Authorized Generic Concerta Update: 3/9/20

Concerta generic

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

I’ve been covering this issue for six years (see list of posts). Today I nailed down the latest details. But be warned: This is a rapidly changing scenario—and much depends on your particular insurance pharmacy benefit.

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

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

Beginning in June 2019, I attempted to gather more details by writing to and calling Patriot Pharmaceuticals. That was unfruitful. In fact, more than once I had to explain to the representative what is an authorized-generic.

Turns out, my reporting the problem here finally caught the company’s attention. That’s what I learned a few days ago, when returning a call from Patriot.

The call actually came last week but I was traveling and unable to follow up. In the meantime, a thoughtful reader, Zach, shared his shoe-leather reporting. 

In speaking with the Patriot representative this morning (3/9/20), here is what I learned.  It confirms and amplifies Zach’s report. (Thanks again Zach!)

There Is An “Exception Process” at Walgreen’s, possibly Kroger and others

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

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

CVS has chosen not to participate.

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

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

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

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

Quick Summary of this Post

In this post, you will

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

First, some background and context.

Tricky  Transition Time Now

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

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

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

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

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

generic concerta

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

A bit of background first.

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

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

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

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

1. Authorized generic (aka branded generic):

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

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

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

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

(but it’s not the authorized generic). 

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

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

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

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

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

2. True generic:

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

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

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

New Concerta Generics From At Least Nine Companies

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

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

 

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

Who Sells the Authorized Generic Concerta Now?

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

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

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

Authorized Generic ConcertaPatriot Pharmaceuticals Is The New Distributor

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

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

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

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

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

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

authorized generic Concerta

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

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

1. Name:

Methylphenidate HCl Extended-release tablets

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

2. You Will Need The  Identifying NDC Code:

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

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

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

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

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

3. Distributors:

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

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

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

4. How Should The Prescription Read Exactly?

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

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

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

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

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

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

5. Pay Attention to the “No Substitutions” Box

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

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

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

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

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

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

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

See Tip: Home Delivery of Prescribed Stimulant Medications

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

NOTE: Look before you pay!

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

authorized generic Concerta

 

 

7. Must the Pharmacy Fill the Prescription As Written?

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

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

8. What Should The Label Look Like?

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

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

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

If All Else Fails, Purchase the Brand

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

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

But Do Investigate Home-Delivery Pharmacy Benefit

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

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

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

Summary

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

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

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

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

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

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

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

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

Summary of Tips and  Strategies:

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

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

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

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

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

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

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

Please Consider Filing an FDA MedWatch Complaint

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

 

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

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

I answer all questions as quickly as possible.
Gina Pera 

623 thoughts on “Authorized Generic Concerta Update: 3/9/20”

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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!

  8. 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

  9. 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

  10. Katherine Howe

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

    1. Hi Katherine,

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

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

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

      g

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

    3. Katherine Howe

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

    4. Katherine-

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

  11. 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

  12. 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!

  13. 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.

  14. 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

  15. 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

  16. 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!!

  17. 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.

  18. 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

  19. 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

  20. 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.

  21. 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

  22. 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.

  23. 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

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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.

  30. 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.

  31. 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

  32. 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

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

    1. Hi Leslie,

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

      If not, you might want to try it.

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

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

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

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

      Elections have consequences. That’s the bottom line.

      Good luck!
      g

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

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

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

    4. Hi Mike,

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

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

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

      g

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

    1. Hi Jessica,

      I’m glad you found my blog.

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

      Good luck!

      Gina

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

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

    Mayor points:

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

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

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

    Still trouble?  Call Patriot at 215-325-7676 

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

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

    —CVS has chosen not to participate.

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

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

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

  36. Francis Williot

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

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

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

    3. Hi Francis,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

      Good luck in finding the medication you need.

      Gina

  37. Laurie Bussard

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

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

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

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

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

    God bless!!!

    1. Hi Laurie,

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

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

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

      Supplies might have lasted longer but the deal stopped earlier.

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

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

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

      g

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

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

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

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

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

    1. Hi Michelle,

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

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

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

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

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

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

      Good luck!!
      g

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

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

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

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

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

      This is all so very wrong.

      Good luck.
      G

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

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

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

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

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

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

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

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

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

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

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

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

    1. Hi Sam,

      That’s quite a testimonial.

      Thank you for taking the time to write it.

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

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

      The 21st Century is a weird place. 🙂

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

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

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

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

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

      Then he went back to venture capital.

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

      Wishing you continued success in your studies,
      g

  43. Hello all,

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

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

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

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

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

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

    1. Dear Zach,

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

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

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

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

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

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

      Keep up the great work in taking care of yourself!

      g

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

    3. UPDATE!!!

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

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

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

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

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

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

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

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

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

      Call that number! Love to all.

    4. Dude! You’re the best!

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

      g

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

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

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

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

    1. Hi Laurie,

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

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

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

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

      good luck!
      g

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

    1. Hi DS,

      I share in your frustration.

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

      Or maybe yours would cover regular genetics more cheaply.

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

      And things constantly change.

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

      best,
      g

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

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

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

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

      good luck!
      g

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

    1. Hi DS

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

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

      There is no conspiracy. Concerta uses expensive proprietary technology.

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

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

      If your son feels a “significant difference,” that seems like a big upside to me.

      Hang in there
      g

  47. I figured I’d chime in. I’ve had the circular generic for the last year when I got a letter stating it would no longer be covered (didn’t specify about brand being the same price). My doc sent in a new prescription to CVS (CVS caremark/BCBS) anyways so I figured I’d try it. to my disbelief, it rang up for the same price I always paid. Bottle is labeled “concerta ER” mfg is “Janssen” but it’s the brand pill pictured with “Alza 36” written on it. I’m not quite sure what’s going on but I’m not complaining. I’m currently at work and would be crashing right about now with the generic. It’s also a much more “calming” feeling where the generic felt a bit more like vyvanse and that made me irritable.

    1. Hi DF,

      Thanks for that field report. Lucky you!

      You have the brand at a generic price — without it being the difficult-to-get authorized generic.

      Pretty much a dream situation.

      I’m glad it’s working better for you.

      g

  48. I wish I could report the same info as FNP. Every pharmacy in our town only carries the circular generic now, currently have Alvogen (Round White AL). We have noticed a definite deference from the Patriot/Alza generic. My daughter can even feel the difference, says she feels like she never took her pill. My only choice to get the OROS tech again is to buy brand. I did file a report to the FDA from your link. Have you heard anything new about being able to get a true authorized generic? I;m really glad I found this site. I couldn’t figure out what was going on with the sudden change until I read all your information. Thanks for your help!

    1. Hi KP,

      I’m glad you found my blog, too. Thanks for filing the MedWatch complaint.

      I can’t imagine that we’ll get the critical mass we did last time (when the FDA downgraded the two inferior generics) — because now there are NINE.

      The outgoing FDA Chief, appointed in 2017, gave many gifts to Big Generic — and much damage has been done.

      I do hear that Patriot is still making available the authorized generic. You might try calling them.

      But, honestly, it’s so variable, depending on your type of insurance coverage, it’s hard to find any blanket statements. About anything.

      Best of luck,
      Gina

  49. I was nervous, but picked up Rx from local Walgreens. No longer reads Patriot; instead Janssen. Still has ALZA on tablet with a different NDC#. I still paid the same Rx copay, but the Retail $ listed is more than doubled; more than $1000!

    1. Hi FNP,

      You have the brand Concerta.

      All NDC #s are specific to the company and dosage.

      So, the NDC # for the Concerta brand and the Patriot authorized generic will differ—even though the Patriot is simply re-labeled brand.

      Even 18 mg, 36 mg, and 54 mg within the brand have different NDC#s.
      g

  50. Update: Was able to fill Brand Name Concerta for generic pricing. Caremark CVS insurance using Abbie Pharmacy (Smaller chain) with my DR writing D.A.W as mentioned somewhere in your blog, I think. lol.. Live in Rosevile, MI

  51. Suzanne K Tyler Stock

    Just letting you know I had success at Costco. I live in Durham, NC. I was using Kroger pharmacy but our Krogers all closed and reopened as Harris Teeters. For a few months everything went fine. In mid December, 2019, I was told that Harris Teeter could no longer get the authorized generic. I called Express Scripts, who my insurance prefers we use. I talked to a pharmacist on the phone and she searched but could not get the authorized generic, either. Next I tried Costco pharmacy. When I called I was told that the one distributed by Patriot was all they had, but when I got that scrip filled the next day, it was 3 pills of alza and the rest something else, so took the 3 (I was already a week behind without my medication during the holiday crazies) and refused the rest. In a few days they had the right medication and I got the rest. Early January I had my 3 month doctor’s appointment and took your suggestions with me. The doctor wrote the script with the NDC number on it. I filled it at Costco with no problems and got the correct authorized generic. Thanks for your help.

  52. Just wanted to add my data point.

    I also have CVS/Caremark through GEHA in Texas. The online pricing tool showed our generic price for the brand and no generics being available similar to others.

    Had my doctor’s visit today and asked to be swapped back to, specifically, Concerta. Not long after I left, I got a call from my pharmacy at Sam’s Club. I thought, ‘uhh oh,’ but they were calling to tell me the doctor was requesting the brand and that they’d need to order the Concerta. While I had her on the line I had her verify the price since she seemed skeptical it would be generic pricing. Luckily she said it indeed came back as my generic price. Lol I had started to get nervous.

    Anyway, I decided to share for what it’s worth.

  53. Hi- A Walgreens near me has been able to special order the authorized generic from Patriot for the last two refills. I also called the Patriot customer service line, which when it picked up referred to itself as the Jannsen customer service line. I selected whole sale retailer option instead of patient option and was able to talk to someone. I left a message for the rep who deals with these meds. It took about three weeks, but I got a call back today.

    She said that they have plenty of product available for wholesale, and all a pharmacy has to do is special order it from them. She said if a CVS or Walgreens or any pharmacy says Patriot is not longer available, that’s not accurate and to special order. She then gave me a list of some more pharmacies in my area that either have it in stock or have special ordered it recently. Most of them were Safeway. I’m in Colorado.

    Of course I don’t know how truthful any of this is, since it hasn’t been this simple so far. But that’s the message they gave me. Fingers crossed my Walgreens can keep special ordering it.

    1. Hi Brittany,

      Great scouting! Thanks for reporting your findings.

      It’s good to know that Concerta manufacturer Janssen and its authorized-generic subsidiary, Patriot Pharmaceuticals, have not made an exclusive deal with CVS Caremark. It was sure sounding like a possibility.

      And yes, we, unfortunately, might want to take a sales rep’s advice with a grain of salt. For example, perhaps CVS or Walgreen’s don’t allow special orders; if the Rx doesn’t come through their existing suppliers, that’s the end of it.

      Good to know about Safeway. Here, only a few mega-Safeways have pharmacies.

      Good luck with future attempts!
      g

  54. Thank you! As a parent and as a physician, I found this incredibly helpful!! Following your directions, I have been able to get the EXACT medication my child needs.

    One small issue came up when my child’s doctor entered “Methylphenidate ER” and the electronic system automatically entered, “Methylphenidate ER (Concerta)”.

    Just as you have said, my pharmacy explained that the prescription must NOT have the word “Concerta” on it. The doctor re-wrote the prescription WITH the NDC and WITHOUT “Concerta”.

    1. Hi Jonathan,

      Thanks for writing.

      I’m glad that the “method” worke3d for you. Many readers are reporting a new lack of access….unless they have a certain CVS Caremark plan.

      (I’ve tried to get the details, but companies currently seem to feel no need to inform the public about new marketing deals.)

      cheers,
      Gina

  55. This is for Linda: it’s Carefirst “Blue Preferred PPO” in the state of Massachusetts where they just filled Concerta 36mg today with the actual name brand at generic prices. My plan uses Caremark. I actually have the name brand in hand right now and it only cost me 10 bucks. Good luck figuring this out.

  56. Hi Gina,
    I’m glad I found your blog post. It actually did come up when I did a search because I’m concerned that my Trigen manufactured generic for Concerta isn’t working (FYI, I searched “Trigen Laboratories”). I’ve felt that it hasn’t been working well for a couple months and, to put it most delicately, recently realized that it is passing through me with only the pink coating missing. I called CVS early this afternoon to ask them for a replacement and was told by the pharmacist, “I will have to call you back after I research the side effects. I can’t do it right now because there are a lot of people waiting.” Needless to say, I have not received that call. It’s 10:30 p.m.

    It’s disheartening to read the issues that so many people are having just getting a drug that works for them. I guess I’m now joining that group. But I wanted to tell you that I appreciate the time, effort, and valuable information represented in your posts. I feel at least a little bit “armed” for the coming battle 🙂 Now I need to find your link for MedWatch…

    1. Hi Joanne,

      Thanks so much for your kind words.

      I tell you what…it’s been disheartening. For 20 years, I’ve worked so hard and plow through so many obstacles. Tirelessly. But this has gotten me down.

      No one knows how the algorithm works, exactly. But definitely, my blog’s traffic has been cut by half. It might be that “Concerta generics” is so specific a search term as to not get caught in the algorithm’s broad net.

      Definitely, self-education and self-advocacy is a must. Otherwise, the consequences are just too costly.

      Here is the FDA Medwatch complaint form: https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1

      take care,
      g

  57. I’m also in the boat of dealing with the letter that came from CVS Caremark in November about only being able to get the brand name. At first it looked like it was going to be great, and I even had a feeling it was too good to be true. I tried to fill my son’s Concerta yesterday, and after a lot of phone calls and confusion, have figured out today that we have to pay a large deductible first before our old co-pay amount kicks in. That’s the catch. So much for the “same amount” as before the letter stated.

    I may try and have my sons ADHD prescription changed completely. Are there other ADHD medicines that are going under the same process with CVS Caremark? I need to know what possibly to avoid.

    1. Hi Heather,

      Once a medication patent expires, the generics enter the market. That is the major issue.

      There are generic versions of Ritalin, Adderall, etc.

      As far as what’s happening with CVS Caremark, it’s apparently on a high-security need-to-know basis. 😉

      So much depends on one’s individual policy, the deductible, the pharmacy benefit. With so much variability, it’s impossible to make any blanket statements.

      There are other MPH medications that aren’t yet off patent. e.g. Daytrana, Jornay PM, Metadate CD, Quillivant XR, Quillichew ER, etc.

      It depends on the individual as to how well one of these works, in comparison to Concerta.

      Good luck,
      g

  58. Hello and thank you for your in-depth analysis. I never thought I would have to be an expert in big pharma supply chain management!!! (Disgusted). I’m an academic researcher so I really fell down the rabbit hole with this:)!!!

    So we had CVS, but my new insurance doesn’t have a contract with then (sigh), so we switched everything to Walgreens. As people have found out, Walgreens stopped their contract with anyone but Mylan.

    So I spent one whole day on the phone with various local pharmacies. I found one without our health care clinic (Aurora in Wisconsin). Last month they did not have a contract with anyone but Mylan, the pharmacist however could track down generics that had a pinhole in them. Apparently the pinhole allows that gastric acid to enter and release the first dose. More similar to the delivery system of Concerta.
    I sent her the link to this site, she and I were reading it together over the phone:) I was able to get 20 of the slow release technology. I called today; she had been researching on my behalf (I think she enjoyed it) some big wig must have had a good golf game because this month Aurora Health Care now has a contract with Patriot!!!!! So she’s ordering me 100 pills just in case some other suit get a better deal with someone else (eye roll). Thank you so much!! I feel empowered!

    1. Hi Johanna,

      I love empowering academic researchers—and everyone else. 🙂

      This is definitely a moving target.

      FYI — the “generic with a pinhole” is probably Trigen. It has an older, simpler osmostic release system—NOT the same as Alza’s OROS system. (But many pharmacists remain confused….or deceptive.)

      I wrote about it in 2017: https://adhdrollercoaster.org/adhd-medications/7977/

      But now it seems you have access to the authorized generic via Patriot. Let’s hear it for golf games!

      Best of new years to you!
      g

  59. I would like to thank you for this blog post. It helped confirm that I wasn’t going crazy with the different pill. As others have noted it felt like I was getting a single large dose of ritalin, which I’d then come down off of.

    I got really lucky in that when Kroger gave me the ‘new generic’ I was able to call a local pharmacy (they’re a tiny chain with three local buildings), and get the authorized generic. I spent a week fighting with insurance, but I was able to get it, and have a regularly scheduled appointment early in January. I’m certainly going to get it for the authorized generic or the name brand – and with a conversation about what to switch to if I can’t keep getting it.

    Thank you again so much for this informative blog post. I had gone off of the meds for a while when the earlier issues with the generics happened several years back so I didn’t know what I was going to be in for, and knowing that I wasn’t alone in this was so very beneficial.

    1. Hi Timothy,

      I am so grateful for your note. It means a lot to me, to know that my work has made a difference in your life.

      It’s sort of crazy that I was the only person reporting on it.

      It’s also crazy that Google’s new algorithm has cut my blog traffic in half, because I dare to write about medical issues despite not having an MD.

      Algorithms don’t know that ADHD specialists at major medical schools tell me they refer their medical students here. 🙂

      Thanks so much and have a great 2020!
      g

    1. Hi Kim,

      Maybe it’s just not the right stimulant for her?

      If she also has anxiety (not solely “cognitive anxiety” from ADHD), it might be that she needs a second medication to counteract the stimulant exacerbating the anxiety. This is quite common.

      But it might be too high a dose, wrong stimulant for her….many possibilities.

      good luck sorting it out.
      g

  60. I live in Massachusetts and just did “price out a drug” (or whatever it’s called) using the Caremark app. I have Caremark through carefirst. Before the new year, the price of brand name concerta 36mg was about 300 a month out of pocket with my insurance at nearby pharmacies. The generic grab-bag of “equivalent” medications was only 8 bucks a month. After the new year, just like magic, concerta was 8 bucks and generic not covered.

    Hooray!

    Let this serve as one Caremark data point. Concerta is now super cheap with my insurance. Generic not covered.

    I’ll let you all know if I can actually get them to fill it now.

    Thanks,
    Steven

    1. Wow, Steven, it’s like you won the lottery!

      Caremark has many different plans, hammered out with insurance companies. Unfortunately, we have one of the lousy ones. Because, no such luck for us.
      g

    2. Can you please let me know which Care First Plan You have. I called carefirst before I had to choose a new insurance company that the authorized generic would be covered under my plan. They assured me it would be. Accordingly, I believe I should be able to get Patriot, or any other authorized generic, or the brand concerta. Because I was told the above by Care First/CarMark…. I am going to try and switch insurance coverage plans if there is one that covers Brand Concerta at a lower price.

      Thanks
      Linda

    3. I hope Steven will reply, Linda.

      Meanwhile, it might be that it was true when you selected the policy but has since changed. Things seem to change quickly with these deals between pharma companies, pharmacies, and insurers.
      good luck,
      g

  61. With my new concerta working about 1/2 as well as it used to, this article is so overwhelming. I am glad to find it, as it tells me that I am not crazy when I kept thinking my meds weren’t working right. Still……….this mom needs this to get cleared up. 🙁

    1. Hi Tracy,

      I’m glad you found me!

      Google, in all its wisdom, has created an algorithm that reduces search results for sites such as mine….medical+ topics not written by an MD.

      My website traffic is down 50% because of this. Yet, I am the one doing a better job than most MDs of informing and educating the ADHD community. In fact, I pick up many of their pieces.

      Good luck sorting it.
      g

    2. Yay! My old meds came today! I am so glad I had this info to help me advocate for myself!! Thanks so much!!!

    1. Hi Steven,

      Sorry, I don’t have time to dig into this.

      One thing is clear: The Concerta patent already expired. The deal with Actavis only forestalled its entry with a generic.

      Janssen will still keep making brand Concerta. But with the patent expiration, Big Generic is free to exploit the market under the lax guidelines this White House administration has insisted remain.

      g

  62. Argh! No ALZA at either Kroger, CVS, or Target here in Georgia after having it filled correctly at Kroger last month. Used every tip and strategy recommended. No other authorized distributors in the area. Have been without medication for a week now. This appears to be a case of butting my head up against a wall. If the authorized distributors are not going to carry it the only recourse seems to be moving to another drug (FYI – standard generic tried barely worked for 8 hours, then dropped me into a post medication hole like coming off a sugar high). Anyone have a comment on using Vyvanse instead? It’s monstrously expensive but at least available.

    1. Hi Michele,

      Yes, something seems to be in the works. But unlike in recent years, businesses seem to think public announcements are not necessary.

      My suspicion is that CVS Caremark cooked up some deal with Janssen-Patriot, to exclusively distribute the authorized generic.

      Another possibility: At the year’s end, some stimulant medications are in short supply. The U.S. DEA allows only X amount of the raw materials each year. It has not kept up with the diagnosis/treatment rates, especially with adults.

      Have you checked the brand price?

      re: Vyvanse, no one can predict which class of stimulants will work best for an individual. It just depends on your neurochemistry.

      If you do best on an MPH medication (not an amphetamine, as Vyvanse is), you might want to look into the bevy of new MPH medications. They tend to have savings cards/coupons, trying to get market share.

      They include (some newer than others): Daytrana, Aptensio XR, Quillivant XR, Jornay PM, Adhansia XR, Cotempla

      g

  63. Gina, thanks for all of your work on this issue. I also received a letter from BCBS of Minnesota that indicates starting 1/1/20 they will only cover brand name Concerta. I haven’t explored this issue further, so I don’t know what will happen when we go to refill in January. Also, we live in the western suburbs of Chicago, and for now we are only able to get the Patriot version at Costco. Walgreens stopped carrying it around June, and Kroger stopped in October. I haven’t followed up with Target, CVS, or Osco since mid-summer, but none was carrying it at that time.

    1. Thanks, John!! Very useful.

      Something is shifting.

      It used to be that companies made announcements. But now, it seems on a “Need to Know” basis (and then even insufficient).

      I have tried to contact CVS Caremark corporate headquarters many times. No response.

      I’m wondering if CVS didn’t anticipate the uproar (and loss of business)—and then moved swiftly to cut a deal with Patriot or Janssen.

      g

  64. Hi Gina,

    My letter actually does not specify storefront pick up or mail. It simply says the generic will no longer be covered and the brand will be offered at the same price as the generic. I assume per the lack of details in this letter that goes for both storefront and mail. We’ve actually never used the mail service, only storefront, which is why I’m assuming it affects both for us.

    1. Ah, now the full details. Thank you, Kristin!

      Perhaps we did not get such a letter because we sprang for the brand the last few refills, rather than get stuck with the Teva inferior generic.

      g

  65. Success and failure in NJ. One wall greens that used to be able to order for me said they can no longer do that but I tried another and they were able to order both 27 and 36 mg. This is for December prescriptions. I might suggest checking more than one walgreens. The CVS in my area said they absolutely couldn’t order it and they didn’t mention anything about switching it for the generic for Concerta prescriptions.

    For people that did receive that letter what did your prescription say concert a generic or was it Concerta please advise.

    I wish I knew a good lawyer or reporter because the Teva application for their generic actually goes back almost 15 years which means they held onto it until the smoke cleared from the downgrade and then inserted it into the market that has to be an illegal activity or at least unethical. Anyone know a good reporter?

    1. My letter stated Caremark would no longer cover the generic Concerta starting at the first of the year. They will only cover brand name Concerta. I do believe this is a Caremark pharmacy coverage thing only and not an actual CVS pharmacy thing. If you do not have Caremark has your prescription coverage then this may not affect you depending on your insurance. As for reporters or lawyers, no. But I did file a report with medwatch. You can at least start there. 🙂

    2. Thanks, Kristin.

      It’s been hard for me to get a bead on the facts because terms are often used imprecisely.

      You are distinguishing CVS storefront pharmacies from CVS Caremark home-delivery pharmacy. Is that right?

      That’s been my understanding.

      It’s not happening for everyone with CVS Caremark pharmacy coverage, though. I’ve called several times and no one knows anything.

      Guess we have a cheap policy. My husband works at a startup.

      g

    3. Yes, that’s what I’ve been advising….check at different stores (e.g. Walgreen’s, Costco, Wal-Mart).

      Yes, I happen to be a good reporter. That’s why you’re learning about this here and virtually nowhere else. That’s why my readership and I got the first two inferior generics downgraded. 🙂

      1. CVS
      It’s not the CVS storefront pharmacies that have issued the letter — it’s CVS Caremark, the home-delivery pharmacy. (At least that’s my understanding from reader comments.)

      2.

      I’m afraid you are misinformed of the facts about the Teva generic.

      Teva’s generic came from its purchase of Actavis.

      Actavis tried to introduce its generic years ago. That was delayed by Actavis and Janssen entering a marketing deal — where Actavis could sell Janssen’s brand Concerta as a generic.

      That Actavis/Teva generic is why Concerta users have been able to buy brand at generic prices for so many years.

      That marketing deal ran out several times, each time re-negotiated. That stopped when Teva bought Actavis — though there might have been other reasons.

      g

  66. I wonder if it is health plan specific and STATE specific. As I wrote a couple of weeks ago, my daughter’s Blue Cross only covers the name brand (under Dad’s Blue Cross out of Illinois) while my Blue Cross (out of Idaho) which covered her previously, made me pay more for the generic (after paying the $150 deductible for January). We filled the prescription in the same place (Walgreens) in Idaho (but his company is out of Illinois), but when the insurance changed (from Mom’s to Dad’s mid year for a job change), the same bottle of pills (marked Alza) got a new label to say it was Concerta and what shows for the insurance’s portion of the bill is ASTOUNDING considering it is the same bottle of pills. It would be interesting to know WHERE Michelle’s insurance is located in or the other locations where this change is noted. Is it possible that state insurance laws drive the same company to cover prescription drugs differently?

    When renewal time happened, I read Dad’s insurance carefully and for the Blue Cross plan (still out of Illinois) only the Concerta is listed…no generic. We’ll see what the cost is in January.

    1. Hi Monica,

      Maybe it is state-specific, but I doubt it.

      It seems the first place to start is with the immense variety of health plans.

      Even within the same company, employees can choose among options that have vastly different Rx benefits

      g

  67. I just got a letter from CVS Caremark saying that starting Jan 1, we can no longer get the generic Concerta covered and will have to get the brand name. However, it says this will not cost us any more than the generic currently does. I find this hard to believe as we only pay $10 for the generic. Anyone have any more info about this? I haven’t had a chance to call yet.

    1. Hi Michelle,

      Yes, other readers have reported this. It remains a mystery to me. Perhaps CVS struck a deal with Janssen/Patriot.

      We also have CVS Caremark and I’ve not received such a letter — and when I call, no info.

      Obviously, we have the wrong health plan!

      good luck!
      g

  68. Thank you so much for keeping this page updated. I’ve been following for at least the last two years. Walgreens had been great (in Ohio, anyways) about getting the authorized generic from Patriot (I specified Patriot at the time last year when we moved here). However, I just got a letter saying that starting in 2020, Walgreens would no longer be in our pharmacy network!

    So, I tried to get the authorized generic from Kroger’s this weekend. The pharmacist tried to order the Patriot (before I came here and saw that I should specific NDC) and she said Cardinal Health ended up ignoring her request and subbed their own preferred generic brand despite her notes. Seems strange considering that Cardinal Health is on Patriot’s website as a distributor. Not sure if I should try again at Kroger with the NDC # strategy, or if I should try to go to CVS at Target and get the name brand?

    1. Hi Batya,

      I’m glad my work has been helpful to you.

      Please disregard Patriot’s website vis a vis distributors. It might be a starting point but it has not been accurate, for the most part.

      It seems your insurance policy might be cutting back on pharmacy benefits. This might also come about due to how cheap these (inferior) generics are.

      As for what to do next, hard to say. I would exhaust all options unless the brand is not very expensive for you.

      Personally, I would not give CVS any of my business (in any way) given how badly CVS Caremark (parent company) has treated its customers with ADHD.

      good luck,
      g

  69. Just thought I’d add in case anyone can help. Been following these posts for awhile and was hoping things might get better. Still can’t find the AG anywhere around here (suburban Philly area). CVS “cannot get,” nor can small local pharmacy although their pharmacist is lovely and tries to help. So frustrating!! Have not had success with home delivery.

    1. Hi Beth,

      Sorry to hear of your plight.

      Maybe your insurance plan is the problem. Maybe it has very tight cost restrictions on pharmacy benefits.

      Do you have Wegman’s there? If so, might be worth a try.

      Good luck,
      G

    2. Just to update – I was able to find authorized generic at a local pharmacy and I received a 3 month supply. I sure hope they still have it when it’s time to renew. Prior to that I had called my insurance company to begin a formulary tier 2 generic exception which may not have helped much anyway. We’ll see what happens in three months.

  70. Hi Gina,

    Kroger here unfortunately cannot order it for me anymore. Neither can Walgreens, CVS or Rite Aid. None of who I’ve talked to can or will order it with the manufacturer or NDC and I don’t know why. They give me no reason other than they can no longer get it. There is an independent pharmacy here, Whitacre’s, and they can order it for me so we’re switching to them. Hopefully they will continue to get it. Since beginning next year my insurance will no longer cover the generic and my secondary insurance is cutting their contract with Walgreens so no prescription there will be covered by them, it seems the insurance companies, pharmacies and manufacturers are in a battle!! I sure hope this ends soon, this is doing no one any favors.

    1. Ach, so frustrating, Kristin. I hope it settles down.

      The hard truth is that popular brand medications reach the end of their patents. That’s when generics can enter the market. That’s just a fact of life.

      The problem, though, is that Concerta is very difficult to approximate in a simple generic (without the OROS technology).

      The FDA chief appointed by this White House really made a mess of things. He came in from venture capital (not medicine or science), ran roughshod over FDA scientists’ concerns about generics that were not truly substitutable, ushered in hundreds of very cheaply made generics (many made in China or India to lower standards) — and then went back to venture capital.

      This was truly destabilizing to all concerned—pharmacies, insurance companies, etc.. I imagine the aftershocks will continue to ripple through.

      This mess comes directly from this administration, and that’s not a political statement. That is just fact. I hope we can correct the course soon.

      In the previous administration, we were able to lobby the FDA (via MedWatch complaints) to downgrade the first three generics for Concerta. But now there are at least NINE companies—and counting.

      g

  71. Hi Gina,
    I’m not sure why this won’t let me reply directly to the previous comment but I meant AG (authorized generic). I had authorized brand in my head. It’s been a very long day with trying to figure all of this out. These other pharmacies are not giving me any reason as to why they can’t get the authorized generic anymore and now this new pharmacy is telling me they can’t guarantee they will continue to get the authorized generic. I’d hate to have to find a new medication for my son when Concerta has worked so well for him all this time. But these other generics are garbage and it’d be absolute waste to get any of them.

    1. Hi Kristin — I think some in the industry do call it a “branded generic.” But the FDA uses “authorized generic”.

      https://www.fda.gov/drugs/abbreviated-new-drug-application-anda/fda-list-authorized-generic-drugs

      I know. It is absolutely crazy-making. I’ve been through it myself. But unfortunately, our Blue Shield plan does not include that sweet deal some are reporting.

      You read the post, right? You know that the NDC has changed, right?

      If Kroger is working for you, maybe stick with it. Then you’ll have a history. That might make a difference if they have to make a decision as to filling it or not.

      I agree. Concerta represents an amazing breakthrough. It’s a huge market. Which is why Big Generic is horning in with its cruddy approximation.

      g

  72. Super super bummed and stressed. Our local Kroger just informed me today that they can no longer get the AB. I am having to yet again switch pharmacies. If this last pharmacy stops getting the AB too then we may just have to be done with Concerta altogether and find a different medication. Insurance will not cover the brand and I can’t afford it out of pocket. 🙁

    1. Hi Kristin,

      I’m confused! Why do you want the AB generic?

      Did you ask about availability for the authorized generic?

      g

  73. Christine L. Cook

    This is additional information concerning a pharmacy in Middlesex County/New Jersey.

    WEGMANS has successfully filled my script for the Patriot Pharmaceuticals 36mg product. In fact they indicated that Patriot was their preferred supplier for that product.

    I’ve not outlined the travail involved to get this final solution, as it mirrors other’s experience.

    Gina, thank you for your doggedness, this site, and the regular communications. You are a Godsend!

    1. Thanks for noticing, Christine. 🙂 I’m happy to help.

      I’ve heard so many good things about Wegman’s! Including it carrying the AG.

      Walgreen’s, too.

      I made a point of getting my flu shot and shopping at Walgreen’s yesterday—and letting the pharmacist know why.

      Happy Thanksgiving!
      g

  74. I just remembered also that the full name brand instead of any generic had something to do with the fact that our cvs caremark insurance came from a very large fortune 500 company that was “self insured”. Meaning they were not part of any other negotiating groups and funded their insurance program themselves. This allowed them to negotiate their own payment tiers and programs with cvs seperate from their health care at UHC. I was the only person experiencing this at our local cvs and had to work with the pharmacy mgr to get it clarified. I wonder if this is the same with rhose of you who got the letter?

    1. Hi Kathy,

      Another reader has pointed me to a recent announcement. I will be following up tomorrow — to decipher it.

      Prices, formularies, Tier 1-2 medications are really all over the map when it comes to insurance plans. No cookie cutter info applies.

      g

  75. CVS Caremark (the home-delivery pharmacy) sent me a letter stating that only brand name would be covered and any generic would be denied in the Calendar year of 2020. Maybe I am interpreting that wrong but I would think any generic, including authorized generic, would not be covered. I’ve been using the generic for the last few months as I was getting the run-around on the patriot ones but happy to be back on ALZA 36. Best wishes to you and anyone else on the roller coaster.

    1. Ah! Thanks, Scott. Now I’m understanding.

      As another reader just pointed out, there was a recent press release about this.

      It’s a big change from just three weeks ago, when I spoke with CVS-Caremark Corporate.

      Sorry to misunderstand.

      g

  76. Hi Gina,

    CVS Caremark will not cover Trigen or any Authorized generic in 2020 per a letter I received a few days back. So anyone that likes the authentic original and has Caremark CVS will get the original but at a higher copay for some with deductibles. There are deals being negotiated with CVS Caremark and the original maker of Concerta to use brand name only. And anyone that has adjusted to any generic will no longer be able to get it unless they pay 100%. And I can still fill it at Walgreens or my other local abbeys pharmacy. Hope that clears up any confusion.

    1. Hi Lisa,

      But are you sure the letter says that — that you will get the brand Concerta at the generic cost?

      I cannot imagine that is the case. But I will check tomorrow.

      g

    2. Lisa,
      Info I found online which supports and explains info contained in letters you guys are receiving.
      “CVS expands brand-over-generic
      CVS will implement a Tier 1 approach to deliver lowest net cost. This move will allow coverage of a brand drug on the first tier if the brand is the lowest-net-cost option. The brand will process with a generic copay, and the generic will be excluded from coverage. Adderall XR, Concerta and Advair will be the first three drugs in this new program.

      All patients utilizing those medications will be transitioned to the brand-name drugs at the beginning of the year. While members will benefit from the Tier 1 copay, it is unclear if plan designs for all plan sponsors can support generic copays for brand-name drugs. In addition, with the longevity of the program unknown, there is a risk of member disruption if, and when, covering the brands no longer makes financial sense.”
      This is unfortunate for me however as my PBM for 2020 will no longer be Caremark:(
      Jess

    3. Thank you, Jess!

      This is indeed new information. I spoke to CVS Caremark management only 3 weeks ago.

      Now, I have no idea what it means. The language is imprecise. I will try to decipher tomorrow.

      It seems to say, from the way I read it, that if there is not a cheaper option available, brand will be delivered at a generic price.

      For example, there is no generic for Vyvanse, so maybe that would be cheaper.

      But there are MANY cheaper generics for Concerta.

      Thanks so much,

      Gina

  77. Hi Kristen,

    Yes, the folks with deductibles, let alone high ones, will suffer greatly, eating those costs before their insurance will start picking it up. When I first got the Caremark CVS letter I assumed it wasn’t covering Concerta at all anymore! I read deeper and found they would cover it but only the authentic name brand (original company with the original patent)! Then read some blogs and found out that the company must be cutting side deals to get business back but at the cost of folks deductibles. Total shame! Then what about those folks that are used to the generic and happy with it?!? They’ll be forced with the original ALZA 36, possibly experiencing opposite of what we reported years ago on this blog.

  78. Hi Scott,

    Ive talked with CVS and felt as you did, it’s all ironic after all the struggles. I was told in 2020, Concerta Brand is all that will be covered. Other generics authorized/or not, would not.

  79. Hi Lisa,

    I got the same letter from CVS Caremark indicating I must use Concerta name brand in the new year of 2020 otherwise I would foot the entire bill. Been fighting for the real deal so long this is so darn ironic.

    1. Hi Scott,

      Yes, CVS Caremark (by that I mean, the home-delivery pharmacy) carries ONE Concerta generic, and it’s NOT the authorized generic.

      You’ll have to go to a storefront CVS for that (and not all will oblige) or another pharmacy.
      Good luck,

      G

    2. I also received the same letter. Doesn’t help me any because my insurance doesn’t cover any of the cost until my deductible is met so it’s cheaper for me to get the authorized generic and just pay it all out of pocket still.

    3. Hi Gina,

      I actually do not go through CVS for my son’s prescription. I get the authorized generic from Kroger. Per my insurance I am not required to use CVS for any prescriptions, that is just who our insurance has partnered with for the prescription plan. We would get reduced rates going through CVS, but we aren’t required to use them as long as the pharmacy we choose is in network. Prescriptions filled elsewhere are still accepted and covered..if my deductible is paid in full. Right now it would cost me less money for the whole coming year to pay out of pocket for the authorized generic than it would be to pay off my deductible to have the brand covered and still having to pay 20% of that cost. So this change doesn’t really help me because it’s never helped cover any of the cost for two years because of my deductible status. Unfortunate.

    4. Ahhhhh I see. Unfortunately we cannot get mail delivery for his prescription anyways either. His pediatrician will not write more than 30 days at a time. I guess this whole thing does not change my situation one bit! For better or for worse. 🙁

    5. Hi Kristin,

      Your pediatrician has no reason not to write 90-days prescriptions. Unless he or she wants your child to make an office visit every month.

      But if that’s the policy, that’s the policy. Sure does make it harder on a parent, though.

      g

    6. Hi Gina,

      I think it’s actually just the pediatricians preference. Not sure if it’s because my son is only 7 right now or if he himself only likes to write it for 30 days at a time. I did have to end up signing a form stating I would not sell his medication so not sure if it’s also an office thing for his practice there. We only have to go in every 3-4 months and still he writes it for 30 days at a time…no idea. I have to submit a refill request every single month. Unfortunately our CVS stores here do not carry nor will they order the authorized generic. I’ve only been able to get it here locally at Kroger. I sure wish a prescription could be sent out of state because I’ve come to find out the authorized generic and brand are much much cheaper in some other states. Even free in Canada!! The pharmaceutical companies sure are a mess!

    7. Hi Kristen,

      First, ADHD medications are NOT free in Canada. Many types of medications are not covered, for the most part, by the Canadian health system.

      re: “selling the Rx” — I wondered if that might be the concern, but that is a concern mostly with college students, away from home and getting pestered to “share.” It should not be the case with a pediatrician. It can really add to parents’ stress.

      It’s really not an issue of state prices. It is an issue of 1) the particular pharmacy or chain, 2) the location (higher-cost area might charge more), 3) one’s insurance plan, if that is part of the equation.

      g

    8. Hmmmm…. in this support group I’m in on Facebook for parents of kids with ADHD, those who live in British Columbia are stating they pay nothing for these medications for children under the age of 18 beginning last year. Either way I am living in the totally wrong state compared to these other state prices!! I am going to ask his pediatrician if there’s a specific reason he doesn’t write 90 days scripts. Because if he can, that will save me a little bit in the long run for sure. I will stick with the authorized generic as long as it’s available!

    9. Medication coverage/cost varies by province.
      Canadians can buy insurance coverage for medications.

      Under the Canada Health Act, prescription drugs administered in Canadian hospitals are provided at no cost to the patient. Outside of the hospital setting, provincial and territorial governments are responsible for the administration of their own publicly-funded drug plans. The public drug plans determine what prescriptions drugs are listed and under what conditions for their eligible recipients.

      Most Canadians have some access to insurance coverage for prescription drugs through a patchwork of public and/or private insurance plans. The federal, provincial and territorial governments offer varying levels of coverage and decide who is covered and what the patient and plan pays.The publicly-funded drug programs generally provide drug plan coverage for those most in need, based on age, income, and medical condition. Many Canadians and their family members have drug coverage linked to employment and some Canadians may have no effective drug coverage and pay the full cost of prescription drugs.

      https://www.canada.ca/en/health-canada/services/health-care-system/pharmaceuticals/access-insurance-coverage-prescription-medicines.html

  80. I also have CVS Caremark and UHC. I did not receive that letter. But that is probably because I never got my daughter’s authorized generic through my plan. I always filled that particular script at Walgreens and used GoodRx because it was a better price than through my plan. Since this fiasco I go to an independent pharmacy in my town. They have been able to get the authorized generic and I’ve noticed they don’t put it through my insurance. They charge me $107 for a 30 count of 27 mg which is what I was paying with GoodRx. I have to call them each month to give them lead time to get it as they don’t stock a large amount. If you can find the authorized generic anywhere I suggest you give GoodRx a try and ignore CVS Caremark. I feel bad that my pharmacy might be losing money giving me this service and I worry that they won’t want to see me monthly.

    1. It really depends on your insurance plan.

      For example, with our policy, we can get the authorized generic or brand at the local CVS store for $30/month. (With GoodRX, we’d pay $92, ($62 more) at CVS.

      I opted for brand via home delivery for $100/90 days. $10 more but much less hassle. Four times annually instead of 12.

    2. We have UHC and CVS/Caremark too, but luckily the way it works with our pharmacy plan is that we can get a 30-day supply filled at any participating (ie., non-CVS) pharmacy for 2 prescriptions, but then we have to get a 90-day prescription that can only be filled at CVS/Caremark otherwise the plan will not cover the cost. However, because the authorized Concerta generic is a controlled substance, you can only get 30-day prescriptions here, not 90-day ones (I live in NJ, I don’t know if this is true elsewhere). As a result, we fall into a loophole where we can always get our 30-day prescription filled anywhere that is a participating pharmacy, we never eventually get forced to CVS/Caremark like we do for other long-term prescriptions. After hunting around (because Walgreens stopped carrying the authorized generic, and of course CVS doesn’t carry it), I discovered that our local Wegman’s grocery pharmacy department DOES use the authorized generic, so that’s where we get it now.

      Like you said, it all depends upon your insurance plan. I guess we are lucky, both in the plan and that Wegman’s uses the authorized generic. I am very grateful for that.

    3. HI Patrick,

      Wegman’s and Walgreen’s have been reliably helpful with the authorized generic.

      I’m not sure what you mean about New Jersey laws. You mean that you cannot get a 90-day prescription at the storefront pharmacy? Or that you cannot get the home-delivery. As far as I’ve been able to determine, there are no state restrictions on that. Last I checked, anyway:

      https://adhdrollercoaster.org/tools-and-strategies/stimulant-prescriptions-via-mail-order-pharmacy-maybe/

    4. In NJ doctors are not allowed to write a prescription for more than 30 days of Concerta or it’s generics because it’s considered to be a controlled substance. When we get prescriptions, they are separate 30-day prescriptions with verbiage like “not valid until Mm/dd/Yyyy” on them so that I can get 90 days of prescriptions, I just have to get a 30-day supply every 30-days. Normally that would be annoying, but if we actually could get a 90-day prescription then we have to use CVS/Caremark, so I’m not complaining.

    5. Hi Patrick,

      I think that’s been the case in most states until very recently. Perhaps in the last year or two, we in California are able to get a 90-day supply at the local store.

      G

  81. Yes Kathy and Gina,

    I’m told its due to cost. My insurance is changing and the cost of brand is less than the cost of authorized generic..thus the switch. We have never used CVS due to Trigen alliance so this is a new ballgame. Truly a rollercoaster!!

    Thank you

    1. Hi Lisa,

      Again, all the factors are endless. Depending on one’s insurance plan, for the most part.

      There are many alliances and marketing deals between pharmacies and pharma. And they change constantly.

      You haven’t confirmed if you are talking about a storefront, etc. so I cannot helpfully comment on that.

      But yes, it is entirely possible that the storefront pharmacy has no cost-effective deal with Patriot. So, the brand would be less expensive.

      Again, if it’s Caremark home-delivery pharmacy, however, they simply will not fill the AG prescription at any price. The only generic they carry is Teva—last I checked.

      I hope that clarifies.
      g

  82. Thanks Gina, yes I knew CVS only carried Trigen (which is why we currently use Walgreens) but I was told the switch is from generic to BRAND Concerta. That’s what the letter says. In speaking to the rep, the mail order would only send the Brand Concerta. She kept using “AD” in her terminology. I continued to stress the need for an authorized generic OR Brand Concerta since they are the same. Again it’s strange and I’m waiting to hear back.

    1. Lisa,

      I’m sorry but it still seems to me that you are confused about the terminology here?

      You say that the letter says CVS Caremark “no longer covers the generic Methylphendidate and that if it is filled , I will have to pay the entire cost.”

      1. Methylphenidate is the stimulant class. It includes Ritalin, Concerta generics, and others.
      2. If you had asked for the AUTHORZIED generic Methlphenidate HCL ER, prompting this letter from CVS Caremark, the letter is telling you that it will NOT fill that prescription.
      3. That if you want the authorized generic (brand), you will have to pay for brand.
      4. If you had asked for generic Concerta, you’d have received the Trigen.

      g

  83. Hi Gina, and others,

    Has anyone heard of CVS Caremark making a change to no longer cover generic Methylphendidate and that if it is filled , I will have to pay the entire cost? The letter states to avoid this charge, change to the brand Concerta? I’ve been on the phone trying to understand what this means. I mean if it’s brand, it’s the same as the authorized generic but it just seems strange. Just wondering if anyone else got a similar letter?

    1. Hi Lisa,

      Let me clarify something for you.

      Yes, the authorized generic is the brand sold as a generic.

      But the two are sold by different companies. So the pharmacy doesn’t treat the two in the same way.

      The authorized generic is more expensive than these inferior generics, because it is Concerta and not a cheap rip-off. Pharmacies make more money from the inferior generics. And sometimes insurance companies have strict rules…only the generic, not an authorized generic. It depends on your policy.

      Yes, the home-delivery pharmacy called Caremark carries ONLY the Trigen generic for Concerta. But you can also pay more for the brand.

      At the CVS stores, it seems to vary. Most do NOT carry the authorized generic. But there have been a few cases where they did. I think it depends on the store or regional management.

      Your letter is stating that CVS Caremark will NOT provide the authorized generic, but it will provide the brand or the regular generics.
      g

    2. We ran into this a few years ago with united healthcare. We had to pay a higher copay and only use the actual brand name Concerta. CVS told us that it was something in their contract with UHC. So we used the true brand name concerta for about 12 months before they changed their policies again.

    3. Hi Kathy,

      Lots of moving targets here. That was then. This is now. 🙂

      Specifically, that was before the clown car of inferior generics was unleashed.

      And just after my blog readers and I (and a Kansas City pediatrician named Kristen Stuppy, MD) lobbied the FDA to downgrade the first two inferior Concerta generics.

      Insurance plans are highly, HIGHLY variable in their coverages. Even within the same company. But what’s happening with the new generics has created a completely different scenario.

      g

    4. Suzanne Chillakuru

      Yes, Lisa, we received the same letter. CVS Caremark will not cover generic methylphenidate, whether it’s authorized or equivalent. If we get any generic methylphenidate, we have to pay the entire cost. Cvs caremark states “ask your pharmacist to fill with with brand name Concerta.”

      I’m looking into using GoodRX going forward because retail brand Concerta is $360 for 30 pills under our insurance plan. Authorized generic was $170.

    5. Hi Suzanne,

      We must be the only CVS Caremark customers NOT receiving that letter (but we’ve used only the home-delivery pharmacy, not the storefronts).

      Doesn’t the letter also say that you will pay the generic price for the brand? If so, I’m wondering why you are looking into GoodRx.

      You mean $360 is its idea of a “generic price”?

      I called Patriot again this morning. Had to talk to three people. Bounced around. The final one said that she would forward my questions to someone else and “if you don’t hear from her, call us back.”

      I said, “I’ve done enough unpaid work for your company. If I don’t get a response, I’ll respond in a public blog post, asking why you feel your consumers deserve no answers.” 🙂

      Good luck!
      g

  84. To those having trouble finding the authorized generic–Both Kroger and Walgreen’s in my area are saying they can no longer order it without getting permission from their supervisors, and they do not make it easy when you ask them to do that. So, yesterday I called Costco and they told me that they have the authorized generic in stock. I gave them all of the NDC codes for the various dosages and they either have it in store or can order it with 2 days notice. I have also spoken with two reps at Patriot Pharmaceuticals and both said they have plenty of the drug in stock; there is no shortage.

    1. Thanks, Holly. These chains are huge and I imagine decisions are made on a regional basis as well.

      g

  85. Danielle D Taylor

    Ok thank you. sorry. I am still waiting to hear if Walgreens actually could fill it. they looked it up and said the Patriot generic was available and were going to order. will keep you posted. its been quite a dilemna trying to get a authorized generic….

    1. No need to be sorry, Danielle. I’m just trying to save you frustration. 🙂

      Yes, I know it’s a dilemma. I’ve been reporting on this issue for several years now.

      My readers helped to get the first two inferior generics downgraded.

      Now that task seems impossible. Unless EVERYONE who has a poor experience with one of the new generic files an FDA MedWatch complaint.
      g

  86. Danielle D Taylor

    After discussing with multiple pharmacists at the Walgreens local to me, they finally ordered the patriot generic. Go on patriot’s website and it says that it is available. if its not it should be noted in the chart they have. I’ll keep you posted, if Walgreens is able to fill it…. haven’t picked it up yet. I had to buy 3 weeks worth of brand name so far at $86 per week.

    1. Actually, that listing on the website is not accurate. I do not recommend going by that, as I wrote in the post:

      WARNING:  Please do not jump on the Patriot site and think you will get useful information from its list of distributors.  If you do that, you will likely end up with the wrong answers.  I’ve provided all the information you need below; please look for this heading: How to Specify the Authorized Generic Concerta

      It might be a starting point. But it’s not reliable.

      g

  87. I have been getting the Patriot generic at a Kroger pharmacy, but as of about a week ago, the Pharmacist said that Patriot listed it as “no longer available”

    I’m now jumping through hoops to figure out whether there are any more authorized generics or whether it’s name brand only now.

    1. Hi Heather,

      There is ONLY ONE authorized generic. You will not find more.

      Kroger might have made an executive decision, to go with a more profitable generic.

      Bring the NDC numbers to the pharmacist to check in the database. Also, try Walgreen’s or other pharmacies.

      Good luck!
      g

  88. Thank you so much for your post!

    I’ve been struggling to find the authorized generic ever since Teva acquired Actavis.

    Walgreens, I believe, has a contract with Actavis, which is why for the better part of the past year they carried the authorized generic.

    But after Teva acquired Actavis, Walgreens started only caring the Teva generic (which is far, FAR inferior the Concerta).

    The side effects from the Teva generic have been awful – high anxiety, trouble sleeping, incessant picking at my thumbs/nails. So after contacting several pharmacies, I finally found that my local Walmart is willing to order the Patriot authorized generic.

    Thank you again so much for this post, and for providing the NDC codes. I don’t think I would’ve been able to find the authorized generic without that. You’re a lifesaver!!!

    1. Hi Kati,

      I’m so glad you found my blog.

      That’s truly horrible, the side effects you describe….and likely being told that it’s “exactly the same as brand.” No. No. No.

      Good luck!

      g

  89. Danielle D Taylor

    My pediatrician just did a peer to peer over the phone with the insurance company. went to pick up my son’s prescription today and it was $366 for 30 days. I’m on the phone with them again, have been making phone calls for 2 weeks on this. We always got the actavis and now no longer available. I am printing now and taking to walgreens to see if they can do anything with the NDC number. I have called around asking for Patriot Pharmaceuticals but not getting anywhere with anybody.

    1. Hi Danielle,

      If you haven’t already, please read the post quickly. You’re going to encounter few people with knowledge on this score. I’m it. 🙂

      Actavis was only the distributor, not the manufacturer.

      Don’t call around asking for Patriot Pharmaceuticals. That is a losing strategy. Patriot is the distributor but pharmacies often go through larger networks that might represent Patriot.

      Please re-read the post to get the details you need.

      The NDC number is a start but read that part. Sometimes in pharmacy databases, the hypen is a zero.

      good luck!
      g

    1. Wow, so all the folks getting their Concerta at military treatment facilities will get one of the non-OROS generics.

      Doesn’t sound good.

      Might be best for folks to try another MPH choice, if there is one, a brand that is.

      The problem is, as long as our FDA remains under control of this administration, these generics will be “legal” as generics.

      Only the FDA changing its guidelines will change that.

      After the downgrading of the Concerta generics a few years ago, the FDA announced that it needed to revise its generic guidelines for medications with complex delivery systems (e.g. OROS).

      Then the new FDA chief said, “We don’t need no stinkin’ guidelines. Quit stalling and churn out the crappy generics so I can get back to venture capital.” Paraphrasing. 🙂

      g

  90. I came across the images on goodrx. The ones I’m talking about are manufactured by Ascent for Camber. If you google Camber generic concerta, it shows the articles about its release and on Camber’s website you can find the NDC#s, ingredients, etc. I understand that its not oros, but was just feeling hopeful as this is the first generic that seems to be even remotely close to original…
    Thanks

    1. Hi Jess,

      Yes, Camber’s does seem to be unrelated to the Andor/Lannett. It was late when I looked for that.

      But these generic manufacturers play so many shell games, it’s impossible to keep track.

      Camber is a division of Hetero Drugs of Hyderabad India.

      Maybe it will work for you. But it’s still a generic. And it doesn’t use OROS.

      I found a photo. To me, it’s a sleazy play to fool consumers. The capsule is shaped like OROS but is not.

      http://camberpharma.com/products/methylphenidate-er-399?s=concerta

      Thanks for bringing it to my attention. I’ll add it to the list.
      g

  91. I just saw that now Camber Pharmaceuticals has come out with a generic Concerta. They are actually the same barrel shape as brand. The ingredients are almost the same as brand (the closest I’ve seen so far between brand and any of the generics) and delivery mechanism is described the same way as the brand. Just wondered if you have heard anything about this new generic?

    1. Hi Jess,

      thanks for checking in.

      Yep, the Camber generic is actually from Andor, as listed in my post. It’s hard to keep up with all these companies, subsidiaries, labels, alliances, etc.

      The Camber pills aren’t the same barrel shape, though, at least to one photo I found (poorly labeled). They look oblong and flat, not round.

      At any rate, if it doesn’t say Alza, it’s not Concerta (brand or authorized generic).

      The ingredients in ALL Concerta, generic and brand, is the same: methylphenidate. That is the only active ingredient.

      The difference is the delivery system—that is, how the methylphenidate is packaged and release within the pill/capsule.

      best,
      g

  92. If anyone lives on the big island of Hawaii, I called around and found that Costco carries the Patriot pharmaceuticals version. I requested that my doctor send my prescription there so fingers crossed!

  93. I feel very grateful to have stumbled upon a most informative thread. And though I’m a bit confused, I am going to re read the heck outta this!!

    I’ve been taking a generic methylphenidate ER 36 mg x 2 per day. I’ve been on this med for quite some time…and I feel like it’s not working very well anymore. And yep, I get it from CVS.

    I thought I was just building up a tolerance. My MD also prescribes 30- 20 mg of IR methylphenidate. I recently received a letter from my insurance co. that say’s that they will no longer cover anymore than 30 pills vs. the 60 I was receiving for the ER.

    I know this exceeds the standard daily rec’d daily dosing guidelines, but I’ve spoken at length with my Psychiatrist about this who keeps reassuring me everyone’s different.

    I work in healthcare and have heard many stories of difficulty that can come fr: changing to alt’s such as adderall.

    1. Hi Shannon,

      I encourage you to read the post first. Wading through all these comments might confuse you until you are clear on the basic facts.

      Regarding your insurance not covering more than 30 pills: Is your prescriber writing it as two different prescriptions? That might work better than writing one prescription with two pills daily.

      But why are you taking two 36 mg ER pills? What’s the rationale?

      To clarify your comment about Adderall: There are two classes of stimulants, amphetamines (e.g. Vyvanse, Adderall, Dexedrine) and methylphenidate (e.g. Ritalin, Concerta, etc.).

      There are many choices within the methylphenidate class if that’s what works best for you.

      You might want to read the three medication chapters in my first book; they explain choices and titration strategies.

      https://amzn.to/2WLDaz7

      Thanks for commenting,
      g

  94. Do you have this information for immediate release methylphenidate?

    Is there an authorized generic manufacturer for regular Ritalin (not LA or Concerta)? I have been on this for 15 years and it works best for me…

    I always used to have my pharmacy get it from the Watson/Actavis manufacturer, because my research and experience trying a couple others indicated that was the only one that would work for me.

    Unfortunately several months ago the pharmacy informed me they could no longer get it because Actavis stopped making the immediate release methylphenidate. :’(

    Since then I have tried other manufacturers again but they are no good. I’m also trying an extended release now, but it’s not working for me. I definitely prefer the immediate release.

    I see all sorts of articles and blog posts, including yours, about the issues with the long-acting/Concerta genetics, but I can’t seem to find any information about what the preferred generic manufacturer would be nice for regular Ritalin (20mg immediate release Methylphenidate) now that Actavis doesn’t make it anymore.

    Can you please help me? I feel like I’m going to lose my mind without this medication I’ve depended upon all these years, and there’s no way I can afford to buy the name brand. :’(

    1. Hi Janel,

      Concerta is something of a special case. It has a very sophisticated delivery system that cannot be duplicated (at least not yet) in cheap generics. Also, it’s patent is much newer than that for Ritalin.

      That said, according to the FDA list of authorized generics, Novartis does make available an authorized generic for its Ritalin:

      https://www.fda.gov/media/77725/download

      It’s listed here, but I’m not sure that means you can obtain it.

      I found this customer service phone number for Novartis. Maybe you can use it to ask Novartis.

      1 (888) 669-6682

      Good luck!
      g

  95. I wish I had found this site years ago.

    My daughter has been on various generic versions of Concerta for at least 7 or 8 years and I’ve learned through trial and error and research about authorized generics and crap generics.

    We went through the generics that ended in 2014 and had a fabulous pharmacist who strived to get us the Activis pills. Then we moved and switched pharmacies to chase the Activist pills until there was a change to the Mallinkrodt generic for about 8 months through May of 2018, when by a job change, I needed to pay without prescription and found Walgreens was the cheapest with GoodRX.

    Had I known Walgreens still had those pills and I could get back those 8 months. The difference was ASTOUNDING and the horrific behavior I attributed to puberty, hormones and growth was really pharmaceutical.

    May 2018 was a peaceful month. I DID file a report with the FDA and I did get contacted by Mallinkrodt who wanted to know the lot number. Um. Not a lot number – it’s two different strengths of your drug and at least 8 months of changed behavior.

    The next month, when she went on dad’s insurance (I fell in love with Dad’s insurance) it turned out the insurance ONLY paid for Concerta – no generics allowed. I was surprised. Walgreens was surprised (and they repacked her June prescription by literally only changing the label on the bottle and increasing the price).

    I paid the $10 copay and everything has been going well. But it is now open enrollment and Dad’s insurance plan is forced to change, and I’m worried.

    So reading up on the generics is good for me in case we need to make changes. I’m not sure what our Walgreens carries in the generic realm. Even with this sweet insurance only paying for Concerta, the monthly tribulations to get her prescriptions and to follow through with the communication between doctor and pharmacy is so exhausting.

    How hard is it to get approved for home delivery? I’ve been told it’s not possible in my state. But her doctor is retiring at the end of this year and I am now needing to look for a new doctor…and new insurance.

    1. Hi Monica,

      I wish you’d found me years ago, too! 🙂 Be sure to subscribe because there will probably be updates. And there’s 10 years worth of award-winning posts here.

      I hope Dad’s insurance plan doesn’t change. But if it does, at least you’ll be fore-armed.

      You ask about home-delivery, I wrote this piece (linked in the article above; maybe you missed it): https://adhdrollercoaster.org/tools-and-strategies/stimulant-prescriptions-via-mail-order-pharmacy-maybe/

      I specifically asked the rep for a major home-delivery pharmacy, ExpressScripts, if this is allowed in all 50 states. She knew of no state that prohibited it.

      Many myths and rumors obscure the facts on this issue. Many simply assume that stimulants cannot be sent in the mail or UPS. But they can, depending on your pharmacy benefit, etc.

      Good luck!
      g

  96. Hi Gina, Here’s an update on my recent dilemma with not being able to get the authorized generic at Kroger.

    I spoke with a rep at both the Janssen main office and a rep with Patriot Pharmaceuticals.

    Kroger is now using another supplier and they have decided that they will provide another generic form of methylphenidate to their customers.

    The Patriot rep said she would call my local Kroger and ask the pharmacist to continue to work with their customers to get them the authorized generic, but she suspects a district pharmacy manager will have to approve this request.

    She recommended continuing to work with Walgreen’s to get them to order the “Alza” pills.

    Just thought some of your other readers might benefit from knowing this if they also have been using Kroger and run into any issues. Thanks for being a forum for sharing information! Holly

    1. Hi Holly,

      Thanks for that report!

      Yes, I’m afraid CVS, Kroger, and others are taking the dark path.

      We should all do more shopping at Walgreen’s, it seems. Put our money where our pharmacy needs are respected.

      g

  97. Monique Carrington

    I was just in the process of refilling the authorized generic, methylphenidate hydrochloride ER, 18mg. 90 capsules.

    I called my pharmacy to see if it was ready and what my cost would be. I was surprised that my co-pay was $100 less than what I have paid in the past.

    Normally it runs between $164 to $157 for a 90-day supply. This time I was quoted $58. The manufacturer is Patriot.

    The pharmacy couldn’t tell me why the price was lower. I called my insurance company and they said it was because the cost of the ingredients was less.

    My concern is that maybe the quality is less too. Based on the information on your website, I looked at the capsule and it does say ALZA 18 on it. So I am assuming that it is an authorized generic for Concerta,

    Yet I can’t help having a niggling concern that the quality may be different. Do you have any information regarding changes to the ingredients of Patriot’s authorized generics? Maybe my insurance company was misinformed.

    1. Hi Monique,

      You won the jackpot! 🙂

      You didn’t even have to fight to get the authorized generic—and it’s cheaper for you than before!

      Yes, if it says Alza, you have the authorized generic (brand marketed as a generic).

      It’s not manufactured by Patriot. Patriot is the distributor.

      The authorized generic IS the brand. As such, it is manufactured by Janssen.

      Patriot only distributes it.

      Bottom line: You have the brand/authorized generic because it says Alza on the pill.

      I hope that clarifies,
      g

  98. So far I’ve been able to get the ALZA pills two months in a row from an independent pharmacy in my small town. However this last time she warned me that the supply is “volatile” and basically I’ll have to check in with the pharmacy monthly as to whether they can get them for me. I told her my plan is to fill it there every month (I had hoped they could procure a large allotment???) Has anyone else been told that the supply is low or hard to obtain? Also, depending who writes the script at my daughter’s pediatricians’ office, they don’t always understand why I want the NDC on there. It’s such a pain to explain to doctors. One would think they know of this or similar situation? Keep hoping for this situation to change…. I know it may not be the worse medical issue to have but it stresses me out so much as a mom to get what’s best for my daughter.

    1. Hi Katherine,

      Though I am now a recognized ADHD expert and educator, I once was a print journalist. I know how to dig for the facts — and to recognize a “story” that needs covering. This is why I have been the primary source for information on this subject. Physicians are reading my blog to learn about this.

      The developments at the FDA with this White House administration are not something everyone is watching in any detail. I have been.

      But once you explain to your prescriber, you shouldn’t have to re-explain. Perhaps print a copy of the post for the office to read. How much effort does it take to jot the number?

      Sometimes physicians belong to networks that oversee what they prescribe — and don’t want them prescribing anything but the cheapest medication option. So, maybe that’s a factor.

      To your question, I have not heard of a “low supply.”

      My guess is that that pharmacy had access to the dwindling supply of the authorized generic when it was still distributed by Actavis/Teva (check your bottle to see if that is the case).

      Or, we’re sort of close to the year end. That’s when the supply of stimulant allowed in production each year (by the Drug Enforcement Agency) tendons to run low. This doesn’t affect all stimulant medications, though.

      Perhaps the pharmacy is losing money on the prescription — maybe a lot of money — and doesn’t want to come out and say that. It depends on your insurance pharmacy benefit.

      Yes, it’s not the worst medical issue to have. But it is an important one. When our loved ones do well on a stimulant medication, we don’t want to send them on a roller coaster of trying others. Not unless forced to.

      Concerta is an excellent medication that has been a boon to the millions of people who take it. It has a very sophisticated delivery system (OROS). That’s also what makes it hard to copy in a generic. But with the loopholes that are now being allowed Big Generic, the manufacturers of the generics don’t even have to try. It’s criminal, imho, and I hope there will be a reckoning.

      Good luck!

      g

  99. Thanks for your quick response, Gina! And, yes, you are right about Patriot being the distributor as opposed to the manufacturer–just mixed up my terminology a bit! Kroger has been great in filling the prescriptions for about 8 months, but I suspect there is some wheeling and dealing with Cardinal Health since the supply has just abruptly stopped with no explanation as to why. As for Walgreen’s, I had gotten the Alza pills there for years and then they switched distributors and told me they couldn’t get them. HOWEVER, I just called one of the pharmacists there and she is going to try to special order it and see what happens. She said there were no guarantees and that even if she could get it, it would be a small amount. In the meantime, I am going to call Patriot and see if they have any suggestions. Thanks again! Holly

    1. Hi Holly,

      Yes, I hate to be nit-picky. But I need to impress upon readers how important it is to get the details straight. It can make a difference.

      Many of the clerks folks are dealing with are not highly savvy as to these systems. The simpler we can make it — without giving misinformation that will send them down the wrong track – the better our chances of success.

      It’s been my experience that most don’t even know what is an authorized generic (also called a branded generic). So we have to keep things simple and precise, I think.

      Keep in mind: We’ve been going through a transition. The Actavis/Teva supply of the authorized generic is probably still making its way through the system. That might have been the supply for
      Walgreen’s.

      Moreover, Patriot was incredibly slow on the uptake. There was a big lag in announcement to availability.

      When I called them back in June, I had to explain what is an authorized generic — from the company whose tag line is “Only authorized generics”! (Something like that). Incredible!

      One would think I’m on the Patriot payroll — doing its work for it — but I am not.

      I hope it works out with Walgreen’s. I bet it was just a matter of timing and maybe not knowing how to enter the number (some databases use a 0 instead of a – with the NDC…follow the link to see examples).

      g
      .

  100. Hello Gina!
    Several months ago, my local Walgreen’s pharmacist told me she could no longer fill prescriptions for the authorized generic “Alza” pills for my 4 family members that have been taking them for years.

    So, using your tips, I was successful at getting them from Kroger UNTIL today. I can not find anyone in Nashville, TN who can get the pills.

    Both Kroger and CVS are on Patriot Pharmaceuticals list of distributors but, today, two different Kroger stores (and 2 CVS locations) said that their wholesaler, Cardinal Health, says that they can no longer get the “Alza” pills from Patriot.

    I don’t know if this means Patriot is no longer manufacturing them, or if there is another problem. Our insurance (Aetna) will not cover brand-name Concerta without a special exception letter from our doctor, and if they do agree to cover it, it’s six times the cost of the authorized generic. Any new insight from you would be greatly appreciated!!

    1. Hi Holly

      First, just to clarify: Patriot is NOT the manufacturer. Janssen is the manufacturer. The authorized generics ARE the brand — marketed as a generic.

      Patriot is the distributor. It is a subsidiary of Janssen.

      If both Kroger and CVS report not being able to fill your prescriptions, that probably means they don’t WANT to order the authorized generics. It’s not as profitable as the regular generics.

      Cardinal might have some deal with the generic manufacturers to not provide the authorized generic. Who knows about the wheeling and dealing.

      But could you try beyond Kroger and CVS? So far, Walgreen’s has been the more reliable pharmacy. Can you try Walgreen’s or another pharmacy?

      Good luck!

      g

  101. I’m a Child Adolescent Adult Psychiatrist in Atlanta and treat many patients with ADHD ( 42 years). One of my patient’s savy mother sent me a link to your website re the Concerta generic confusion I applaud your research, thoroughness, clarity, and obvious good intentions—-and the obvious huge amount of time you devote to this blog. I’ll be recommending it to patients.
    Generic Adderall tablets have been a recent concern also as I have had a number of patients complain about lack of efficacy with certain generics. So far I haven’t been able to figure out a definitive pattern to explain the problem. If you have any insights let us know. Thanks from emerald and I’m sure all the people you reach

    1. Thanks so much for the kind words, Dr. Waugh, and for recognizing the importance of this for your patients.

      Yes, my intentions are good. I have never taken support of any kind from pharmaceutical companies (not that it’s necessarily a bad thing). So I’m certainly not profiting from my labor. As a former print journalist, I feel compelled to inform the public.

      You’ll find posts on generics dating back to 2009. That’s when I first discovered the nature of the problems that many readers were experiencing.

      Including this, about Consumer Reports’ horribly bad advice to consumers:

      https://adhdrollercoaster.org/tools-and-strategies/consumer-reports-on-vacuum-cleaners-maybe-on-adhd-medications-definitely-not/

      And a follow-up post:

      https://adhdrollercoaster.org/tools-and-strategies/update-on-generic-rx-approach-with-caution/

      You’ll find a list of all posts on generics here:

      https://adhdrollercoaster.org/?s=generic

      In this post, I detail some of the issues with generics and “bioequivalence”:

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

      excerpt:

      Q 1: Hey, what’s the problem with generics, in general? Aren’t they the same as brand by law?

      No, generics are not the same as brand, no matter what some misguided pharmacists might tell you. There are two key differences, and they are particularly relevant to psychiatric conditions.

      First, let’s distinguish between the two types of generics:

      Authorized generic:

      These are brand medications marketed as a generic for price and insurance purposes. This tends to happen when the brand is nearing the expiration of its patent.  To forestall competition from a generic manufacturer, they strike a marketing deal: The competing company can market its brand-manufactured pills as a generic. It’s a win for each company and a win for consumers because these authorized generics are typically cheaper than brand.

      True generic:

      This is a generic in the commonly understood sense: a medication that is manufactured separately than the brand, typically for a lesser price, but is “bioequivalent” to it. Once a brand medication goes off patent, generic manufacturers can produce their own version.

      I hope it is obvious by now. The problem with these “true generics” is that they weren’t true.  One highly placed source told me:

      If the Mallinckrodt version is the one I was consulted on, then the story is this.

      All the company had to do is replicate the pharmacokinetic curve of Concerta without the OROS technology, which is patented.

      Simply defined, a pharmacokinetic curve is a graph that plots the concentration of a drug in blood plasma against time. This graph below plots, over almost 32 hours, the plasma concentration of Concerta vs. an immediate-release methylphenidate product.

      Important Differences between “True” and “Authorized” Generics

      Here are two key differences between brand/authorized generic and the true generics:

      1. Variable dose of effective ingredient:

      Bioequivalence does not mean true generics are exactly the same as brand. In the U.S., the FDA requires the bioequivalence for the generic product to be between 80% and 125% of the original product. Yes, that’s roughly 20 percent up or down—a huge window of variance.

      This variability alone can wreak havoc for the many people with ADHD. They might do best with a specific dosage; taking much more or less than that dosage is not as effective—and can even be very problematic. Especially when you’re not expecting it. And especially when you question the pharmacy about the different-looking pill and you’re told that generics are the exact same as brand. Wrong.

      For example, you and your prescribing physician have established that 30 mg of medication X is best for you. You’ve tried 40 mg and 20 mg, both to poor effect. It is 30 mg!

      Given this allowed ”bioequivalence” generic range of 80 to 125 percent, your generic pill could be anywhere from 24 mg to 37.5. Even that number will not be constant; it might vary each time the prescription is filled, because pharmacies often switcher suppliers.

      2. Different dyes, fill material, and binding

      Moreover, branded drugs and their true generics almost always contain different dyes, fillers, and binders. These are all ingredients to which many people are allergic or have other adverse reactions. (I cannot cite research to support it, but abundant anecdotal reports indicate that people with ADHD might be more prone to these sensitivities.)

      Imagine when your physician has no clue that the filler is the problem, not the medication—and not some additional condition, such as bi-polar disorder.

      Thank you!
      Gina

  102. Walgreens caught on and is switching their supply chain to Teva. I’ve been going Walgreen to Walgreens in my area every month filling my script with the last of their Alza stamped pills. They say that they have the prescription with the new supplier but only have what they have of the “old type”.

    1. Hi Lauren,

      Did you give the Walgreen’s pharmacy the NDC numbers?

      I’m not sure what you mean by “they have the prescription with the new supplier.”

      g

    2. We have had luck with asking our Walgreens to order it special for us. The pharmacist remembered me this month from when we requested the Patriot pills last month, and we refilled this time with no problems. We should just need to ask a few days ahead every 3 months to make sure they can order the new pills for us from the warehouse. I called Patriot and they were able to give us the name of 3 or 4 pharmacies close to us as a backup who will either carry the Patriot pill or be able to order them for us (a Walmart, a Kroger, and a couple of local pharmacies).

    3. Allison Paveglio

      My Pharmacist at my local Walgreens is aware of this Concerta issue and gladly gets the “alza” labeled pills. They just ask to have the Dr write the current distributor and NDC # on the RX and has noted my sons file in there system. Try talking one on one with the pharmacist.

    4. I’m glad that’s working for you, Allison.

      Walgreen’s has really been a notch above these other pharmacies, for years, on this issue.

      I might suggest caution to others on including the distributor name, instead of only the NDC.

      Some pharmacists will see “patriot” and say, “No, we don’t use that distributor.”

      There are all kinds of “middlemen” in the distribution chain, and I’ve found that confuses as often as it helps.

      g

  103. I’m newly diagnosed at age 52. I was put on generic by Trigen Laboratories, LLC. I noticed they looked different from the ones with OROS delivery system and had my doctor write a new script. Unfortunately, the generic seemed to work better for me than the ALZA one. Has anyone else had this experience…or was it just that it seemed to work better because I was going from no medication to finally medication? Are the pills from Trigen dangerous? Should I avoid them? Any feedback would be greatly appreciated. Thank you

    1. HI Cammie,

      Yes, that’s a common question or report — that the generic Concerta actually work better than brand (and authorized generic, which is the brand).

      Here’s the thing: These medications are not bad or dangerous. But they don’t work enough like Concerta to be called its generics.

      Some people will find a generic’s release profile works better for them than Concerta does.

      But again, that’s not the issue. The issue is that millions of people who do WELL on Concerta are now being forced to take medication that does NOT work as well as Concerta.

      In your case, it might be that you gauge the generic as working better than Concerta because you haven’t been taking medication at all prior to that.

      g

  104. Thanks for all of your research and information on here!
    We had one of the “other” generics last spring and noticed a difference and have been sure to get brand or (unknowingly) the authorized generic ever since. Our pharmacy tried to give me generics from two different manufacturers this last refill. I didn’t even look at the pills and told them no and that I wanted the brand filled instead. They were not helpful and tried to tell me that my insurance was suddenly asking for a pre-authorization for the brand. I left the store (quite annoyed) and we found this site with so much great information. After calling around with the new NDC number and everyone telling me that their warehouses were empty for this number, we went back and re-verified our insurance and started working with a new pharmacy and were able to get the brand with no issues (and no prior-authorization required). I will have to keep the info on the hyphen/0 substitutions in case we have any issues in the future as maybe that is why there was nothing to be found in my area for the Patriot Pharma generic.

    1. HI Kathy,

      Yes, I just discovered the issues with zeros and hyphens today.

      Other readers have found the original NDC number to work.

      Pharmacies vary in their databases — and the one national home-delivery pharmacy I called uses the 0s instead of the hyphens. It was only by a fluke that I discovered this. 🙂

      G

  105. Folks – I have a hot new tip.

    Apparently, the NDC number will be slightly different, depending on the pharmacy database.

    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.

  106. Thanks Gina, that is one option. I’m going to ask my doctor to appeal to Cigna; and my husband will ask his employer if they can do anything since it is a company benefit. That said, after this year of hell with Actavis / Teva… I’d sooner change insurance than medication. (Famous last words haha).

    1. I hear you, Vicky.

      At least there are tons of choices now. Not so long ago it was Ritalin, Adderall, and Dex. All immediate-release.

      Now…I can’t even keep up with them….and their wacky names. 🙂

      Good luck!
      g

    2. Definitely have your husband say something to his employer. We had Cigna for a year and they were AWFUL. I’ve known other folks who also had terrible experiences with Cigna. My husband’s company actually switched back to CareFirst in part because so many employees complained about Cigna, and as a former HR manager I always told people: if no one says anything, admin staff may not realize there’s a problem!

    3. That’s a great point, Jaclyn. Thanks for chiming in.

      It might be that in some cases, however, it’s better not to raise red flags.

      For example, a small company might realize that one employee is a “heavy user” of the prescription benefit. If that employee raises concerns about pharmacy benefits, it might put a target on his/her back.

      I’ve seen it happen, unfortunately. Of course, these are the companies that typically do not have HR managers. 🙂

      g

  107. David P Pomeroy MD

    Suggestion – ask your doctor to ask for Prior Authorization on the Concerta (or generic), because the FDA-approved dosing goes up to 72mg. Insurances don’t understand that this one doesn’t come in a 72mg single tablet. Usually they will allow it when it is pointed out that 72mg is an acceptable FDA-approved dosage and it requires 2 tabs.
    Hope it helps!

  108. In Jan 2019, Cigna stopped paying for Concerta brand name. With Gina’s help we finallyyyy our local Walgreens to order the authorized generic.

    Then this weekend, we got a very disheartening letter in the mail. Starting Jan 2020, Cigna will now only pay for ONE tablet per day, even for the generics. I take 72mg, so that means they will pay for only 1 x 36mg tablet each day. Sadly they don’t make 72mg tablets, but it should only affect people like me who need the highest dose.

    I’ll be discussing with my doctor for a way to appeal, but I wanted to share a heads-up to this group. Will keep you posted and please, if you have suggestions, let me know? As always, thank you for this forum!

    1. Hi Vicky,

      How frustrating — and infuriating ….and short-sighted of Cigna.

      I wish you luck with your appeal.

      Maybe it’s time to try another methylphenidate product…..e.g. Aptensio XR…which might still offer a savings program.

      Or Quillivant, etc.

      g

  109. Great, thank you so much Gina! Just called my doctor, the receptionist is the one that normally handles the actual data entry aspect of sending scripts- it was sort of confusing but essentially she is going to call the pharmacy and give them the NDC number for the Patriot generic, although I could tell she had no idea what an NDC number was!

    At the beginning of the phone call I was trying to explain to her the situation, told her I hadn’t actually purchased the medication today, but she said there is nothing they could do for the prescription because it has already been sent out. I asked her if she could “void” the script that was sent out, and send in a new one, with the NDC code included, and she didn’t give me a straight answer (there’s a bit of a language barrier as well, unfortunately). Regardless, she said she’d call the pharmacy and see what she could do. Fingers crossed!

    1. Ah! Good luck! I hope it works out.

      There are so many rules with Schedule II substances. I’m not sure the prescribers can account for an Rx that is refused. It probably varies by state, too, just for fun.

      g

      P.S. NOBODY knew what an NDC number was before I started digging. 🙂

  110. Thank you Gina for all your work on this! I have been following this page and this comment thread specifically for a while now-

    I have been getting 36 mg alza generic for years now from Walgreens and last month received the Teva “726” out of the blue. For reference, I live in New York City.

    A similar thing happened to me a few years ago with the Mallinckrodt generic, so I knew I was kind of screwed for this month, but knew to ask my doctor to specifically write Alza for my next prescription.

    He sort of ignored the NDC number for the Patriot Pharmaceuticals generic (10147068601) thinking writing “Actavis” would be enough and sent it off (In his defense, I should have been more pushy in my insistence in including the NDC number, I sort of assumed he knew what he was doing).

    Alas, when I went to get my prescription this morning- Teva “726” again!

    Obviously I didn’t purchase it this time, and instead called Patriot right away- they were actually quite nice (the woman on the other end literally said “Oh yeah…. you aren’t the only one… we’ve been getting a lot of these kinds of situations lately) and provided me with the names of a few pharmacies in my area that should carry the Patriot generic.

    I called 12 pharmacies (10 Rite Aids and 2 local pharmacies) and none of them had them in stock.

    I asked a few of the Rite Aids (after I had tried 8 or 9) if they could order it for me and they told me they could, but they couldn’t guarantee it would be the exact one I was looking for, it would just be whatever was in stock. Is that even true? The person didn’t seem like they were an expert by any means, but still, they are the one at the pharmacy, not me!

    I called Patriot back and someone else answered, told me “I’m not sure who you talked to earlier, we don’t have any localized list. You have to go to “pickyourpharmaceuticals.com” to see that. That website doesn’t exist? Very confusing.

    Sort of getting near crunch time for me now- I’ve been struggling through the far inferior Teva generic this month, it’s so strong and has made me feel so lightheaded and given me heart palpitations and ruins my ability to fall asleep or sleep well that I’ve been taking only half or less a day, so I have a few left.

    I’m already in a weird headspace by not having my medication, and have been having a lot of personal stuff hit me as well, independent of this, and now I have to deal with this nightmare that even Kafka would smirk at- the irony certainly is not lost on me. I’m relatively young and well, single, no children- I can’t imagine how difficult it must be for someone worse off/more stressed than I to navigate through all this!

    Anyway, thanks for all your work on this, it’s been extremely helpful.

    If nothing else it’s helped me feel at least like I’m not alone/going crazy! I’ll definitely keep everyone posted here on what I’m able to find out, I think the only thing I can do is to keep calling some of the more local pharmacies and ask them to order it, and hope they can/it comes in sooner than later?

    Maybe I should keep calling Patriot and hope I get the same nice lady I got on my first call?

    1. Hi Austin,

      May I say…..ARGGGGGHHHH!

      This is so wrong. So very wrong.

      Here’s one key problem: Your physician screwed up by specifying Actavis—and by ignoring the NDC. By doing that, he ASKED FOR the generic from Teva (which purchased Actavis a while back).

      (Actavis, which used to have the authorized-generic marketing deal with Concerta manufacturer Janssen. So, many people have come to associate the authorized-generic with “Actavis.” BUT NO MORE.)

      Never assume the doc knows what he/she is doing! I’m afraid that most do NOT in this regard.

      QUESTION: ARE YOU SURE THAT WALGREEN’S CAN GET IT FOR YOU?

      It seems that you kept shopping after Walgreen’s gave you the Teva generic. But that’s not Walgreen’s fault; your physician requested it.)

      I suspect Walgreen’s might be your best bet.

      There won’t be a local list. It’s still a fairly new NDC and pharmacy suppliers don’t change that quickly. Some Walgreen’s will help, some won’t. And the same is true for other pharmacies. It often depends upon the pharmacy manager (but also your pharmacy benefit).

      MY ADVICE: Get a new scrip from your doc and go back to Walgreen’s.

      Good luck!!! I’m so sorry this is happening to you.

      g

  111. I took my 7 year old son’s script to King Soopers for fill with Patriot (after verification that they do indeed have Patriot in stock). Doctor wrote Concerta 27 mg Patriot only and checked substitution permitted box. The pharmacist refused to fill until speaking verbally with doctor. Doctor verified accuracy of prescription and preference for Patriot which pharmacy had. Pharmacist stated prescription was invalid due to Patriot only/substitution permitted and that it would not be filled nor would paper script be given back to me. Doctor insisted to at least give script back so I could fill at different pharmacy. Pharmacist refused, even though they had the Patriot brand in stock. I went to pick up the medications and was told that there was a “problem” and that doctor cancelled the prescription. I called doctors office and was informed of 30 minute rude phone call with pharmacist and that pharmacist cancelled script, not the doctor. It’s hard enough dealing with 2 kids with ADHD but then to have to deal with a pharmacy that won’t even return a prescription so I could fill elsewhere. Is this even legal for them to confiscate my son’s prescription for a much needed ADHD medication. I live in Colorado.

    1. Oh, okay.

      Well, obviously your prescriber should NOT check the “allow substitutions” box/line.

      The wording varies by state. But the gist is: Dispense as written.

      Might want to add “medically necessary.”

      Much of this depends on your prescriber, the type of insurance you have, if you are in an HMO or other “chain-type” clinic that has its own rules, etc.

      good luck!

      g

  112. Hi Gina

    I heard from my daughter’s doctor today and there is the concern that if the all substitutions line is signed that even if the ndc # is provided we may still not get the correct med. I’ll call Walgreens in the morning.

    Also I would love to only deal with this 4 times a year. I also use CVS caremark and can get 90 day supply in store
    .but they only carry Trigen in store and for mail order. I can also get brand mail order for 900.00 for 3 months
    So I’m stick using Walgreens or wherever each 30 days.

    1. Hi Lisa,

      That’s too bad about CVS Caremark.

      I’m sorry but I don’t understand your question or comment:

      I heard from my daughter’s doctor today and there is the concern that if the all substitutions line is signed that even if the ndc # is provided we may still not get the correct med.

      What is the “all substitutions” line?

      Generally speaking, if the prescriber specifies “no substitutions” and provides the NDC, that is very specific. The pharmacy still might not fill it but it should call you/doctor for further instructions.
      g

    1. You’re welcome, Lisa.

      I know it’s a LOT to wade through. I tried to make it clear but provide all the details.

      Because if I didn’t, there would be questions and answers would be scattered all over creation. 🙂

      g

  113. Hi Gina,
    I just asked my daughter’s prescriber to write a new prescription with NDC xxx only. Should she sign the dispense as written line as well? Or is the NDC only sufficient? Trying to get this right in order to take to the pharmacist in a few days.

    1. Hi Lisa,

      I can’t advise you definitively. Did you ask your prescriber or pharmacist?

      It might be that “medically necessary” would work best.

      It depends on your state, your prescriber, and your pharmacy insurance plan.

      Here is what I wrote in the post:

      5. Pay Particular 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!

      good luck,
      g

  114. Oh my god, this was SO helpful. I was able to get my son’s script filled and only missed a day of meds. And now I know where to go in the future! I was able to contact Patriot and get a list of several pharmacies close to me that will have it or can order it. You’re a lifesaver; thank you so much!

  115. Update to post on September 23, 2019 at 8:38 pm

    As of now, here in Tacoma, Washington, we found 3 pharmacies that only carry the Patriot Pharma AG. Costco, Rite Aid and Safeway, and all had the 54mg in-stock. So I got that with the GoodRX coupon. $120 for 30day supply of 54mg.

    Other Pharmacies were all over the place:
    Fred Meyer – Mallinckrodt
    Bartell – Krevens
    Walgreens – Teva (their version as the supply of the AG ran out in Aug)
    WalMart – TriGen

    One thing to note all 7 of these pharmacies only carry 1 generic.

    I’m going to make more calls tomorrow and provide a more comprehensive list to my sons doctor so he can pass this info on to other patients who may have adverse reactions to sub-par generics. I’m also providing him with the 5 point flyer and will discuss what options he has in writing these prescriptions – especially adding the NDC# – as he uses EMR (Electronic Medical Records).

    I will also go back to Walgreens and do some educating so they know why they lost a customer and see if they would be willing to order the Patriot. For some families they can’t wait the few days it may take to order this so it could be faster to go to a pharmacy that carries it and is also accepts your insurance!

    I spent quite a lot of time explaining this to the Pharmacist Tech at Rite Aid – she wrote Patriot Only on my sons profile and on next months script which I left with her. She said they only carry AG’s.

    PS. Costco in Phoenix AZ is stocking the Patriot, but it is on backorder.

  116. Hi Gina,
    Thanks for all your research and explanations of a confusing and frustrating mess, even to us docs. I cannot keep up with which company markets which generic and which one bought which other one.

    The difficulty I have, which may be shared by other docs who use Electronic Medical Records (EMR) is that the NDC# are in the system, not ones I can choose. Each manufacturer has a different initial 4 or 5 digits of every NDC # for their products. Therefore if my EMR folks just grab an NDC# and do not have all of them per manufacturer per dosage, the NDC may indicate Mylan or TEVA or Janssen or Patriot. But the pharmacist can substitute ANY generic, authorized of not, regardless of the NDC# on the RX.

    It complicates my process for sending (electronically, thank goodness I don’t have to print them!) RX for MPH ER 18/27/36/54 as I would have to enter the NDC# manually and in the Comments section of the RX. I have received pushback from pharmacists who call and say “but the NDC# of what you ordered is not what you specified”.
    The other issue is cost. Brand Concerta usually costs more…unless the insurer requires Brand; I suspect this means they have a silent deal with Janssen to buy it at reduced price, not necessarily trying to deliver the best one to clients.

    Generic prices vary all over the map, by manufacturer and by pharmacy. Many recently bumped up from ~$200 to $350 to $500 per month. !! Unethical and immoral IMO but that’s business. 🙁
    Unfortunately I suspect if I specify Patriot generics that I will get calls from patients saying it’s $100 or more compared to other generics stocked by the pharmacy.
    Many folks find that other AB-rated generics work well for them. For those who do not, I will try the Patriot only, NDC# specified gambit.

    Thanks again for keeping us all up-to-date with generics and MPH ER/Concerta.
    Cheers,
    David Pomeroy MD 3000+ patients with ADHD seen in past 14 years…

    1. Hi Dave,

      I’m glad you find my work helpful.

      Yes, prices are all over the map. And so are the choices consumers can make with their healthcare plans.

      It seems many people don’t understand this. For example, they might choose a cheaper policy with a high co-pay for Rx (or one that doesn’t include Rx until a certain out-of-pocket maximum is reached)—and then be surprised when they see how much their RX costs.

      I’m not sure I understand the situation with EMR (Electronic Medical Records). You mean you must select from a list—that you cannot enter a preferred NDC? But then, from what you wrote, it does seem you can enter the NDC—but perhaps another part of your specifications conflict with it? (e.g. “No generic”)

      At any rate, if the physician writes, “dispense as written,” the pharmacist cannot substitute any generic, right?

      And, you can’t anticipate what a patient will pay, given the variations in healthcare policies. Right?

      I think the most important thing is to let patients know: You might receive a pill that does not look per usual. So, if you notice differences in efficacy (better or worse), please think “horses, not zebra.” In other words, that it might be the medication change and not other life factors.

      thanks for writing,
      g

  117. Filed two separate FORM FDA 3500B’s today.

    My 16 yo son has been on 72mg of Concerta for years, always either brand or AG with ‘azla’ printed on the tablet. We’re in Tacoma WA and usually fill prescriptions at Walgreens. After a few changes in insurance companies we have run into a couple problems. We had to fill this script in Phoenix, AZ in April 2019 at a CVS and received the TriGen generic. My son had serious adverse reactions including complete lack of focus, feeling he could not control his actions, worried about being left alone and digging a hole, the size of a pea, in his upper arm.

    We immediately went back to Walgreens at home and paid OOP with the help of GoodRX. All good until this week.

    Walgreens no longer has the AG and substituted TEVA’s new generic. This time the adverse reactions included; complete lack of focus, compulsions, feeling hot ‘inside’ and insomnia.

    I’ll be camping out in the Drs. office tomorrow for new prescriptions and calling around to see if I can locate the correct medication.

    What a nightmare!

    1. Hi Susan,

      So, you tried to get the AG from Walgreen’s back in April. That might have been too soon — the “no man’s land” of the transition.

      At least your son tried the Teva generic and had a bad reaction, which should help make a case to your insurer that you need brand.

      Please make sure that your doc knows what to ask for.

      Thanks for filing the FDA MedWatch reports.

      Good luck!
      g

    2. Walgreens was able to order it for us here in Decatur, GA. You might also try calling Patriot directly; I got a call back from a rep who gave me the names of a few pharmacies near us that either will carry it or can order it (Walmart and Kroger, plus a couple of locals). Good luck!

  118. I switched from Vyvanse to Concerta 2 months ago. Discovered your article this morning, checked my pill bottles and discovered my pharmacy had given me the Mallinckrodt generic.
    The last 2 months have been really hard and now I’m steaming mad.

    (╯°□°)╯︵ ┻━┻

    Thanks for all your work on this

    1. Dear DQ,

      That makes me steaming mad, too. And you know why?

      Not just because this is one of the new clown car of Concerta generics that in no way resemble Concerta. It is not.

      But because the Mallinckrodt generic was DOWNGRADED several years ago. We lobbied the FDA (via MedWatch complaints) to do that! And it did!

      I can find no evidence that the FDA reversed this decision. The NDC list of Mallinckrodt products does NOT include a methylphenidate product.

      Mallinckrodt’s CEO threatened a lawsuit against the FDA (it was eventually thrown out of court).

      And did NOT pull it from the market! CVS was the worst about continuing to substitute it. Despite the FDA statement: “They are not
      recommended as automatically substitutable for Concerta.”

      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.

      If I were you, I’d march back, to that pharmacy and ask what the heck.

      I’m glad you found my blog. Thank you.

      g

  119. Two weeks ago we were finally able to locate a pharmacy that carried the authorized generic and get the prescription filled there. Night and day difference!!!

    Had I never came across this website from researching my son’s medication I would have been, like you said, one of those people who thought the medicine just stopped working. Not only that but I considered having the Dr prescribe an additional dose of Ritalin to make up for the lack of control with Teva Concerta! That was short lived.

    I wish it was considered more the little effect these generics have on those with ADHD.

    With Teva, my son may as well not have been on medicine at all. It was like having the old him back…aggression, hostility, uncontrollable emotions. Not only is ADHD frustrating for us as parents and adults, but it is also just as frustrating for young children. They don’t like being at constant battle with themselves and having no control! I have filed a report with MedWatch and I hope it some day will make a difference and these generics will be reevaluated.

    1. Hi Kristen,

      Congrats!!

      Thanks so much for filing the MedWatch complaint. I have a feeling that FDA staff ARE reading them with interest—and just waiting for the chance to do the right thing.

      These generic companies are acting sociopathically. Without doubt. They are exploiting (and being allowed to exploit) loopholes without regard for patient safety or medication efficacy. And because they make them so cheaply, they become the “must try first” option for many people.

      I find it unconscionable. And I am so grateful that you found this information and that it helped!

      g

  120. Hoofa.
    No WONDER we nurses have been having a time with Georgia Medicaid’s formulary rules for Concerta!
    We were told, by OptumRx, to tell pharmacies to use Actavis/Watson generic if the pharmacy wants to avoid being reimbursed for generic instead of brand. (BIG price difference).
    Georgia Medicaid families cannot afford out of pocket expenses for their kids’ stimulant meds.
    Thank you for your post; I’m sharing it with my providers and colleagues.
    Nurse Nancy

    1. Hi Nurse Nancy,

      Wow, good sleuthing on your part!

      I’m glad you figured it out.

      It’s become obvious to me now what a bad idea it was to have ever asked for Watson/Actavis.

      It did not take into account future mergers, a White House kleptocracy that would push through tons of generics without too many questions, etc.

      It actually should be no surprise to us that Watson/Actavis/Teva has its own generic now. That company is the one that challenged Janssen years ago with a Concerta generic. That was forestalled by the authorized-generic marketing agreement.

      Anyway, I am so glad you are helping Georgia Medicaid families to get the medication they deserve.

      Nancy, I have a private question for you. I’ll send it via e-mail.

      Thanks for your comment,
      g

  121. Hello Gina

    First time web site viewer. Many, many comments I see everywhere.

    My comment!
    Specially chosen lady! Your are strategically chosen by our God!
    You are appreciated for the wisdom you share.

    Thank you, Audrey

    1. I agree with you Audrey. Gina is a gift from God. I am praying as I print all this information and get ready to call my pharmacist at Walgreens and my daughter psychiatrist today. Praying that this is not a battle just to get what my child needs to function everyday. I pray for you Gina asking that God richly bless you for the work you are doing here. I also pray for all the parents and those on this blog that with the help of God we will fight this and win!

      Last week I had to pay full price because my daughter picked up the generic based on the name the manugacturer name on the bag and bottle. It read “Actavis” so she felt she was good until she got to her room and opened it to see it was not. I had to pay full price at another Walgreens because of that but I was able to get a new bottle the next day with the old authorized generic NDC. The pharmacist I spoke to was amazed at how much knowledge I had about this. She turned to her coworker and said “She needs to be working back here with us!”. I told her there is a blog to keep parents up to date on all these changes. She said she was going try and figure our why all of a sudden Walgreens had switched. At that time I had not read the blog fully but now I have so I will be calling back today praying she is the one that picks up the phone!

    2. Dear Lisa,

      Haha! Good for you! You knew more than all of them! Great work!

      I so appreciate your kindness and prayers. I am pretty tired this morning, as my local Adult ADHD group went late last night, as usual.

      And I am facing a MOUTAIN of work to complete my online training course (for adults with ADHD, their loved ones, and mental health professionals).

      Because I am tired of hearing about poor treatment outcomes! People deserve better!

      And they certainly deserve to get the medication they know works for them—and not be forced to take a grossly inferior substitute. It’s not right.

      Your kind words boost my spirits and keep me going today.

      thank you,
      g

  122. Thanks Gina, for this excellent research and post. I am a psychiatrist and the complaints have started to come in again on this issue with “Concerta” not working the same, and as the local Navy base pharmacy seems to not be carrying the equivalent for Concerta anymore (and I write a good number of Concerta scripts). So now I am also wondering if this is why Concerta med trials I have done haven’t been working as well. So far the main complaint is decreased efficacy and/or a dramatic crash too early in the afternoon.

    The questions I have on this are: Why the AG Concerta is so expensive still? and Why don’t other generic manufacturers create a better equivalent pill? It seems that the generic should not be allowed if it is not passing some equivalency standard. Is there some added patent to the Concerta osmotic system that allows them to keep their process to themselves and thus maintain their own monopoly and high prices?

    I submitted a complaint to the FDA and may end up sending a few more since whatever they are dispensing on the base does not seem to be passing muster.

    And I am starting a dialogue with the pharmacists on the base so we can be speaking the same language on the matter.

    But my other recourse is to just start trying other and likely more expensive medication trials with Mydayis and Vyvanse since I want my patients to have a smooth and long lasting delivery with one pill only. For Tricare, this will just cost them more money since they will cover these other medications despite the premium.

    Ugh. Meds are too expensive. 🙂

    Cheers! Dr. C.

    1. Hi Nate,

      Thanks for visiting.

      Between my posts and the comments, I think I’ve covered most of your questions.

      But here are some quick points.

      1. AG Concerta is not necessarily “expensive.” It is simply not the lowest price generic for Concerta. Many insurers stipulate that the generic be given if one is available. If there are multiple, start with the cheapest one.

      2. Thanks to the FDA Chief cum Venture Capitalist cum Heritage Foundation Fellow appointed in 2017, Big Generic has been enjoying a bonanza.

      He scoffed at FDA scientists concerns that we need better guidelines for developing generics of drugs using sophisticated delivery systems (i.e. Concerta) and said, “Crank ’em out!” I don’t blame the FDA. They were very helpful when I was working to get the first two crappy generics downgraded. Elections have consequences. 🙁

      3. Why should Big Generic create a better Concerta when they can make much more money on the cheap knock-offs. Concerta’s OROS is proprietary technology. It is hard if not impossible to replicate in cheaper form. Current guidelines require only a vague approximation.

      4. Yes, I recommend that folks at least try alternatives, especially the ones offering savings programs (typically the new ones).

      5. All things being equal, Concerta is still a fantastic medication that works well for millions. What is the cost of lower functioning? Much depends on one’s insurance policy, though. We don’t have particularly great insurance, but we can get brand Concerta via home-delivery, a 90-day supply, for $100. Not the $20 we were paying before for the AG, but not horrible. (I live in California.) That’s $400/year. Not chump change. But what some people spend on Starbucks every year, if not more. 🙂

      6. Yes, meds are expensive. But so is drug development. I feel lucky that here in the U.S. we have a broad array of choices, unlike all the single-payer NHS countries I am aware of. (Last I heard, the main choice for those in the Australian NHS is Dexedrine, generic. Perhaps that’s changed.)

      Many pharma companies have generic assistance programs. Last I checked, Vyvanse’s is one of the better ones.

      7. The key problems right now are this administration and Big Generic.

      cheers

  123. Thank you for all of your help and research into this. I have taken Concerta for many many years, since I was in grade school. I have tried many different meds and this was the best for me. The nightmare I have been through trying to get my prescriptions filled in the past 4-6 years has been insane! The Trigen brand CVS has as there preferred brand (as many have also stated) doesn’t work. It is not at all the same. I pray that something will be done as it was with the Mallinckrodt and the other one that was FINALLY downgraded! (Which CVS has started carrying to fill prescriptions with again) My story is so long it would take me forever to try to write it all out right now. I’m so frustrated with all of this (I spend so much time and energy every time I turn around in this fight to get what I need). We shouldn’t have to pay the ridiculous higher prices either when the other drugs are not equivalent and do not work the same way! It’s crazy!
    And CVS Caremark is monopolizing the market and I can’t use any other pharmacy and they consistently choose ones like Trigen as there preferred brand for these prescriptions and their system is often so backwards and works against the customer and their needs.
    What can we do to get the FDA and whoever else on this? Especially to have the backing of substituting non equivalent brands like Trigen used to fill prescriptions as an equivalent (even though they do not work the same way)

    1. Hi Ashley,

      The first two inferior Concerta generics didn’t get downgraded on their own. Many of us worked very hard to make that happen.

      I spoke with the FDA and opened a MedWatch complaint. Readers filed their complaints. Critical mass was achieved and the FDA downgraded those generics.

      That was just two. Now we have about 7. But we don’t have the same FDA directors in charge now.

      That is thanks to a very bad political appointment in 2017 to the FDA chief position. Elections have consequences.

      Yes, CVS Caremark is truly scary.

      You can file a MedWatch complaint. See my post for the link.

      Meanwhile, it might be worth your prescriber specifying the authorized generic and indicating it is “medically necessary; patient has poor response to Trigen”.

      Or you might see if you have a home-delivery pharmacy benefit and get the brand Concerta through that. It’s likely to be cheaper for 90-day prescriptions than paying every 30 days at the pharmacy.

      Good luck,
      g

  124. Javier Valladares

    Hi Lisa,

    Thank you for all this valuable information. It has been very helpful in educating our family on the process. Unfortunately, I am now on the rollercoaster. Our previous health insurance covered the brand medication at a $50 copay. We recently had a change in health insurance which has started my roller coaster ride. The new plan covers brand at a much higher cost $140, but we are willing to go the authorized generic route since it is covered at $30. I have gone through the process at CVS, Walgreens and Publix with CVS appearing to be the most helpful(at first), but after two weeks of trying it seems they may just be giving me the runaround. They’ve stated that they attempted to order the Patriot NDC twice, but that the order hasn’t come in. On Friday, my wife stopped by and they stated that they received a letter from the DEA that they couldn’t order that NDC. Therein lies my question to you. Have you heard any reports of such notifications to pharmacies from the DEA? I find that statement to be odd, but I am not familiar with all the agencies controlling and/or involved in the procurement of these drugs.

    1. Hi Javier,

      I can’t imagine such a letter from the DEA. Perhaps CVS is just trying to put you off—and hoping you don’t investigate.

      The DEA controls drug supplies — the raw materials. It has nothing to do with consumer access to FDA-approved medications.

      You might want to try Walgreen’s again, this time a different shift. Some employees are more helpful than others. Or maybe ask for the pharmacist.

      good luck!
      g

  125. Hi Gina I have CVS Carmark as well. How are you able to get a 90 day supply? I was told could only get 90 day from CVS and had to be the Trigen. How are you getting brand?

  126. I know that using GoodRx all this time, even their price would fluctuate. Even though their coupon would say one price, it would go through at another price. Last month when I used GoodRx to fill the new Activis/Teva it came to $115.56. The time before that when I got the Activis Alza, it was the same price. Now I remember long ago CVS Caremark had prices over $300 on their website. I think when I spoke to them they gave me another price, but still high. So I was shocked that the Patriot script went through for $116.00. But now that I hear you pay $30 for a 90 day supply I can’t believe it!!!

    1. Hi Katherine,

      Yes, that’s how much healthcare policies can differ.

      I’ve had to make the choices each time my husband has changed jobs over the years. So I’m familiar with it from that angle, at least.

      I like having choices. For example, people who don’t need much of a pharmacy benefit can choose a cheaper policy appropriate for that. Those who do pick that choice. There are also choices for co-pays, including for pharmacy.

      The array of choices overall, for employers and consumers, is huge. And most people don’t understand that. They think that the insurance company sets all the prices uniformly. But it doesn’t work that way.

      BUT!!! Since CVS-Caremark bought Aetna, it is the 800-pound gorilla. Unfortunately, Blue Shield of California (our insurer) went with CVS-Caremark as its home-delivery pharmacy instead of our previous ExpressScripts or PrimeMail. It plays hardball. We can get only the inferior Teva Concerta generic now. Previously, we got the authorized generic for $20, for a 90-day supply. Most insurance policies will stipulate the cheapest generic; that’s why introducing this clown car of inferior generics has created such chaos. It’s a race to the bottom.

      Currently, we pay $100 for brand Concerta for a 90-day supply via our home-delivery pharmacy benefit. Still, that’s only $30/month and no dealing with the storefront pharmacies. I consider us lucky.

      I could risk sending in the script with the doc having written the NDC code and “medically necessary”. But that means risking a delay of supply.

      By the way, I find it interesting that you paid $115 for the new Actavis/Teva true generic (not the authorized generic, if I am understanding correctly). I find it hard to believe that GoodRx didn’t make a bit of money on that one. Perhaps that is how it stays in business. Then again, it could be a cynical profit play by Big Generic.

      These true generics for Concerta are basically generic Ritalin. All the methylphenidate class stimulants contain the same medication. It is only the delivery system that makes a difference among Ritalin, Ritalin LA, Concerta, Quillivant, Daytrana, etc.).

      For folks experiencing trouble with the true-generic Concerta options, they might do better (and spend less) on a generic Ritalin—multiple pills throughout the day. Not ideal, I know. The extended-delivery options are typically so much better. But when the choice is that or a problematic Concerta generic….

      g

  127. Hi Gina,

    Well it’s very interesting because I explained to them that I used GoodRx to fill it in the past because it was a LOT better price than going through my insurance ( CVS Caremark. ) I showed her the 104.00 GoodRx Walgreens coupon and she said it was less than their cost so they couldn’t do that but they could probably go halfway. Then they ran it through my insurance and it was $116.97 for 30 pills, 27 mg. I was pleasantly surprised. Do you think they are still losing money? Does Alza cost them more than the other generics?

    Kathy

    1. Hi Kathy,

      Interesting about the GoodRX.

      I’m glad your insurance covers it. It does seem high, though. I wonder what you’d have to pay for one of the new Concerta generics? With our insurance coverage, my husband’s Concerta prescription at the local pharmacy would be about $30, for brand.

      I wonder if your insurance would give you the brand Concerta for the same price. And that would make things easier. Worth checking into maybe.

      Yes, that’s the thing….these new generics are cheap cheap cheap to make. They do not use Alza’s proprietary OROS system. These generic makers exploit the lack of good FDA guidelines for creating generics of medications with sophisticated delivery systems. It is all about bloodless profits with “Big Generic”. Truly some sociopathic plays.

      Given the wide variability among insurance coverage options—even within the same insurer, so many levels of co-payments, out-of-pocket maximums, drug payment, etc.—it’s hard to say if the pharmacy is losing money or not. I’d say your pharmacy isn’t making much, at the very least.

      g

  128. No luck at Walgreens. Was about to pitch at CVS but instead drove straight to a “family” pharmacy and they were so helpful and will have it for me tomorrow. I had no clue about this until my daughter asked a few weeks ago why her pills looked different. Thank God for your website I learned so much. My daughter has been having brain fog, forgetfulness, headaches, meltdowns and falling grades for the past weeks. Took awhile before I put two and two together. What a horrible state we are in. Another reason to dump this administration in Washington as soon as possible.

    1. Hi Katherine,

      I’m so glad you got the information you needed here — and the family pharmacy came through for you.

      I’m not sure but they are probably losing money on that one, so that is a very nice bit of customer-service.

      g

  129. Thank you for this post. I had read it before and knew to ask for Actavis brand and that Alza was on the correct pill. My daughter went to college to have it filled at Walgreens as always. She knows what to ask for as well. They said they had to order it. She picked it up at Walgreens and the bottle and wording and manufacturer looked exactly as it had in the past yet this morning she opened the bottle and the tablet was triangular with 725 on it. She knew it wasnt the same despite the wording. We found the nDC number was the onlydifference. instead of 00591271501 it was 62037072501. I looked it up and it is is by Actavis Pharma. Called around and found a Walgreens with the old ndc number and had to pay out of pocket. my daughter has a certification exam this weekend so didnt want to chance the teva brand. My guess is that all Walgreens will now carry this Teva brand…sigh…So are you saying the NEW manufacturer is patriot with new ndc numbers but the pills are Alza? Am I to go searching all over again? This is crazy!

    1. Hi Lisa,

      I know. It’s confusing. I didn’t make the rules! 🙂

      And the rules keep changing.

      The fact is, we’ve been pretty lucky to get brand Concerta at a generic price for many years. And that contract expired.

      Combined with an FDA chief who pushed through hundreds of generics (without a thought toward equivalency with sophisticated delivery systems, like Concerta’s), it’s created confusion.

      But I have laid it all out for you.

      1. Actavis was never the brand. It was only the distributor.

      2. Janssen is the manufacturer of Concerta and always has been; it is also the manufacturer of the authorized generic (because it IS the brand, marketed as a generic). Concerta relies upon a unique proprietary delivery system (Alza’s OROS capsules), and none of the other generics uses that. Hence they are much cheaper.

      3. The old NDC number will no longer work because Actavis/Teva no longer has the license to distribute the brand as generic.

      4. Moreover, Actavis/Teva has its own generic now (which does NOT use OROS from Alza).

      5. Use the NDC numbers I list in the post. Each number is unique to a medication (dosage and manufacturer).

      6. Patriot is the new distributor of the authorized generic, so forget all about Actavis/Teva.

      7. But don’t ask for the “Patriot generic.” That might only confuse the pharmacist. Again, use the NDC number.

      8. As I wrote in the post, Walgreen’s has been one of the “better actors” when it comes to trying to get the authorized generic for customers.

      Good luck!
      g

  130. While that is a huge problem, and I am no fan of T, let’s not forget this is the administration that lifted the gag order on pharmacists who finally were able to talk to us about the real numbers.

    1. A republican Congress. And let’s not forget this administration also lifted the rule that allows terminal patients to try experimental drugs. We had a little boy in my community with a rare brain tumor (DIPG). We fundraised night and day to send him to Mexico for experimental treatments that he can probably now get here (had he lived long enough). Lastly, FWIW it’s my ACA plan that is making it hard for me to get my daughter’s Concerta (no mail-order benefit and must use AB rated generics) , the private plan we had covered it.

    2. I did not mean to launch into an expansive political discussion. Sorry.

      My only point is that when people complain about the FDA, they need to remember what happened here: The FDA scientists wanted to come up with new generic guidelines, and the FDA was very responsive when I opened the MedWatch file on the previous two generics (since downgraded). But this administration’s 2017 appointee, a venture capitalist, scoffed and pushed through 100s of generics. Then went back to venture capital.

      But as far as your insurance, perhaps if massive efforts to destroy the ACA and make it non-viable had not been ongoing, you’d be happier with your plan. 🙂 Many things have changed in the past year, especially policies around generics.

      g

  131. I’m so glad I found this article.

    My DD said her medicine wasn’t helping. I didn’t really focus in on this until I noticed that the pharmacy refilled her script with the Teva generic.

    We have used Walgreens FOREVER, and they did not notify me of the change in their supplier prior to completing the refill. I called Walgreens and was initially told they couldn’t obtain the authorized generic.

    I called another Walgreens and talked with the pharmacy manager. He initially said they are limited by their supplier and cannot special order, they are limited by the DEA on what they can fill and the number of pills they can distribute, the generics are AB DEA approved and should work the same, he would get into trouble if he ordered more than his allotted quantity by upper management at Walgreens, he would have to request local, national and top management approval to order more than his allotted quantity of any generic concerta, blah blah blah…

    I kept challenging him, told him it was illegal for the DEA to dictate what a patient can and cannot have regarding medications (don’t know if this is really true, but threw it out there), that patients have the right to request which manufacturer they want to use for their medications, let him know I know the difference between Alza’s OROS delivery system and Teva’s osmotic delivery system, explained the FDA’s rating of the Mallinkrodt generic concerta (which they gave my son), and a few other counterpoints.

    I eventually said “so what you’re really saying is that you don’t want to order the authorized generic from Patriot Pharm because your butt will be in hot water.” After some more explaining by him to me, I kept countering with my own knowledge and understanding…then he actually agreed that he didn’t want to get into hot water.

    At this point, he looked at the computer and said he was allowed to order one bottle of 100 pills from Patriot, and he could do this…but to contact my original Walgreens location first because of our history with them. he said in doing so, they would have an easier time justifying the additional number of pills in their inventory because of the pharmacy-patient established relationship and history.

    So, I contact our original location and speak directly to the pharmacist. He tries the EXACT SAME reasoning with me that the previous Walgreens pharmacist did, but I tell him that I’ve already talked with the pharmacy manager at his sister location. I explain what that pharmacy manager stated, and he stopped talking. He looked in his computer, and said he could order 200 pills from Patriot, and to give him a few days to get it in.

    ALL OF THIS, and we do not even have insurance coverage. We have to pay out of pocket for this medication. So, they wouldn’t even have to argue with an insurance company on how to fill the prescription.

    I hope someone from the DEA/FDA is keeping track of all of these comments, and the difficulties families are having in advocating for their loved ones, and helping their loved ones succeed. I can’t believe the conversations I’ve just had with these pharmacists.

    1. Hi Christine,

      I’m surprised you encountered the same problem despite being uninsured—that is, paying out of pocket.

      And yes, it is shocking how pharmacists have been co-opted into the for-profit pharmacy system to misrepresent medical facts to consumers. Truly shocking.

      BUT! Here’s the thing — and I keep emphasizing it but maybe you missed it: It’s probably best NOT to mention Patriot Pharmaceuticals. Instead, have your prescriber indicate the NDC number and write “no substitutions.” I can’t promise, but you might have better results with that approach.

      The FDA scientists are well aware of the problems with generics for these sophisticated delivery systems, such as that used in Concerta. The FDA was very helpful to me a few years ago in getting the first two Concerta generics downgraded.

      Since that time, we have a new President, who installed as FDA chief a venture capitalist from the Heritage Foundation. He chastised the FDA scientists and regulators for wanting to have better controls on generics. And he passed through 100s of generics.

      Having inflicted this massive damage, he is back in Venture Capital and the Heritage Foundation. Also on the board of a pharma.

      It’s not “government.” It’s this particular administration.

      I do not mean to wade into the thorny thicket of politics — but these are the facts. And they aren’t a state secret. 🙂

      https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-policy-improve-access-and-foster-price-competition

      excerpt:

      This new pathway for Competitive Generic Therapies (CGTs) is a significant advancement in generic drug competition. Designation of a drug as a CGT can be granted to a company submitting an application for their generic drug when there’s inadequate generic competition for that drug, meaning there is not more than one approved drug in the active section of the Orange Book. The designation, which was established by Congress when it granted the FDA new authorities in the FDA Reauthorization Act of 2017, provides certain incentives for industry to develop generics for drugs lacking competition that have been designated as CGTs.

      g

    2. Hi Gina

      I agree…being self-pay should lift some of the pharmacy restrictions. My whole argument is that patients shouldn’t have to go through all of this (special requests, jumping through hoops, prescribers indicating NDC numbers on the script, and so on) to get a medication. I found a Reddit post discussing this very topic about Concerta. I was surprised to see the number of comments from pharmacists and pharmacy techs who were actually supportive of patients requesting authorized generics. They seem to be in agreement that it’s a patient’s right to request it.

      To clarify, we do have health insurance – but it does not cover ADD/ADHD treatment, etc. Hence being self-pay for the medication. I talked with a pharmacist that works with our insurance company at length about this. She was very informative. She said that Walgreens, Walmart and most of the big box/corporate pharmacies are difficult to work with on the insurance side, as well. (I find this interesting.) She and I both called the mail order pharmacy that our insurance company contracts with…they supply the authorized generic, but because we are self-pay they will not fill the prescription. No good reason provided for this. The insurance pharmacist suggested using local, independent pharmacies as they are more likely to be accommodating to special requests. They are not bound by corporate policies, etc. That was a helpful suggestion.

      I am happy to report that I was able to obtain the authorized generic from Walgreens without needing our MD to indicate a NDC number, etc. I talked with the supervising pharmacist, and she was very nice and accommodating. She explained that it is better to walk in with your paper script when requesting a specific brand/medication. They are more likely to complete the special order when they see the actual prescription. They don’t want the medication sitting on their shelves unused. (I believe this was previously stated by someone else in a comment on this blog post.) She now has us in their system as using authorized generic only, and stated there will not be an issue in obtaining the right medication moving forward.

      So, perhaps a lot of this is also in who you talk to, persistence, and patient knowledge. Thank you for keeping everyone informed and all your hard work in this!

      Christine

    3. Hi Christine,

      Congrats!

      You’ll get no argument from me, that we shouldn’t have to jump through so many hoops. But you know what? We still have it better in the U.S. when it comes to quality medication access than almost anywhere else on the globe. We tend to take it for granted, though, and see only the problems. Can we improve this system? Yes. But I see the global picture, and let me assure you: Folks in the U.S. with ADHD are lucky.

      Yes, absolutely. It will always work better (at least in terms of getting a definitive answer) if you walk in with the script.

      The trouble with that is, vis a vis Schedule II medications:

      1. There is typically a very small window in which to fill Rx. (Some people have figured out how to work around this, with their prescriber’s help. But many haven’t or can’t.)
      2. It can take several days to a week for the pharmacy to receive the order. Many people cannot wait that long. It would mean they are operating without medication for that time.
      3. And, if it takes several days for the pharmacy to say, “Nope, we can’t get that,” that creates an even bigger problem.

      I try to keep these common situations in mind when I offer suggestions.

      You found a helpful person. Fantastic. And that is exactly what I have recommended: If one person at the store isn’t helpful, try another — perhaps during a different shift. But in order to be helpful, many will need as much information as possible because they aren’t as knowledgeable as the person you encountered.

      Your account is now flagged in the system. Perfect! It’s always best to try developing a relationship with the pharmacy, so they know you are a regular patient and not a “drug seeker.”

      As for Walgreen’s and big-box pharmacies being “difficult to work with,” yes, I have mentioned this previously. The pharmacy these days seems increasingly profit-driven more than customer-driven. That was glaringly obvious when CVS, a few years ago, continued to substitute the FDA-downgraded generics for brand. Illegally.

      But then again, I’m sure the insurance companies need a little push-back now and then. Overall, Walgreen’s has been mostly helpful. CVS the worse.

      As for the home-delivery pharmacy not covering your medication, if you aren’t covered for ADHD then why would they cover ADHD medication?

      You don’t mention if your insurance covered your store-front prescription. If that’s the case, my understanding is that these are two different relationships with the insurance companies: storefront and home-delivery. Maybe that explains it.

      At any rate, I’m glad you found success!
      g

    1. Yes, I’m pretty sure that’s it.

      I first learned about Alza’s OROS from a retired neighbor who made smart plays in the stock market. He made a bunch from Alza in the 1990s.

      If you have a few hours, you might find this 2009 lawsuit interesting. 🙂

      Andrx was Watson (then Actavis, then Teva), the company that entered the original deal to market the authorized generic.

      excerpt:

      This action was brought by Plaintiffs, Alza Corporation (“Alza”) and McNeil-PPC, Inc. (“McNeil”), against Defendants, Andrx Pharmaceuticals, LLC (“Andrx”) and Andrx Corporation (“Andrx Corp.”) (collectively, “Andrx”), in connection with the Abbreviated New Drug Applications (“ANDAs”) filed by Andrx seeking to market generic versions of CONCERTA®, a drug developed and manufactured by Alza for distribution by McNeil.

      Joint Statement of Admitted Facts ¶¶ 10-11. Alza is the assignee of U.S. Patent Nos. 6,919,373 (the “‘373 patent”) and 6,930,129 (the “‘129 patent”), which pertain to extended release tablets containing methylphenidate (“MPH”) for use in treating Attention Deficit Hyperactivity Disorder (“ADHD”). Id. ¶ 7.

      https://www.courtlistener.com/opinion/2371057/alza-corp-v-andrx-pharmaceuticals-llc/

      A report on the outcome here: https://www.orangebookblog.com/2010/04/federal-circuit-affirms-invalidity-of-concerta-patent-for-lack-of-enablement.html

  132. You did mention that the other generics are cheaper, but I just wanted to throw out there what I heard from the pharmacist about how suddenly available the AG will become when I call back and say I will pay out of pocket.

  133. Thanks for keeping up with the ever changing landscape of the Concerta’s Authorized Generic (AG). Just went to pick up my daughter’s script from Walgreens and opened it to make sure they filled it right and saw odd looking pills–not like any I’ve seen before. I said it was filled wrong and the pharmacist came out and showed me my TEVA script in the computer and that these are TEVA pills. I left them there so I could do my research on WTH those were and I knew right where to go: Here. Thanks. I’m in the NYC suburbs of Westchester and called 15 pharmacies until I got a really nice man from Costco on the phone who said, it’s readily available, anyone can order it. The problem is insurance will only reimburse for the lowest cost generic and the AG is about 2x that. He suggested I call them back and say I am paying out of pocket and then I’d see how available it truly is. Sigh. I can’t find it anywhere. I’m going to have my DD try the TEVA and if it doesn’t work looks like we are going to have to pay out of pocket 🙁 $230 a month for 54 mgs. Just like the other ineffective generics if this doesn’t work I’ll file the FDA report. The thing I don’t understand is if the patent for Concerta expired in 2011 why hasn’t someone better copied the OROS delivery system yet? Thanks again Gina and commenters who let me know I can expect her to crash at the end of the day.

    1. Hi KrisHur,

      Good for you, for being on the ball!

      To answer your question: OROS is owned by a company called Alza, not Concerta maker Janssen. It is a proprietary delivery system.

      Also, yes, that is exactly the reason in many cases: These new generics are extremely cheap (and thus more profitable to pharmacies and even to some insurance companies).

      I thought I’d mentioned that point somewhere but maybe I should re-emphasize for clarity. Thanks!

      g

  134. Hi Rob,

    Yes, so many layers of complexity — not only one’s insurance company but the specific plan (with so many options) and the particular business deals the insurance company has with pharmacies, etc.

    Yes, most storefront pharmacies carry a very limited supply of ANY stimulant. Apparently, it’s seen as a security risk (e.g. robbery, etc.).

    good luck!
    g

  135. Just found out Walgreens can’t order TEVA brand anymore. So I just read your post. And I just took the NDC code over to Walgreens. Here in Mansfield TX.
    They said they could order it. So hopefully they will come through.
    Having to jump through hoops. Just to get the right medication is becoming insane. I am 44 now and started with Concerta at 32. And it’s becoming more and more difficult to find the right medication. Before it was easy to fill. Now it’s just ridiculous.
    And I have tried the garbage generics before. There is a world of difference between the authorized and down graded.
    This is why I try so hard to get the right medication. But it’s so difficult to make the pharmacy and insurance understand.

    Thank you for all your research and information. Without this I don’t know what I would do.

  136. Make sure before you leave the pharmacy that the pills say alza on them. Most of the time, pharmacies won’t take them back once you leave the pharmacy and then it can be difficult to get the correct (authorized generic or Concerta itself) prescription for your kid.

    I left, opened it when I got home, and saw that the pills had changed – didn’t know the authorized generic was no longer by Teva. Our Walgreens, even with the NDC #, could not get the authorized generic when I called them to ask if they could get that instead. The pharmacist got hufffy and insisted the drug I picked up was the same even when I patiently explained that the drug itself might be the same, but the delivery system was not. Tried CVS; they said the NDC was not on their preferred list and they could *try* to order it with no guarantees. Also, they said because I had picked up a prescription for it in the last week or so – even from another pharmacy – they couldn’t prepare a new prescription until a month later (because it’s a “schedule 2 controlled substance”.)

    The Walgreens said they aren’t supposed to take drugs back once you pick them up and that was the only way we would be able to cancel the prescription. I begged, they relented, and then I contacted the MD who re-wrote it for Concerta. We’ll buy the brand name (for a bit more $) until they sort out the authorized generic issue at our local pharmacies.

    1. Hi Margaret,

      Thanks for emphasizing the importance of checking before you purchase.

      I mentioned that twice in the post, but extra emphasis is always good.

      If you can afford the brand, great; that saves you many hassles.

      I doubt things will sort themselves out without consumers asking for it.

      g

    2. Yes—always have the tech open the bottle in front of you to show you what’s in the bottle. It’s been wrong for us about 30% even though we have explicit instructions to full the Alza pills.

    3. In my experience, Dustin, most pharmacists don’t know what is “Alza” or “OROS” — and sometimes even “authorized generic.” 🙂

      So, best to use the NDC number, I think.

      g

  137. I am overwhelmed with all of this! I’m so glad I stumbled upon this. Noticing my daughters different behavior the past few months, never THOUGHT it could be the different make of meds. I just looked at the bottle and its a TRIGEN from CVS. A few months ago, we used Kroger (not sure what generic that was)
    Ok, so what exactly do I need to do to get her the authorized generic? Im so confused!

  138. Been following this blog for years as we have gone through the same struggle monthly first with the Mallenkrodt garbage and the Trigen. We had a good run at Walmart actually as they were the last in our area to get Actavis in stock for us. All it required was a repeat of the story every month about what manufacturer we needed and why. When Patriot came out they let us know they would stock it and we thought this would be the end of it and so this month they tried to fill the Trigen again and the pharmacist was pretty pathetic about understanding what we needed when we spelled out the differences in Oros, manufacture change, etc. Found a new supplier at HEB and a pharmacist that was familiar with the difference between oros and osmotic so am hopeful we can make this less stressful each month. The tip to indicate the NDC number for the Rx was gold and we are having our Dr send this over today for our refill.

    Thanks for these timely updates, we’d be lost if not for this blog starting years ago when Mallenkrodt came out and our child regressed from being in control to her former ADHD Tigger-mode.

    1. Thanks, Dustin, for letting me know.

      I am so grateful to know that my work has made a difference for your child and your family.

      Your girl is fortunate to have such a vigilant and persevering parent!

      g

  139. Unfortunately, my family and I have followed the guidelines you listed and have gotten no where. We just finished a med trial with the TEVA generic and it was awful. We did it so we can appeal to insurance for brand Concerta coverage because no one within 2 hours of our area will order authorized generics or can get it. yes that does include independent pharmacies too… it’s been a nightmare for the past few months…. thanks for all the helpful information though.

  140. I just came across this. Thank you for laying this all out. We’ve been battling this every couple months for my daughter. Tracking down pharmacies carrying the authorized generic. We’re on our 4th now in 8 months. I’m in Ohio and I’m not sure of the logistics behind all this, but do you know for certain that a physician can prescribe the med, including the NDC and the pharmacy will have to get that one specifically? Any insight on this would be greatly appreciated.

    1. Hi Kitsen,

      It tried to find a definitive answer to that question — that is, if the doc specifies the NDC code, is the pharmacy legally required to fill it — and I could not find one.

      The situation should be stabilizing now. Instead of hanging in limbo, the authorized generic is now distributed by a company owned by Concerta’s manufacturer.

      good luck!
      g.

  141. Allison Paveglio

    Thank you so much. I thought I saw a change my my sons demeanor and went searching to see if something changed with his generic Concerta. Sure enough, he got the bioequivelant last month. I just called the pharmacy and informed them what I learned. They are ordering the authorized generic for me instead and just advised to have our prescriber to note to only fill from Patriot.

    1. Smart mom, Allison!

      I’m glad your pharmacy is serving you well.

      I’d just like to caution others reading that asking to specify Patriot might not b