP on how to prescribe (you can download the PDF — see the link at the beginning of the post).

      BUT PLEASE NOTE……DO NOT ASK FOR ACTAVIS!!! THAT IS EXTREMELY OUTDATED INFORMATION — and it will only get you another Concerta generic that doesn’t work as Concerta does.

      Yes, it’s ridiculous there can be so much inconsistency.

      Elections have consequences. The Trump White House gave the greenlight to many very questionable generics. Not a political statement. Just fact.

      But notice how it works to anger people and cause them to castigate government.

      Good luck
      g

  11. Last month, I wasn’t able to get my Patriot generic from the pharmacy I use, but luckily, the pharmacy at the store that’s closest to where I live was able to order it, so I ended up getting there. I get my prescriptions from a local grocery store (it’s a regional chain in East Texas located in my hometown), and we have three locations where I live (two have pharmacies), and they were able to transfer the prescription over to the pharmacy at the store nearest where I live, and then this month I was able to use the pharmacy I normally use to get the Patriot generic.

  12. I just want to thank you so much for taking the time to write this extremely detailed and well-written post. I was just diagnosed with adult ADHD and thank God I found your post before filling my subscription, so I was able to get the authorized generic. Thank you and God bless you!

    1. Yay! And good for you, Omenka, for being a smart mental healthcare consumer!

      If you had tried one of the inferior generics, to bad affect, you might have given up on the entire class of stimulants (methylphenidate).

      The doctor might have then moved to Strattera (generally considered helpful for only 25% of people with ADHD, and many prescribers foil that by increasing the dose way too high) or the amphetamines.

      Generally speaking, people with AHDD will respond better to one class of stimulants than the other (methylphenidate and amphetamines).

      So, yes, these details are important! And, darn it, many prescribers remain absolutely clueless.

      good luck!
      g

  13. I just wanted to report that when I picked up my son’s Concerta 54 prescription at CVS on 4/27/21, they unexpectedly had filled it with the Janssen (alza) brand OROS tablet. Janssen is listed on the bottle, not Patriot. I didn’t ask why, in fact I only discovered it when I was back in my car and covered in hand sanitizer. CVS had been filling his script with Trigen for the last 13 months after my health plan switched from Express Scripts to CVS Caremark exclusively. I haven’t found any news about this on the web, i.e. if it is a change in CVS policy, or an aberration. Thought you’d like to know and wonder if others have had this experience.

    1. Hi Charles,

      Congrats and count your blessings!

      I addressed this in another comment somewhere.

      You’re not going to see any public declarations of policy from CVS or anyone else, imho.

      This is a rapidly changing issue. Janssen has obviously started fighting back against the incursion of these junk generics.

      The only way to compete is to make it more profitable for the CVSs of the world. Somehow, it has, I guess.

      I wouldn’t leave it to chance next time, though. I’d find out how your prescriber needs to specify this, exactly, and do it.

      g

    2. You might check with your insurance. Our CVS Caremark policy *requires* branded Concerta which is made by Jansen. Sounds like you ended up with the branded product. If so, check out the Jansen coupon program. It covers what insurance doesn’t up to $150 per fill. Saving me tons of money.

  14. Has anyone here moved overseas and tried to fill a Brand Name Concerta or Patriot Prescription before? I’m thinking about moving out of the US entirely. I did see Janssen has a partnership in Mexico where they plan to make Concerta accessible. Just wondering how difficult it would be to continue the medication if leaving the US healthcare system.

    1. That’s a good question, Zach. Sorry I can’t answer it.

      I would contact Janssen’s customer support line — but expect disappointment. It’s a bit beyond the standard consumer questions.

      Maybe they could put you in touch with that division.

      good luck!
      g

  15. I just want to say that the insurance companies are a big scam. Necessary, but totally full of dog poop. I was on brand concerta until generics were available. Then I was getting the authorized generic up until feb. 2020. I switched from cvs to costco and costco would only give me the patriot generic… now Im finding that my insurance wont cover the “costly” patriot generic, but will supply the BRAND CONCERTA for only $16 a month/30 pills… I’m so thankful to get the brand again, bur hecken confused why they price negotiation keeps happening.

    Anyway. Maybe some of yall will get lucky and experience this as well…

    1. My bad. Patriot is the brand manufacture. I was denied NORTHSTAR MANUFACTURED GENERICS.

      This is all so confusing to me.

    2. Hi Sara,

      Yes, it’s confusing. I try to simplify but there’s only so much I can do. 🙂

      The easiest way to think about it is this: The brand (manufactured by Janssen) and the authorized generic (manufactured by Janssen and distributed by Janssen subsidiary Patriot) are the same thing.

      The only difference is how it’s marketed.

      g

    3. Hi Sara,

      I wouldn’t say the insurance companies are a “scam.”

      You are getting brand Concerta for $16/month. People with ADHD in most every other country, including those with “great” national health systems, would envy you.

      The problem came, as I’ve written about many times in these comments, is when the Trump administration appointed an FDA chief that over-rode FDA scientists’ concerns about generics for novel-delivery systems such as Concerta’s.

      g

    4. Yr insurance won’t cover Patriot but will cover “Brand “ Concerta for $16?? What Brand or are you say a non generic Brand ? My Patriot Concerta is lighter in color, I was concerned it was changing! I went thru the Patriot hunt and YES for Costco!!
      Just saw yr update !

  16. Just wondering if anyone has tried the Camber pill, and how did it work for you. I know a gentleman “Bob” stated in December he was going to try it. It’s what we received today to use for the next 30 days!

    1. Hi Leslie,

      It really doesn’t matter how the Camber worked for others. It only matters how it works for people that did well on Concerta.

      Some people might do better on these Concerta generics than they did on the brand.

      The problem is that they don’t work as Concerta does.

      That said, I have not heard good things about Camber.

      Depends on how much you’re willing to risk go badly…..what’s on the line.

      g

    2. I had the same thing happen with Frys (Kroger)! The Lennett was on back order and I was given Camber (my husband didn’t know and picked it up) without being told. I took it 1 day and it ruined my entire day. I am going to try again this weekend and see if it was a fluke (maybe I forgot another medication the night before). This is just so sad that the pharmacy doesn’t inform you prior to pick up.

    3. Hi Jessica,

      We definitely must be pro-active.

      I’m not sure how it would work, to have the pharmacy call the customer every time a generic changed manufacturer. This happens constantly with generics. It’s just accepted practice.

      The difference is that the generics for Concerta work nothing like Concerta.

      This is the Trump administration’s fault. Not your pharmacy’s.

      g

    4. He has his check up next week and I’m thinking about trying out Vyvance for a while. He’s 11 now, and has been on Concerta since kindergarten or first grade (I can’t remember). Some generics have worked great, others have been awful. I just don’t have the time and energy to have to call 50 pharmacies every month to see who has what. I’ve asked pharmacies repeatedly if his doctor put the NDC and manufacturer will they order it. I hear the same thing at CVS, Walgreens, Walmart and now Kroger. “We get what our supplier sends us. We can’t special order”. Going brand is not an option either. My insurance won’t cover it, and being a single mom on one income, it’s just not in the budget.

    5. Hi Leslie,

      I’ve responded to you but it’s unclear to me if you have seen my responses.

      As I emphasized in the post and MANY times in these comments, it’s pointless to “call 50 pharmacies every month”.

      Did you say you wanted the prescription filled as an “exception process” — also as I indicated in the post?

      Did you call Patriot to ask for help on this…also as I indicated in the post?

      Finally, also in the post, did you see that Concerta has a savings program?

      I know this is a hassle, but so is living with untreated or otherwise poorly managed ADHD.

      Perhaps Vyvanse will work well for your son. (Have you asked your insurer how much that will cost?)

      But these medications are not interchangeable.

      COVID has already created so many stresses for schoolchildren, perhaps it’s not wise to add another uncontrolled variable?

      If you know Concerta is helpful for your son, maybe it’s better to focus on exactly what you might need to try, as I write in the post?

      Good luck,
      g

  17. So today, I asked my mom if she could pick my son’s medicine up for me. Kroger pharmacy where we had been getting Patriot was about 45 miles away. She was going into town anyway, so I didn’t have to go up after work. Anywho – my heart broke to see that we now have the Chamber “brand”. I’m praying by some miracle that it works ok for us – I can’t keep calling and chasing and running into pharmacists that just refuse to help. Even my sons pediatrician doesn’t seem to take this as seriously as I feel he should. He just says “just tell me how to write the prescription and I will”. I’m almost at the point of switching to a different medicine in hopes that it isn’t like this with others. We live in a fairly rural area – so we don’t have a plethora of options.

    1. Hi Leslie,

      I know it’s frustrating. That’s why I cover this topic.

      It seems that you have a willing prescriber. Maybe you should just do as he asks and find out exactly what the find out needs to write. In written form.

      This would involve asking the pharmacy exactly what it needs to say. Especially if it’s in an electronic form — sometimes that’s unclear to prescribers who are used to the system.

      good luck,
      g

  18. I feel like I just fell down a rabbit hole!

    I was diagnosed ADHD a little over a month ago at 34 years old. I wasn’t given much information, just asked what I wanted to try. My brother takes Concerta and so I asked to try that since we are full siblings. I was not explained anything about the delivery system. I was given a generic (Lennett) and I started it. I tried 18mg for 2 weeks (last about 4 hours) and then 2x18mg (worked a little better). I tried one day so 54mg and went back to 2x18mg. I had minimal anxiety (my brother had some as well). I went to get a new months worth and was given a different manufacturer (Camber). This is when I discovered the rabbit hole!!!( My bottle was specifically written for Concerta and I was given a generic)

    I tried 2x18mg Camber and it exploded my day. I requested a fill of the Lennett 36mg just because I knew it worked while figured this all out. I’ve been back on that for 2 days and there definitely is a difference between the 2x18mg and the 1x36mg.

    My question is… I cut open the Camber today because I saw on here is was just an illusion. It looks EXACTLY like the Alza pills. It has the hole, the layers, and the casing. I put it in a bowl of water and it does exactly what the Concerta does.

    I am beyond confused. Is that not the same? Is to a fake OROS? Is that maybe why it worked so bad because it was too much?

    I spoke to my brother because he just got back on Concerta. He sent me a picture and his is Alza. He said his anxiety is all the way down and it’s much better than the “white pill” one he had before. So I assume it would work the same for me.

    I just want to get my facts straight for when I speak to my psychiatrist.

    And had I not been given the different manufacturer and not found this page I probably would have never known any better and just went about my day feeling good with just a little anxiety not knowing it could be better.

    Thank you-
    Jessica

    1. You’re welcome, Jessica. I’m glad you found my blog — and my extended work guiding folks through this Concerta-generic mess.

      Yes, Camber was very …….clever. Looks like Alza. Isn’t Alza. As I noted in the illustration (in the post).

      What you can’t see, when you put an opened capsule in a bowl of water, is the rate at which the methylphenidate is released. And that’s what makes Concerta, Concerta. Otherwise, it’s just methylphenidate.

      These days, the delivery system is almost more important than the medication.

      As for why you received the generic, there could be lots of reasons.

      For example, your prescriber did not check the “do not substitute” box. Typically, the pharmacy will fill with generic unless stipulated otherwise. Especially if those are the terms of your pharmacy insurance benefit.

      Each of the Concerta generics are a little different. Each might work well for some people.

      The problem is, they don’t “behave” like Concerta.

      That’s why I succeeded in getting the FDA to downgrade the first three generics years ago.

      Times change, though, and so did a political administration.

      g

    2. Thank you so much. That what what I thought I was understanding, but I was greatly confused when I saw the inside.

      I will be taking a much deeper look into your website this weekend! The generic Lennett does work, but if it’s not what I was truly prescribe I feel I deserve to see if the Alza works better with the actual OROS. If not, I might as well try a different methylphenidate that’s not based on delivery system.

      Amazing work!

    3. Hi again, Jessica,

      The thing is, there are degrees of “working.”

      Ideally, new patients with ADHD should be given a few trials — different class of stimulant and different delivery system, at different doses.

      That’s how you get a better feel for what’s “working” and what’s “really working” and what’s “NOT working.”

      To be clear: The delivery system is central to how any stimulant works. Some are more complex than others.

      Some release more at the beginning, some more toward the end (with a big drop-off), some release at a steadily ascending rate — some at a steadily descending rate.

      For example, Vyvanse is Dexedrine — in a complex delivery system.

      Neurochemistry differs greatly among the individuals who have ADHD, so there’s not just one fit.

      If you can afford it, it probably is a good idea to try the brand Concerta (or, if it’s more affordable, as I write about in this post, the authorized-generic).

      good luck!
      g

  19. So last year, I had so many issues getting the Patriot ordered when my insurance took Walgreens out of our network. CVS and Kroger tried to order it with a “dispense as written” and even included NDC codes for the Patriot. However, their distributor (Cardinal Health) would regularly substitute some other generic in the shipment delivered to the pharmacy the next day. My Kroger pharmacist would call constantly and try to get the Patriot and it was always inconsistent and I ended up driving to different Kroger locations to fill my kid’s prescription.
    Until one day, there was a tech working who told the Kroger pharmacist that she had to select a “no substitutions” button WITHIN the electronic ordering system in their computer, and that calling will not work. Fingers crossed, but we have had no issues so far for the last few months. She did mention to me last month that she was relieved we went up in dosage bc they were having trouble ordering the 36mg, but there was plenty of the 54mg.
    Passing along all this info bc this website has been so helpful to me ever since I got onto this roller coaster ride in 2017. Thank you!

    1. Hi there,

      All it takes is one person getting the details right!

      When I read “dispense as written,” I thought that might be the problem.

      There are so many permutations on what exactly will do the trick.

      “Order as an exception process” is one.

      In some cases, “no substitutions” means only “brand, no generics.”

      It’s great to have a problem-solving tech on your team! Kudos!

      g

    2. That is so odd. My Walgreens pharmacist says he has trouble getting the 54 mg tablets! He gets plenty of 27 and 36 mg but only gets the 54 mg every 3 or 4 times he orders it! I was thinking of calling my insurance and asking if they’ll cover 2 27 mg/day but I’m not optimistic it would work and the medication dispersal would probably feel different and that’s the whole reason for getting Patriot in the first place!

    3. Hi Emily,

      It’s possible that the two 27mg pills would work just as well — and even give you a little more flexibility in timing.

      You probably know that Concerta pills have an outer coating that starts releasing immediately, while the medication within the pill is released over time.

      From what I’ve read of the manufacturer information, there would be no difference in that coating between 1 54mg pill and 2 27-mg pills.

      The response to the two 27mg concerta taken at the same time and the 54mg concerta would be identical: https://www.janssenmd.com/pdf/concerta/concerta_pi.pdf

      It might be worth a try. If your pharmacy benefit will cover two pills daily.

      good luck!
      g

  20. Hi Gina,

    I have been buying the brand name Concerta from Walgreens. But this month they have taken so long to refill my script. It’s taken a week! And of course, I am out of my medication. Called them last night and said it would be in after 2pm.
    Have you heard of any others having to wait this long for a refill? I wish they knew what they put people through because of the wait time.
    I have a 6 year old at home learning remotely. And it’s definitely not helpful for me.
    Laura

    1. Hi Laura,

      It’s definitely beyond-the-call….what adults with ADHD must go through monthly jumping through all the Schedule II hoops. Just punitive.

      It makes it hard for everyone, patients and pharmacies, to have such a tight window. Walgreen’s has been such a hero throughout the Concerta authorized-generic mess, too.

      This is why I recommend, when at all possible, looking into any home-delivery pharmacy benefit. Why go through this torture monthly, with all the logistics, when you can do it maybe 4 times a year?

      https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/

      I’ve heard that some pharmacy benefits now cover a 60- or 90-day supply at the store, though. Might be worth checking into if you haven’t already.

      good luck
      g

  21. Hi Gina
    I can’t thank you enough for all of the work you have put into this. It has been extremely helpful. I want to report that none of the pharmacies I have been using in the LA area will provide the Patriot authorized generic. I had been able to get it at Rite Aid, but they no longer have it. I have repeatedly asked pharmacy managers if they will submit an exception request as you have suggested, but they either look at me with blank stares or simply say that they get what they get from their suppliers, and they can’t change it.

    I called Patriot and spoke to a woman named Pat who was terrifically helpful. She spoke to the Rite Aid hdq and asked for permission for the pharmacy manager at the store near me to submit a request for authorization. That request was submitted and approved, and today….I picked up the Patriot generic. Pat was terrific in following through on this, and I expressed my sincere gratitude to her and the local pharmacist for their effort. I certainly want to thank you as well.

    – Steve

  22. I can’t thank you enough for this post AND ALL the updates! My son is 24 finally has a job with benefits, but is losing his mind trying to navigate the cost of this one drug he needs. Now even this patriot generic is costing him over $100/month. He cries sometimes when he thinks about having to deal with the soaring cost of this for the rest of his life. I swear, sometimes it’s enough to make an American seriously consider moving to England, Canada, Finland… anywhere else where humanity outweighs corporate greed! Thank you for all of your research and activism on this!

    1. Hi BJ,

      I’m so glad my work has been helpful to your son.

      I’m not sure why you’d want to move to England, Canada, Finland…. it’s much WORSE there for people with ADHD, including with the choice of medications.

      Single-payer NHS countries, in particular, such as the UK, absolutely fail adults with ADHD. They must wait YEARS for an evaluation, if they can get one at all.

      Then they risk being diagnosed with much more “acceptable” conditions.

      Their choices of medications are extremely limited. For years, Australians in the NHS could only get Dexedrine! Only within the last few weeks has Vyvanse been introduced, but who knows how accessible it will be. And it’s still a huge uphill climb to get an evaluation as an adult.

      For a long time, no adult could even be evaluated for ADHD who wasn’t diagnosed as a child. Nice little closed loop there.

      No other country has the access to care and the choices of medications that the U.S. has. Elsewhere, it’s the government bean counters who decide what is acceptable.

      So, before folks believe this slogan that single-payer is the answer, I encourage everyone to learn more about the situation. I’ve received e-mail from desperate people, for years, stuck in these NHS nightmares.

      Patented medications expire. Concerta’s patent expired years ago, but manufacturer Janssen was able to forestall the first generic by making a deal with its manufacturer.

      That’s how we got it for years at a generic price.

      But then, we allowed demagogues to spoil the 2016 election, believing their slogans instead of examining the facts about healthcare policy. As a result, the man who took the White House appointed a Heritage Foundation fellow as the FDA chief.

      He overrode FDA scientist concerns about bioequivalency with novel-delivery system drugs. And that’s when we got a slew of inferior Concerta generics. With not a thing we could do about it.

      Under the previous administration, we successfully lobbied the FDA to downgrade the first few inferior generics. I opened the case and was helped by a very concerned FDA staffer.

      Then we threw away our country.

      Sorry to be “political” but actions have consequences. When we act on bad information — even with the best of intentions — we create a world of hurt for many innocent people.

      Just as people who don’t “believe” in ADHD believe they are being kind in not wanting to “label” people. 🙂

      take care,
      g

  23. Gina,

    I had my local pharmacy filling the Patriot Pharmaceuticals generic because my insurance would no longer cover the brand name and one day last year I came home with a generic from Northstar RX and I noticed a difference immediately. I’m still using that pharmacy, but I now have to insist when I call my medication in that I get the Patriot. All other generics of Concerta need to be yanked off the shelves and done so immediately. The Patriot Pharmaceuticals generic is the only one that should be allowed. After I had used the Northstar RX generic, I called in my prescription and asked for brand name Concerta, thinking my insurance would cover it. Nope. However, the pharmacy I use has the Patriot, and I’ve been back on it ever since.

    1. Shew! That’s great that the pharmacy is meeting your needs.

      After all the work we put into lobbying the FDA to downgrade first two inferior generics—and succeeding!—I was just heartbroken when the new White House appointed an FDA chief who overruled FDA scientists’ longheld concerns about generics of novel delivery system medications.

      There must be at least 12 Big Generic players pushing inferior generics for Concerta. And I can’t imagine the FDA withdrawing approval for all of them. But who knows….maybe those generics will die a lonely death due to shrinking demand. We can hope!

      Take care,
      G

  24. Adding to the many reports of experience in the field. As of January 1, my plan, Express Scripts, no longer provides any coverage for name-brand Concerta. I called today, the first time I’ve needed a script in the new year, and asked for a pharmacist to discuss what manufacturer’s generic they were carrying for Concerta and, low and behold, I was put through to a pharmacist!

    I was told that Alvogen is the generic. I then asked if Patriot could be made available because my son requires the delivery system. The pharmacist looked it up and, low and behold, yes, they can get Patriot.
    I was told to have my physician write “Patriot Manufacturer Do Not Substitute” on the script.

    I then faxed a letter to my physician with the new instructions.

    So, that’s where things stand – I’m hopeful that I’ll get what my son needs and that it won’t break the bank. In my state, the script goes directly to the pharmacy from the physician and I never see it, which is problematic because things go wrong and I have no clue about what the actual script said. I have also been told things by the pharmacy in the past about how to have the script written, which turned out to be wrong. Now I wait to see what happens next. Gina, I keep this page bookmarked and come back often to see what’s new. Thank you for giving me (and all of us) a solid knowledge base to work from – I could not have navigated this mess without you!

    1. Hi Linda Jean,

      Way to self-advocate!! I’m happy you find my work helpful.

      I hope it works. It might be enough to say “Patriot only” — without the extra words.

      Also: “Do not substitute” is the phrase typically used to mean “Stick with brand, do not substitute with generic”.

      But if that’s what the pharmacist said!

      Still, it might be confusing to those who don’t read carefully. And, the electronic prescription forms might make it trickier, how to indicate that.

      I hope it works. If not, maybe you can try those changes.

      I always tried to make a human contact with the mail-order pharmacy — someone who I could call to check that things are going as planned. It’s not always possible, though.

      Good luck!
      g

  25. Gina –

    I wanted to offer some more experience with the Jannsen discount card. This month is the first time I’ve used the card since the new insurance year started for our plan. Normally I fill my son’s Concerta prescription for 90 days (our BCBS plan offers 90 days for the price of 60). Since we haven’t met our deductible for the year, it’s $400 for 90 days. The tech at the pharmacy put through the discount card and it came down to $250. Reading the fine print, the card pays up to $150 of your cost after insurance per fill. It does *not* take in to consideration that I was filling for 90 days. So, we opted to only fill for 30 days. In that situation it took $150 off the 30 day price and ended up costing me $32. If you figure that I’ll then have $32 each of the next two months as well, it’ll end up at right around $100 for 90 days instead of $250. Moral of the story, if you take advantage of the Jannsen discount card, calculate the cost of 3 x 30 days vs 90 days to see which saves more money. Once we meet our deductible, I will be able to go back to filling 90 days again bc my cost share after deductible is around $100 for 90 days, so the card will pick that up and I’ll pay $4 for 90 days. Score! Hope that all made sense and is useful to someone. 🙂 -Deborah

    1. Thanks for that report from the field, Deborah!

      Yes, typically the 90-day home-delivery prescriptions don’t allow any discount cards, etc.

      Now that storefront pharmacies are allowing 90-day prescriptions, I wondered how that would work (or not work). Sounds like it will work for you, once you meet your deductible.

      If that’s not right, don’t worry. I’m just tired probably. 🙂

      Wish we could use those cards in California!

      g

      g

    2. Yes. It worked for me in December on a 90 day refill. We had already met our deductible at that point and I got his 90 day refill for $4. Once we meet our deductible, it should be $4 for 90 again. I’ll just keep doing 30 days at a time until we meet our deductible. Concerta is exempt from the rule that requires a 90 fill on a “maintenance med” with our policy. Thankfully the PA that writes his prescription has known us long enough that she won’t freak out when I tell her that they fill my 90 for 30 days and I need a new scrip.
      -D

    3. Kudos, Deborah. You are dealing with all the angles.

      This is one reason that I, for years but not now, dealt with getting my husband’s prescriptions filled.

      He deals with complexity in his work every day — cancer genomics! — but the complexity and potential quagmires of getting Rx filled was just too much for him. 🙂

      g

  26. Doh! I finally found a pharmacy (one Walgreens in the neighboring town) that regularly special-orders my son’s prescription – which specifies “Patriot only” in writing. I dropped off his latest prescription last night, and SURPRISE, they would be happy to fill the prescription, but they no longer take my INSURANCE! Apparently Anthem BCBS couldn’t come to a contract agreement with Walgreens, and so now the ONE pharmacy that reliably fills this prescription is no longer available to me. AAAAAAACK!

    When my son began taking this medication 5 years ago, I was able to find the authorized generic (whatever its name was back then… Watson, I think?) with limited trouble – usually the 3rd or 4th pharmacy I called had it. It has gotten harder every year, and now it is basically impossible. Some cycles (every 90 days), I’ve had to call 20+ pharmacies before I have found one that would provide Patriot/Watson/Actavis/whatever. This usually involves pharmacists running the gamut from friendly and apologetic, to dismissive to rude. I remember the one time we tried another manufacturer – I had his prescription filled at a CVS we had used the previous month, and I didn’t bother looking at the pills until I got home… they switched to Trigen, I believe it was, and of course didn’t bother notifying me of the change. My son said the new pill left him feeling foggy and unfocused, and he just didn’t “feel” right. I wasn’t about to mess with a drug that was going to unpredictably affect my teenager’s mood – that’s like playing with fire.

    I am now on hold (interminably) trying to see if my insurance will allow me to do mail-order… though my pediatrician’s office doesn’t do electronic prescribing for controlled substances, so I’d have to pick up a paper scrip and MAIL it to my insurance, and then wait for it to be processed and mailed back to me – the whole turn-around could take 2 weeks. EVERY TIME. With my son preparing to go away to college, and having to shoe-horn in doctor appointments during school breaks, this could be totally untenable. I feel like I’m having to work so hard for something so basic, and I just don’t understand why it has to be this complicated…

    1. Hi Rebecca,

      Darn.

      The reason that getting the authorized-generic is harder now? A flood of Concerta generics allowed approval by the previous White House administration’s FDA chief.

      The truth is, though, we’ve been lucky to get the authorized-generic for as long as we have. The only thing that staved off generics years ago is Janssen cutting a deal with Actavis: Actavis postponed introducing its Concerta generic and Janssen allowed Actavis to distribute the brand as a generic (that is, an authorized generic).

      This is just the nature of patents. But really unfortunate for many Concerta users.

      Do you quality for Janssen’s discount program? https://Concerta.net

      It might be a good idea to try one of the newer stimulant options, the ones for which there is yet no generic. (Unless your insurance policy requires generics and charges a big premium for brands.)

      QUESTION: Why do you have to mail the script to your insurance?

      When I started getting my husband’s medication via home-delivery, I would send an SASE to his prescriber, who would use it to send me the script. I would send it to the home-delivery pharmacy. Never left my house.

      QUESTION: Why do you have to wait “interminably” to see if your insurance allows you to do mail-order? You can’t look it up online and contact the pharmacy rep directly? Maybe you’d tried this.

      At any rate, good luck!
      g

    2. Gina –
      Thanks for the swift response, and thank you SO much for this website… it is the ONLY resource I have ever found online that explains all this adequately. I was on hold for a long time because, to make my day even MORE fun, the prescription dept. at my insurance is having technical issues, and their system is down. (They kept me on hold for 21 minutes just to inform me of that fact!) I want to see if they will fill the prescription with Patriot… otherwise there’s no point doing mail-order, and tacking extra time onto the filling of the prescription each time. I think at this point, I’m going to price out Concerta, using the card you’ve linked to here – I called several pharmacies and they all say I have to come in person to see what kind of benefit I’d get from the card. Of course, it’s a fun thought, during a pandemic, walking into multiple pharmacies to get pricing, since none of them will do it over the phone.
      Again, I SO appreciate your advocacy and effort and insight on this issue – I sure wish it wasn’t needed!

    3. Hi Rebecca,

      I’m happy my work has been helpful to you. Thanks for letting me know.

      On hold for 21 minutes. Sheez. Reminds me of the nightmare that was CVS Caremark (I gave them the motto: “Where if you think we care, you’re a mark!” haha)

      They would never give me a straight answer on the Patriot authorized-generic. “Send it in and we’ll see,” they said. The reason? They’d have to order it as they didn’t stock it. Maybe they’d get it. Maybe not.

      My husband got yet another insurance change with a new job. This time with Blue Cross-Blue Shield Illinois — and we live in the Bay Area. I anticipated red tape and problems. But the pharmacy contact was SO NICE. I kept saying, “Thank you. Thank you. You don’t know what your kindness and patience means. Thank you!”

      She probably thought I was nuts. lol

      In the interim, I worked with our local Walgreen’s store, and they were SO helpful. But they said they cannot check the price without an actual prescription being in the system — because it requires that in order to communicate with the insurer.

      Sorry it’s so hard! I would definitely see what might happen with the brand savings program — as long as you’re not in CA or MA.

      g

    4. Hello Rebecca.

      My insurance is through AARP United Healthcare. Pre-authorization approval for Authorized Generic Concerta is even harder than finding a pharmacy to fill my prescription.

      Walgreens will fill my prescription; it took quite some time and maddening frustration (experienced by so many of us) to get my doctor and pharmacist on the same page. I was fortunate to identify GoodRX and use it to reduce the cost.

      Although GoodRX also lists a number of pharmacies with lower prices than Walgreens I have been able to find another pharmacy that will consistently make the Patriot NDC available to me.

      Perhaps GoodRX is an alternative affordable option for you. I hope so.

      Be safe and well, David

    5. Hi David,

      Thanks for responding to Rebecca.

      I’m wondering if you really have to get pre-authorization for the Concerta Authorized-generic.

      It is, after all, a generic.

      g

    6. So sorry: I have been UNable to find a consistent lower cost alternative to Walgreens.

      David

    7. Hi Gina. Sadly for me it was pre-authorization hell to get the Specific Authorized Generic Concerta NDC and I had to get pre-authorization any time my dose changed and I had to get the pre-authorization all over again every year. There are other (less expensive) Concerta “generics” that United Healthcare would rather pay for. Same deal as the pharmacies. Both assert that one generic Concerta is equivalent to another, which of course isn’t true.

      I have said this before but I want to say to you again how valuable you have been as an advocate and resource for us.

    8. Thank you, David.

      I was just checking! Because some people automatically assume they need pre-authorization—when really they only need to have the prescriber specify Patriot generic.

      Why go asking for trouble, is my thinking.

      But yes, I understand your situation….that’s the very nasty problem with these junk generics. They are CHEAP and have flooded the market.

      take care,
      g

  27. My son was recently prescribed methylphenidate HCL ER and it was filled by our local pharmacy (Giant) with brand Concerta at generic prices. I have CVS/Caremark for mail order prescription and when I used their website to price the generic it comes up as “unauthorized,” while brand Concerta is available at generic prices ($20/90 days). I was surprised because even their preferred name-brand medications have a $500/90 day cost (under my insurance). I’m hoping this low cost for Concerta via Caremark actually pans out because I’d like to send him off to college without having to worry about potential problems with new generics.

    1. Hi Wendy,

      Lucky you! So much depends on one specific insurance policy.

      But, as I wrote in the updates to this blog post, it’s a rapidly changing landscape.

      The release of this clown car of generics might have caught Janssen flat-footed. But they seem to have jumped into the fray swinging. Who knows what the situation will be next month—or next week. Unlike in previous years, companies don’t issue press releases regarding these deals. It’s the Wild West.

      You don’t mention when you son goes to college but forewarned is forearmed. 🙂

      good luck,
      g

  28. I have followed this post for a few years. I am on Concerta and was getting the Patriot brand as the other generic medication gave me GI issues. Recently I received my prescription from Walgreens and noticed it was Janssen. Are they now making the authorized generic? I am a bit confused.

    1. Hi Tonya,

      I know it’s a lot to wade through—and hard to be much more concise.

      Maybe sometime, you’ll sit down with a cup of tea and take it paragraph by paragraph.

      In the meantime, yes, Janssen is the manufacturer of Concerta. Patriot is their subsidiary that markets Concerta as an authorized-generic.

      So, as long as you didn’t pay a vastly higher price, you lucked out!

      Gina

  29. I go to Pepperell Family Pharmacy in Pepperell MA. They are able to get it for me but each month I have to call and have them order it if they don’t have it in stock. They stock very little. Their supplier is able to get it for them. Every month I cross my fingers however.

    Kathy

    1. Thanks, Kathy.

      Do my knowledge, no pharmacy stocks the Patriot authorized-generic. It’s ordered.

      Moreover, most pharmacies tend not to stock much of the stimulants in general.
      g

    2. All – Just a quick kudos to Gina. Without her and her invaluable information, I too would have found myself stuck in this generic shell game hellhole. Her advice and direction have been a godsend for me and my son for the past 2 years.

      Please listen to her advice:
      1) mail order instead of local pharmacy if your insurance allows. (Your chances to get the authorized generic increases drastically)
      2) 90 day supply instead of 30 days in your insurance allows (Chances are, your insurance will cover 90 days at cost of 2 copays saving you a month of copay)
      3) Rx should specify “Methylphenidate HCl Extended-release tablets, xx mg, NDC xxxxxxxxxxx ONLY, 1x day, DAW1” (The key here is the NDC number + DAW1 which does NOT allow the pharmacy to substitute. It must be dispensed as written using the NDC number and the NDC number is specific to the Authorized Generic.)

      Again Gina – *YOU ARE A GODSEND* – THANK YOU!!!!

    3. Aw, thank you for noticing my work, Kim.

      Unlike many ADHD-related blogs and websites, I do not accept pharma funding (nothing wrong with that for researchers and speakers, imho, but as a trained journalist, I realize it can introduce conflicts of interest).

      So, knowing that my work is important to readers means everything.

      Thank you for bringing up the home-delivery angle. People tell me all the time….”but you can’t legally get stimulants delivered to your home!”

      BUT YOU CAN. 🙂

      Here’s a blog post with the details: https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/

      Gina

  30. I would appreciate any advice for getting the Patriot version of Concerta in the greater Boston area. I originally got it 4 years ago at Rite Aid without any special ordering needed. Then it turned into Walgreens and no luck. I switched to another Rite Aid, then it also turned into Walgreens, but the pharmacist there still ordered the Patriot version (he said it was the only one he trusted). Then that pharmacist left but I suddenly was able to get it at a closer Walgreens, although it required special order. In December it started to become more difficult to get. The pharmacist said he ordered it but it was not sent to him. Told me it was back ordered. I spoke to someone at Patriot who assured me it was not on back order, plenty of stock. She reached out to some people at Walgreens corporate but I’m not sure how that panned out. Eventually in January I called Walgreens and low and behold, it was sitting on the shelf but no one had contacted me because the prescription had expired in the meantime.

    Now we’ve started this same process again. Walgreens ordered it at the beginning of last week and now it’s Thursday. They still haven’t received it. They told me to keep calling to check. My mom and I both take this drug so I have to go through this process twice a month. My doctor can send it the prescription about a week or two before it’s due to be filled, but I have to call to “activate” the prescription on exactly the day it can be refilled, which is only 2 days before I run out. Walgreens will not order it until this time. They tell me there’s no “exception process” to do here because they are able to order it but the distributor just isn’t sending it. I even called the distributor (found some evidence online that it recently changed from Walgreens Boot Alliance to AmerisourceBergen – maybe this is the source of the newest problems???). AmerisourceBergen told me they couldn’t talk to me because I didn’t have an account with their company.

    I was thrilled to read about the $4 per month program by Jansenn. Then found out it’s not available in Massachusetts. When I am able to get the Patriot version, I pay about $140 for 30 pills. My mom has Medicare and pays between $5 and $20 per month. What????

    1. Hi Emily,

      Sorry you’re having so much trouble.

      $140 for 30 pills seems like an awful lot. Do you have a home-delivery pharmacy, with a 90-day prescription?

      The hard truth is that we have been lucky to get this authorized-generic at all, for as long as we’ve had it.

      It might have continued, had the Trump FDA chief not decided to run roughshod over FDA scientists.

      Now it’s a free-for-all.

      g

  31. Printed the “Authorized Distributors” list off the Patriot Pharmaceuticals website. Also printed the “Product Portfolio” page from their website showing the NDC codes for each of the Concerta generics. Took them over to my local Fry’s Marketplace (Kroger family of stores, which is a listed distributor). Kindly asked/explained that I wanted to see if they could get this because other generics are not the same delivery system and not as effective.

    They were awesome and said they can order any of them. Helped me set up my daughter’s profile with specifications about “Patriot Pharmaceuticals” generic only (no other generic) and noted the NDC codes for the 2 dosages she may need. They told me to have my dr. specify ONLY this brand and NDC when he transmits the prescription. Told me it would take 2-3 days to get it in.

    Fingers crossed! This could solve some major headaches. Kroger/Smith’s/Fry’s are a LOT of places!

    1. Good for you.

      That’s the advice I gave in the post, including the NDC codes. 🙂

      Except: The list of “authorized distributors” is not necessarily accurate, as I wrote. It might make a good starting point, though.

      g

  32. We are in Massachusetts and have been lucky in that we found an independent pharmacy (somewhat out of our way) that could get the authorized generic for my daughter. But each month it is stressful. I always breathe a sigh of relief when I get it. It shouldn’t be this way. Now that my daughter is almost 19 and in college she will be assuming the responsibility of her Rx. She thinks she will switch to Adderal hoping it’s easier to obtain. Has anyone had experience switching to Adderal after being on Concerta?
    Kathy

    1. Hi Katherine,

      Adderall and Adderall XR also have generics. So, I’m not sure what your daughter’s rationale is there.

      Moreover, stimulant classes are not automatically substitutable. Given her genetics, it might be that she does much better on methylphenidate than amphetamine — or vice-versa.

      For some, Adderall is more problematic than other stimulants:

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

      So, it doesn’t really matter what others’ experiences might be. The only thing that matters is what is right for your daughter.

      You and she might want to read my book’s chapters on medication: https://amzn.to/36pR4gm

      good luck,
      Gina

    2. Would you be willing to share the independent pharmacy name and location with me? I am in Waltham and have been having a lot of significant problems getting it at Walgreens after 3 years of moderate problems off and on.
      Thanks,
      Emily

  33. I take Metadate CD and it works fine for me.
    I was on Concerta before there were any generics and the cost was too high for the drug allowance at my HMO, so they switched me. I have used several different kinds over the years and they usually settle in after a bit.

    My husband and our housemate have been prescribed both Concerta brand or generic. Until this month, any generics they have gotten have been ok.
    The generic they got this month was radically different in both looks and action. Very destabilizing, including our housemate stopping at urgent care because she was so out of whack. They administered an antagonist and we had to go pick her up because they didn’t want her to drive.
    Follow-up pharmacist interactions have been mixed, one said they could swap them out if they took them back to the pharmacy. But when our housemate went, the pharmacist onsite said they couldn’t and it shouldn’t matter because they are identical to the Concerta brand…Additionally, they won’t be getting the others any more. There was a general lack of caring in their attitude.

    Your site has been a wealth of information!!

  34. Thank you so much for this information! I spent hours last night researching what to do now that our BCBS won’t cover brand name Concerta, and the generics our pharmacy is offering are causing my son to feel depressed. The worst was the one made by Alvogen – he felt suicidal, so he stopped taking it immediately. The next month they gave us Lannett (which I thought was one of the ones that was downgraded?). We even tried to fill a prescription for another brand name (Aptensio XR), but none of the pharmacies around here have it or can get it. It took a week for my pharmacist to tell me that. I was super excited when I read about the Costco Authorized Generics program. I called our local Costo pharmacist to confirm they have the Patriot one. She said they only carry Northstar brand and had no idea what I was talking about with the Authorized Generics program. She tried to convince me that the Northstar generic they have is approved to be the same. That was getting me nowhere, so I am grateful for the Concerta Savings Program Card for now. I am thinking that if all goes well with filling it at the Walmart near me and using the Savings Program, I can hopefully get it for $150 the next few months (after $4 the first month, which would be awesome). That will give me time to try to track down someone who carries the Patriot version. But this has been a nightmare. It was so validating to come to your website and see that we are not alone in the struggle. Thank you!

    1. Hi Steph,

      Glad you found the ADHD Roller Coaster!

      Sad but true, it seems most pharmacists have been brainwashed into believing that generics are “exactly the same” as brand. Sometimes, it doesn’t matter — and generics present a significant savings. But sometimes ….. many times…especially with psychiatric medications and other uses where dosing is precise…it matters a LOT.

      I’m glad you’ve got a plan now. good luck!
      g

  35. Hi.
    Ugh.! I have had the patriot pharmaceuticals special ordered for me at Walgreens for months.
    Now they want to give me cambers, I have not accepted it yet. I put a call into Patriot to get some help. I am waiting for a call back. It takes 24-48 business hours. I am in Southern CA so I cant use the Concerta Card. My two options going forward are the Costco program or getting the doctor to do a prior authorization for the brand. Blue Shield told me that they would only hassle me about once a year to renew it. I will update once a get a call back from Patriot. Thank you for this website.

    1. Good luck, Tina.

      I imagine this flood of generics has wholly destabilized the market. The Big Generic companies are probably competing fiercely for market share.

      Sure wish that patents lasted longer on some medications.

      As it is, we’ve been lucky to get the authorized-generic Concerta for as long as we have.

      g

    2. Don’t give up. I had been getting the Patriot Pharmaceuticals special ordered for us at a Walgreens near us that we use on a regular basis. They now say their supplier no longer carries it. I pressed them several times but they stuck to their position that the supplier doesn’t carry it. So I called a different Walgreens (also close by) and the pharmacist said they can order it. So, we just switched the prescription to another Walgreens willing to place the special order. I suggest you call other Walgreens in your area to find one willing to place the order.

      P.S. I also called a CVS pharmacist near us. While they said their supplier did not carry the Patriot Pharmaceuticals generic, they suggested calling other CVS pharmacies in the area because each CVS store used different suppliers. Not sure if this is the same structure for Walgreens but I’d just call around until you find a pharmacy willing to place the order.

    3. Hi Vincent,

      I’m glad persistence paid off.

      The thing is, Walgreen’s MUST be losing $$$ on this.

      We do all our drugstore shopping there, as a thank you. 🙂

      g

    4. I moved to Florida five months ago. I called around and Walmart Pharmacy was the only place that said they could order Patriot brand for me. I had my doctor write the NDC on the order. It took about two days to get the order. They charged around $125 and I used my GoodRx card and they adjusted the price to $68. They kept the coupon associated with it and every month I go to get that price without it having to get adjusted and every month it’s the right thing with Alza on it. I don’t know if all Walmart Pharmacies run so smoothly, but I’ve been very happy.

    5. Same here. My luck ran out at Walgreens.

      Gina, thank you SO MUCH for your continued help and information. I’ve been following this for years, and your contributions are invaluable.

  36. Hi Gina (and others on this list),

    FYI. It appears that Walgreens is no longer an authorized distributor of Patriot Pharmaceuticals authorized generic Concerta according to the Patriot website. Not sure if their contract is being renegotiated or if this is a permanent change.
    https://www.patriotpharmaceuticals.com/authorized.html

    We have been getting the authorized generic from Walgreens for months. This month (January 2021) they called to inform us the Patriot generic is no longer available and their system does not indicate when (or if) it will be in stock.

    For anyone using Walgreens, they can check the authorized distributor list to find an alternate pharmacy. Looks like we can switch to CVS as an alternate pharmacy. We are in CA so we can not use the Jansen discount card.

    V

    1. Hi Vincent,

      Thanks for joining the collective here. 🙂

      Some points:
      1.
      I think I’ve cautioned elsewhere (in the post or among these comments) to disregard patriot’s published list. It might not be accurate. In fact, I’m not sure that Walgreen’s was ever on that list.

      It might be helpful as a starting point, but it’s not reliable.

      2.
      This authorized generic is never “in stock” — and precise wording matters. Instead, ask that an “exception process” be ordered for you.

      3.
      Call Patriot when you encounter these problems. Pharmacy business relationships are constantly shifting, so it’s best to go to the source.

      I am in California and successfully received my husband’s Concerta AG order last week.

      It might be that you encountered a pharmacy clerk who does not know the ropes — or that the MD did not correctly specify or you didn’t ask for an “exception process.” Many possibilities.

      I’d try again. Or, try a Rite-Aid if that’s convenient.

      good luck!
      g

    2. Hi Vincent, From what I’ve read on Gina’s site and what I’ve experienced personally at our Walgreen’s in Virginia, they do not “stock” Patriot’s version of Concerta, but mine has ordered it for me/my daughter, every month for the past 12 months. As Gina has mentioned, you have to make sure your provider uses the specific NDC code for Patriot. And, I’ve learned recently, also include Patriot name on the script. The NDC code should be enough on it’s own, but the Patriot name should ensure that’s the only way they fill it. I would recommend dropping off the script in person so you can speak to someone in the pharmacy department acknowledging the special order/request for Patriot. Good luck to you!

    3. Thanks, Paula.

      I’d also recommend asking the pharmacy clerk to flag your account. That way, it comes up when the script comes in….to know “Patriot” only.

      Some will do that. Some won’t.

      g

    4. Thanks for all the advice. To reiterate, our medical professional does place the order specifying only Patriot Pharmaceuticals generic is to be used to fill the prescription. And, Walgreens has special ordered the Patriot Pharmaceuticals generic for us in the past. What they are saying now is they cannot special order it. We’ll press them again with this month’s prescription. If they continue to say it cannot be ordered, we’ll go somewhere else.

    5. Thanks for clarifying, Vincent. Wasn’t sure if you had all those niggling details. 🙂

      Sometimes it really does boil down to the particular clerk.

      It’s a mystery how these things work — that our Bay Area Walgreen’s can order it but your SoCal Walgreen’s can’t.

      You could try calling Patriot. Sometimes the person answers and is responsive. Sometimes now. Maybe COVID….
      g

    6. Hi.
      AmeriSourcebergen is the wholesaler for walgreens. They are on the list. I am also having trouble getting patriot from walgreens. Never had trouble before as they special ordered it for me. I live in Southern california and cant use the drug card. I put a call into patriot. Waiting for a response right now. My two options are to use costco in the meantime and get my sons doctor to do a prior authorization for brand, supposedly Blue Shield will only hassle me once a year to have it renewed. Will update when I get a response

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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

  43. 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

  44. 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.

  45. 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

  46. 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

  47. 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

  48. 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

  49. 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

  50. 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

  51. 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

  52. 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

  53. 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.

  54. 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

  55. 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

  56. 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

  57. 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

  58. 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

  59. 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

  60. 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

  61. 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.

  62. 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

  63. 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

  64. 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!

  65. 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

  66. 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

  67. 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. 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.

  68. 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

  69. 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!

  70. 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.

  71. 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

  72. 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

  73. 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!!

    3. Gina,

      I asked you this question almost a year ago. Thanks so much for your response. I realize I never responded.

      Since last July, my psychiatrist at Kaiser has been writing the prescription for brand-name Concerta or the Patriot brand. The pharmacy has ordered the brand-name drug, which takes a few days, but I have been able to get it. I pay the copayment for a covered brand-name drug, which is $55 for a one-month supply. I really appreciate that he writes that prescription and that they are able to get it for me. I notice a huge difference over the inferior generics I had been taking.

      Thanks again,
      Will

    4. Hi Will,

      I think I need to re-jigger something. I answer all questions, but I wonder how many people see them! 🙂

      At least someone else does. Sometimes.

      That sounds like a very reasonable setup you have. That seems better than most I know who use kaiser.

      Thank your pharmacist! 🙂

      take care,
      g

  74. 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.

  75. 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

  76. 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

  77. 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.

  78. 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

  79. 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.

  80. 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

  81. 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

  82. 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

  83. 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

  84. 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

  85. 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

  86. 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.

  87. 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.

  88. 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

  89. 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

  90. 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 com