Having trouble receiving the authorized generic Concerta medication for ADHD — again? Well, you’re in the right place.
UPDATE June 3, 2024
—Most of the information in this post won’t help you to get Concerta now. The latest information is here: Janssen Quietly Ends Concerta Authorized Generic.
—Yes, the situation has changed drastically, but this post does explain the background around Concerta and its generics since 2014. You might find it helpful in making sense of this mess.
Bad Experience? File a Complaint
I am re-leading the effort to downgrade these generics – FDA Medwatch
If you used Concerta brand successfully but have a poor reaction to a. Concerta generic, please consider filing a complaint.
Here’s how: Please go to this link (FDA Medwatch) to state any adverse experience with any of the Concerta generics (you’ll find the list of companies below). If you’ve thrown away the bottle, try to get the info from your pharmacy.
These generics are nothing like Concerta. They were FDA-approved over the objections of FDA scientists, due to concerns about bioequivalence.
These generics (that I describe in this post, originating in 2017) come to us courtesy of Big Generic and Trump’s FDA Chief. Robert Gottlieb, MD, was and is a venture capitalist.
How Did This Happen?
Previous to his short FDA stint (2017-2019), he had long harangued against FDA regulations for complex delivery-system medications (e.g. Concerta’s). Shortly before Trump slotted him at the FDA, he was at the American Enterprise Institute and on the board of a vaping company. (Vaping Venture Poses Potential Conflict for Trump’s FDA Nominee).
That was 2017. It’s now 2023. With high hopes that decent people can again help right these wrongs, I am re-launching the effort to downgrade these indecent generics.
How to File a Complaint with the FDA
AGAIN: Please go to this link (FDA Medwatch) to state any adverse experience with any of the Concerta generics (you’ll find the list of companies below). If you’ve thrown away the bottle, try to get the info from your pharmacy.
It probably won’t be helpful to provide a lot number, though. This is not a manufacturing problem. This is a exploitative Big Generic problem, and that’s consistent lot to lot.
The rest of this post might still be useful to you. It explains the difference among Concerta, its authorized-generic (gone 1/13/23), and its other generics.
But please know that the recommended method of getting the authorized-generic (brand sold at a generic price) is no longer relevant. For now. Things could change. Stay tuned!
Please Support This Reader Service
-
- Since 2014, I’ve taken the lead in first successfully lobbying the FDA to downgrade the first two inferior generics and, since 2017, guiding readers on procuring the authorized generic. Others might “borrow” my work. But I put in the legwork.
- For 20 years, I’ve accepted no pharmaceutical funding or support of any type. That includes from the makers/sellers of Concerta!
- That makes me one of the very few ADHD “names” rejecting pharma industry support. It’s called a conflict of interest.
- I avoid advertising — because it’s too distracting!
- If my self-funded work has saved you thousands of dollars and much consternation, please consider a donation of any amount via Paypal — or Venmo. You can also shop via my Amazon link to right—and support this blog cost-free to you! Thank you!
Quick Summary Points on Concerta Generics:
As the first and only person to cover — and advocate on — this issue in-depth since 2014, I can tell you:
- I aim for simplicity. But if I cut details—sure enough, comments will ask for them! So, I happily risk Google docking this post for “too long.” (It favors short and superficial!) And I try to keep it well-organized and scannable.
- This slew of cheap generics (in price and content) has sent pharmacies and insurance companies scrambling—only intensified by COVID demands..
- Concerta pills use a patented delivery system (Alza’s OROS). It’s what makes Concerta distinct from the other methylphenidate-class choices.
- The authorized-generic is the brand; it’s only marketed as a generic. The other Concerta generics are mostly “bare bones”—little different than a generic Ritalin.
- If you’re confused about generic versus authorized-generic, you’ll find the details below.
- Much depends on your particular insurance pharmacy benefit. Even within the same insurance provider (e.g. Blue Shield) different policies bring different benefits.
- Don’t count on the average prescriber understanding this issue. But do share the link!
- If you have a home-delivery pharmacy with one of the big warehouse pharmacies (e.g. Express Scripts), that might be your best bet. Seriously. See Home Delivery of Stimulant Medications
- It might be that one of these generics suits you better than Concerta. That isn’t the issue.
- What is the issue? These generics do not perform as brand Concerta does. That’s a big problem for people who respond best to Concerta’s sophisticated delivery system (OROS).
- If you participate in an ADHD-related forum or another type of group, please share the link to this blog post. I’m seeing sites repeat tidbits from this original reporting. But it’s out of context and without updates—and therefore unhelpful and also violating copyright.
In This Post on Authorized-Generic Concerta:
Again, December 2022 had us in a rapidly changing situation. We were waiting for the year-end supply issues to resolve AND waiting to see if Concerta manufacturer Janssen would continue making the medication available as a brand.
Again, that means any information about obtaining the authorized-generic is outdated. Still, you might find this background illuminating. Each item in this list links to the topic in this post.
- Your best options now — overview
- How to specify the authorized-generic for Concerta on the prescription – step by step
- Consider home-delivery pharmacy, if you have that benefit (yes, it’s legal for stimulants!) — please know there’s a difference between a local pharmacy that delivers to your home and a “home-delivery pharmacy” (e.g. Express Scripts, PrimeMail, etc.) These large warehouses typically are more likely to have the authorized generic and allow 60- or 90-day supplies. So much easier!
- Consider brand; there’s a Concerta coupon now
- Background: How this clown car of Concerta generics burst onto the scene
- Whatever happened to the “Actavis” generic?
- Now — Concerta generics from at least ten companies!
- Still confused about generic vs authorized generic?
- Consider filing an FDA Medwatch Complaint. This is not the FDA’s fault. Please don’t blame “government.” This was a cynical, profitable move by the previous administration’s FDA Chief—a huge gift to “Big Generic”
1. Your Best Options Now — Detailed
Here’s an overview of the best current strategies. You’ll find more details about how the script should read in the next section.
—Aim for Authorized Generic (from Patriot Pharmaceuticals)
This involves getting your prescriber’s cooperation, detailed below (Specifying Authorized Generic Concerta).
Tips:
- Do not ask the store if it carries the authorized generic. Keeping a medication in stock and ordering it are two very different things.
- If the pharmacy says it cannot fill your prescription, ask that an Exception Process be ordered for you. (This is working less reliably now than it did initially but it’s worth a shot.)
- Still trouble? Call Janssen 1-800-631-5273. Ask for its subsidiary, Patriot.
- The representative can sometimes intercede with a pharmacy.
- The list of pharmacies said to be carrying the Patriot generic might or might not be helpful.
- Just because a pharmacy carried it one point doesn’t mean it is now. Moreover, it doesn’t mean that your particular insurance coverage will qualify you for it.
—Patriot Pharmaceuticals: Authorized Generics ONLY
Just in case Patriot website visitors also don’t understand the term authorized generic, it says this:
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”.]
—Check out the new Concerta Savings Card
If you can swing the brand Concerta, that makes things much easier! Check the savings-terms at the link. It works with your insurance. Note: Does not apply in MA or CA.
—Try another stimulant option
There are many choices within the methylphenidate category, including Ritalin, Daytrana, Aptensio XR, Metadate CD, Methylin, Quillivant XR, Jornay PM, Adhansia XR, Cotempla, etc..
One of these might work better for you than Concerta. Or they all might be worse. For the most part, you just don’t know until you try.
To be clear: These all contain the same active ingredient, methylphenidate (MPH). The only difference is in how it’s delivered to the system (how much, how quickly, etc.). But that can be a huge difference.
2. Specifying Authorized-Generic Concerta
Share this information with your prescriber for your next prescription. It should help to specify the authorized-generic Concerta on your next prescription. Here’s the short version, followed by the details:
- Name: Methylphenidate HCl Extended-release tablets
- NDC Number: for example: 10147-0685-1
- Specify distributor: Patriot only
- How it might read overall (example): Methylphenidate HCl Extended-release tablets, 36 mg, NDC 10147-0686-1 ONLY (or, simply Patriot generic only)
- A special note for electronic subscriptions: Sometimes the prescriber will specify all this in the electronic prescription—but it’s not visible to the pharmacy. Ask the pharmacy to look for the special instructions box or to print the prescription; that typically reveals full instructions.
- Always provide the information specifically to your prescriber. Each time. Some prescribers tell me they cannot see what they wrote for a previous prescription when they go to write the next one. Make their job easier—and ensure your success in getting the right Rx.
- The “no substitutions” box. This is tricky. See more details below.
- Check the pills before you pay for them!
How long will this information remain useful? It’s anybody’s guess. Subscribe to stay tuned — and check back often.
Here’s more details on the 5 steps above. I accessed this information from the U.S. National Library of Medicine “Daily Med” website.
—Name:
Methylphenidate HCl Extended-release tablets
NOTE! You cannot rely solely on the name. All the Concerta generics (including the authorized generic) share this name!
—NDC Number:
Each FDA-approved medication 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 and “Patriot generic only.” At least the first time. It might be unnecessary after that.
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.
—Distributor: Patriot
What if the pharmacy tells you, “But we can’t find that”? or “It’s on back order”?
Maybe the store or chain simply doesn’t want to order it for you.
To check, call the Patriot Pharmaceuticals customer service at 215-325-7676
—How Should The Prescription Read Exactly?
No ironclad answers here. Your prescriber might have a preference. The pharmacy might, too. Tip: 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 again, in the case of Concerta generics, they are ALL called Methylphenidate Hydrochloride (HCI) Extended-release tablets. That makes it critical to establish which one.
As the issue first emerged, the prescription should have read something like this (for example, for the 36 mg dose):
Methylphenidate HCl Extended-release tablets, 36 mg, NDC 10147-0686-1 ONLY (or Patriot generic only)
The “ONLY” at the end indicates, “do not substitute with another generic.”
Now that the Patriot generic is more familiar to pharmacists, adding the NDC might be overkill.
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.
—Tricky Bit #1: Generic substitution laws vary by state.
Your prescriber must pay attention to the prescription pad checkbox that indicates “no substitutions” or “dispense as written”.
If that is checked, pharmacists typically take that to mean, “Do not substitute a generic.” That means you might get brand—at brand prices.
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. ? Anything can happen! That’s why you might follow my suggestion above. But again, ask your pharmacist first!
If you use a home-delivery pharmacy, consider attaching a note to the paper order form detailing clearly your request.
See Tip: Home Delivery of Prescribed Stimulant Medications
—Tricky Bit #2: Some generics utilize a different type of osmotic technology.
But that is not the same as Alza’s patented OROS (osmotic-controlled release oral delivery system). Many pharmacists do not know this! You might need to tell them! (But don’t count on them believing you.)
—Look Before You Pay!
What Should The Pills Look Like? Look for alza 18, 27, 36, 54 etc
Look before you pay!
The pills should look exactly the same as the brand—because they are the brand. It’s easy. Look for the word alza on the pill. Not there? Then it’s not Concerta brand or authorized generic. Simple as that!
—Must the Pharmacy Fill the Prescription As Written?
It depends on your state laws. Again, check this article in U.S. Pharmacist: Generic-Substitution Laws
—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. The Concerta brand/authorized-generic should look like the pills in the photo above. You can typically see this through the semi-translucent brown bottles.
3. Investigate Home-Delivery of Concerta
Does your insurance pharmacy benefit include a home-delivery pharmacy? If so, consider using it!
Again, home-delivery pharmacies typically have bigger inventory. Plus, you might be able to get a 60- or 90-day supply. Imagine enduring this misery only 6 or 4 times annually—instead of 12 times!
Yes, this is legal! Read more here: Tip: Home Delivery of Prescribed Stimulant Medications
4. Consider Brand Concerta Or Coverage Exception
Don’t forget to look into brand. Janssen is making brand Concerta more accessible in some ways, including a savings card.
- Check your pharmacy benefit’s cost for brand Concerta
- See if you qualify for Concerta’s savings program
- Check out savings from GoodRx
Have you already tried one of the inferior generics, to poor effect? You might ask your pharmacy-benefits-manager about pre-authorization or “medical coverage exception.” This is where your prescriber documents your previous experience and why you need the brand.
5. Background: Why This Clown Car of Concerta Generics?
When the first three Concerta genetics arrived, I started hearing from readers. Lives were going off the rails — too many to attribute to personal issues. Something larger was going on. I shared some of their stories here: Sound Off – Users of Downgraded Concerta Generics
What does “downgraded Concerta generics” mean? It means that I spoke with the FDA and, following the helpful representative’s suggestion, opened a formal MedWatch Complaint. Then, readers followed through on reporting their adverse experiences on these generics. The FDA came through for us in 2014: Victory! Concerta Generics Downgraded
Unfortunately, the new administration that moved into the White House had other plans. Donald Trump named a a new FDA chief, Scott Gottlieb, MD. He was and is now, having left the FDA a short time later, a fellow at the conservative American Enterprise Institute. He over-rode FDA scientists’ long-held concerns about bioequivalence. That is, do these generics work as well as the brand versions?
Bioequivalence Matters
Bioequivalence is especially critical when it comes to novel delivery systems, such as Concerta’s OROS, patented technology from Alza. That’s why the FDA downgraded the original three generics. FDA scientists were pushing for new guidelines.
Next thing we know: A clown car of non-bioequivalent Concerta generics flooded the market. Pharmacies and insurance companies have been log-rolling in response this enormously unexpected change. But one thing’s for certain: This been a huge gift to “Big Generic.” (Check the end of this post for links to my various posts on that topic.)
Reader comments sometimes blame the “government” or the FDA for this. That’s a mistake. We can lay this outrageous situation squarely at the feet of one administration. (Don’t like me “bringing politics into it”? Sorry, these are the facts, and facts still matter.)
This turnabout came as a stunning disappointment to Concerta users. We thought that hard-won war was over.
Fortunately for consumers, Janssen continued to make available the authorized-generic Concerta. But the landscape continues to shift.
6. Previously: Concerta Brand and Authorized Generic—Same
Many years ago, Concerta users became accustomed to receiving the authorized generic. That is the brand marketed as a generic, at generic pricing. It was marketed by a company called Actavis.
How did this come about? Concerta manufacturer Janssen made this deal to forestall Actavis introducing its own Concerta generic. That marketing agreement expired several years ago. A generic manufacturer named Teva later purchased Actavis. Then it released its own Concerta generic.
Shortly after, Concerta manufacturer Janssen made the authorized generic available through a subsidiary, Patriot Pharmaceuticals. For more than a year, largely thanks to my guidance, Concerta users were able to ask their pharmacy to order the Patriot authorized generic via an “exception process” (explained below).
A few drugstores reliably honored the request, even if it meant losing money. Walgreen’s was a particularly good “corporate citizen.” But obviously, Walgreen’s could not continue taking such a financial hit, compounded by COVID. If you’ve been getting the authorized-generic from an independent pharmacy, it’s might have lost money providing it.
New Generics — Not the Same
For the most part, these generics resemble generics of Ritalin or Ritalin LA. These brand drugs already lack Concerta’s sophisticated delivery system. So you can imagine how little they resemble Concerta. They perhaps cost pennies to make, in China or India. In factories increasingly shown to be poorly regulated.
By contrast, brand Concerta uses a proprietary technology, OROS™, from a company called Alza. FDA guidelines on producing brand drugs are highly controlled. The medication (methylphenidate) is released at a steadily ascending rate. With the generics, it tends to be uneven, in jumps, starts, and stalls—with a fast drop-off.
7. Still Confused by Generic vs. Authorized Generic?
If you remain confused about generic vs. authorized generic and the historical changes, you might find the following information useful.
- If you’re still asking for Actavis/Teva, you risk an unpleasant surprise.
- The authorized generic is the brand; it’s simply sold as a generic.
- The authorized generic (brand marketed and sold at generic prices) is now distributed by Patriot Pharmaceuticals, a subsidiary of Janssen, Concerta’s manufacturer.
- Look for the infographic below.
- Consider getting the brand until the dust settles, if it’s affordable (remember the new savings program at Concerta’s website). Or, try one of the other brand methylphenidate medications
- Always look before you pay! If the pill does not say alza, it’s not Concerta (brand or authorized-generic). Simple!
Again: What’s An Authorized Generic?
I understand the confusion. Even many pharmacists and physicians can’t tell you the difference. Even worse, 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:
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.”
As mentioned above, 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. 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. It is owned by a company called Alza and licensed 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. In some cases, this matters little. When it comes to sophisticated delivery-system drugs, it can matter a lot.
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
8. Now Concerta Generics From At Least Ten Companies
Over the last two years, the situation has grown even more confusing. At least seven companies released Concerta generics since July 2017 [Note: there are even more now, in 2024]:
- Manufacturer: ACTAVIS LABS FL
Approval date: March 21, 2018
Strength(s): 54MG [AB] - 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. - Manufacturer: ALVOGEN PINE BROOK
Approval date: November 30, 2018
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: AMNEAL PHARMS
Approval date: February 1, 2018
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: ANDOR PHARMS
Approval date: April 24, 2019
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: ANI PHARMS INC
Approval date: July 14, 2017
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: MYLAN
Approval date: October 21, 2016
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: OSMOTICA
Approval date: July 28, 2017
Strength(s): 18MG [AB], 27MG [AB], 36MG [AB], 54MG [AB] - Manufacturer: PAR PHARM
Approval date: July 15, 2019
Strength(s): 36MG [AB], 54MG [AB] - 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 barrel-shaped pill. It seems designed to fool consumers/physicians/pharmacists that this generic uses OROS. It does not.
9. Consider Filing an FDA MedWatch Complaint
To be frank, it’s going to be much harder to reverse this horrible decision by the Trump White House’s FDA Chief Gottlieb. He left after about 17 months, back to the rightwing think tank, the American Enterprise Institute. It would take a cataclysmic event to reverse this decision. And they all knew it.
Still, it’s worth putting it on record. As I mentioned, the FDA in 2014 was incredibly responsive to our complaints about the first two Concerta generics. Then a new White House occupant moved in.
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. Click here to go directly to the FDA Medwatch form.
Summary—Whew!
For sure, this is a lot to take in! (Guess what! It was a lot for me to research and write, too—and constantly re-write—not to mention field 100s of 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.
Many argue that without that delivery system, it cannot be a reasonable substitute for brand Concerta. FDA scientists agreed with them. That’s how my blog readers played a critical role in lobbying the FDA to reassess the first two Concerta generics. The FDA downgraded them as not being close enough to Concerta. Then another White House forced a change.
Here is my report on that issue: Consumer Q&A on Generic Concerta
The first version of this post appeared 6/19/15 but my reporting on Concerta generics began in 2014!
I answer all questions as quickly as possible.
Gina Pera
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1,182 thoughts on “Authorized-Generic Concerta Medication Update”
Clear, concise, and straight to the point. Great job!
Patriot’s website lists ‘Methylphenidate HCl ER Tablets have been discontinued and are no longer available.’
Yes, I reported on that here a long time ago. Maybe 2 years? Something like that.
Patriot was the authorized generic (brand marketed as a generic). It was a subsidiary of Janssen.
When the boatload of junk generics arrived, the authorized generic shortly went away.
Is there any update here? Is there any info the Trigen generic?
Hi Gregory,
What kind of update are you looking for?
g
I guess I’d like to know if there are any generics out there now with the OROS tech?
Hi Gregory,
No, That’s the theme of my posts for the last 2 years at least. There is no more authorized generic for Concerta. The only Concerta with the OROS delivery system is brand Concerta. Period.
More here:
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
g
The Trigen generic uses an osmotic delivery system that, while similar to the OROS, is not the same as the OROS. I am lucky enough to be able to take it, but a lot of people don’t do well with it. If you try it and it works for you, you still have to be hyper vigilante about getting the osmotic. I’ve had pharmacies give me the non-osmotic one several times. You *have* to check every single time.
Thanks Felicity! How would I check if I received the osmotic?
Trigen uses a basic osmotic delivery system. So just look for Triigen. That’s what you were looking for to begin with, right?
All the Concerta generics use different delivery systems. Some will find the Trigen the best of an iffy lot. Some will not.
It just depends on your individual neurochemistry.
You can always use the search box on my blog. Lots of comments on Trigen Concerta generic on the post I just shared: https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
Gina
My UnitedHealthcare insurance no longer covers brand-name Concerta as of 2024 (back in 2018 they wouldn’t cover the generic) and the copay card isn’t valid in my state (California) nor my parents’ state (Massachusetts) 🙁 I’ve had bad side effects from extended-release medication in the past and am giving up. Back to IR and setting loads of alarms for me…
Hi Kate,
Darn. Before going back to IR, you might want to consider other MPH choices. Just because the prescribers tend to know only Concerta and Ritalin, that doesn’t mean that’s all there is.
You might want to check out my online training (medication, sleep, exercise, nutrition):
https://ginapera.adhdsuccesstraining.com/course-2-physical-strategies
I created it because the ADHD community really needs to learn how to self-advocate. And they’re not going to know how to do that if they don’t have a solid education in their choices.
good luck!
Gina
Have you found an equal Concerta replacement since March when the Jensen/patriot generics was discontinued?
Hi Andrea,
I’ve seen no reports here…that anyone has found a generic that works as well as Concerta. Sorry!
My advice is to try branching out into the other methylphenidate stimulants. The brands, if you can get them.
good luck
g
So if I understand correctly, what you are saying is Concerta will no longer be available as a generic brand option as before. This will create a financial hardship for anyone wanting this specific brand and its specific delivery system as other generic medications do not work the same.
Who said these medications were the same In regards the delivery system? Who said they are not?
Where is the Medical Literature to back up either claim?
Hi Veronica,
The “Generic brand option” is the authorized-generic. And yes, that ceased being available officially in mid-January. I reported on that here:
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
As for your other questions, please read this post. It’s all there. In short, Trump’s appointed FDA chief decided, against all evidence. Now we’re stuck with this horrible decision.
thanks
Gina
I just got a call from my pharmacist that Patriot is no longer making their authorized generic Concerta. I checked their website, and it says “Note: Methylphenidate HCl ER Tablets have been discontinued and are no longer available.” Do you know if someone else is making them now? We have used this exclusively for years and don’t want to go to other “generics” and would rather not pay the extra brand name cost. Thanks!
Hi Katie,
I’m sorry you didn’t find my blog last fall. I announced that Janssen was eliminating its Patiot authorized-generic.
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
It’s important to understand: the Patriot authorized-generic IS THE BRAND. It’s only sold as a generic.
So, in order for another company to make the authorized-generic, they’d have to make the brand.
I don’t see that happening, but I suppose it is possible. If it is ever announced, you will probably read about it here at my ADHD Roller Coaster blog.
Gina
No, no other company has announced plans to take over manufacture of Concerta from Janssen.
Hi Gina, Thank you for all your work on this. My question is if you have ever heard of an insurance charging a penalty for using the name brand? We have been able to jump through all the hoops before us to get an approval for a medical necessity to use the brand name only. Which we were able to use one time for $165/30 days. The next month they charged $800. I was told due to deductible not being met. This month again, they wanted $800. However, this time, they informed me that they are charging me a $635 penalty for using the name brand. Even though they have an approval for the medical necessity. I feel like this should not be legal to do and was wondering if anyone else has experienced this?
Hi Kathy,
You’re welcome!
It’s quite dizzying, all the permutations on insurance policies. Consumers have more choices but it does complicated things!
It really pays to get familiar with the exact terms of your policy. There’s typically a summary on the website.
Do you know if the exception process was granted just for those 30 days or was it longer? If not longer, maybe that’s why you’re being penalized.
My understanding is that, if the exception process is approved, you’re charged the brand formulary cost of your policy. Sometimes this is called a “prior authorization”, though terms will vary.
What you’re describing doesn’t sound like a deductible issue, not if the first go-round was covered. Unless that was in 2022.
good luck
g
It VERY much seems like you got an ’emergency exemption’ for the first month, after that, they have allowed you to get the name brand, but you are STILL responsible for your deductible, period. Nor do you seem to have an ongoing authorization.
I have a high deductible plan myself (which we knocked out this year with my fiancé’s new insulin pump in February). Anyway, I did the legwork with my insurance, and got a PRIOR AUTHORIZATION (not ’emergency exemption’; as that only applies to a VERY short term, think hurricane, or natural disaster, or you had a fire, ect.) for name brand.
My prior authorization is valid (provided I don’t change insurance companies) until 2039. (the pharmacist actually laughed).
That being said, each year, I STILL have to meet my $3k deductible before I can pay just the Tier 3 rate, so each year I am paying OOP for the first few months. As will you, and anyone else who has a plan with a deductible until your deductible is met.
Anyone know when a new approved generic for concerta with oros release will be available now that patriot is no longer available? What are you guys using now? Or will I be requesting emergency exceptions for brand name concerta 3-minths at a time until forever?
Hi Betty,
I encourage you to read my latest post. I linked to it at the beginning of this post, but here it is: https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
As the author of these blog posts, I work to bring you the most accurate information available. I do not recommend asking random readers for specific information such as this. They might be wrong.
Short answer to your question: There is no talk of a “new approved generic” for Concerta with OROS. Not while the brand is still available. The authorized-generic (the brand marketed as a generic) was a special situation.
Ask your insurance company if they can extend your exception for a year. That wouldn’t be an “emergency” exception, though.
good luck
Gina
thank you so much for putting this together. I’ve filed a complaint with FDA since all the generics except patriot are so bad… the situation is crazy
Thanks, Adam. We did it in 2016. But there are 10x the “Big Generic” products now. Thanks for filing the complaint!
g
Don’t believe I’ve seen this addressed before, although it’s possible I missed it. Would like your opinion Gina, (and readers) on how long Concerta is considered safe and effective? My son refused to take his Authorized Generic meds (on and off) for a period of about 2 years. Consequently, I have a bunch of the “good stuff” saved up, and am hoping it is ok to give him now that he’s willing to resume his meds. Seems inconceivable to waste these pills, especially now that they are so hard to obtain. I know that most prescription meds have a “USE BEFORE” date of one year after the prescription is written. But it seems ridiculous that the med would suddenly become ineffective and/or dangerous to take on day 366. I understand that the FDA requires all meds to have an “Expiration Date”, which at times can seem somewhat random. In the case of Concerta, with its unique 3 layer composition of “solid” substances, it seems that it should theoretically be ok indefinitely, as long as it’s not been exposed to liquid or extreme temps. Your thoughts?
Hi Ann,
I can’t possibly say but my hunch—and everything I’ve read on the topic— is that they will be fine.
Much depends on how they were stored but the proof will be in the pudding — how they work.
Of course, if they did not work well for your son before, they won’t now, either.
good luck,
g
Anyone having any luck getting brand Concerta? All the pharmacies by me are saying they have been out of stock and that it’s backordered for ages. I had commented in the past and can’t take the other generics, had an awful response to them.
I have had good luck getting it at Kroger (in Nashville).
Hi Jamie,
Please read my latest post on Concerta. It contains tips on what you can try now.
For example, I don’t recommend exhausting yourself with local pharmacies. See if your insurance benefit includes a home-delivery pharmacy.
And, since you had a poor response to the generics, you might want to get cracking on filing an exception form, with your MD.
Instructions in the post:
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
good luck,
Gina
Well I’m in this mess here as a longtime user of Concerta ALZA 36 for a head injury.. In reading these boards, I see steer clear of CVS, try other pharmacies. We have Caremark Insurance. What influence if any will that have with Walgreen’s for example?
Gina your website was a saving grace when unbeknownst to me I was given a concerta substitute in 8/18. The pill looked the same but my family noticed a deterioration in my functioning. Mercifully i had saved one pill from the prior batch and it had ALZA on it. The substitute did not. When I googled this dilemma, your website popped up -just the exact info and support group I needed.Going forward, My neurologist took great care to write name brand only on all subsequent scripts. The last copay was 150/3 months. Seemed something up since previously 25/3 months. This time I was told I couldn’t have concerta because I hadn’t tried a generic. So I need to try a generic , have it fail and then go back to concerta with oros delivery that says alza. Please clarify that I read the oros delivery system might be eliminated. I’ve been getting confused with info overload. Thanks for your help.
Hi Judy,
Yes, the price has gone up for most Concerta users.
Yes, the dramatic situation created by “Big Generic” is making it much harder to get brand Concerta.
No, there is no stated plan to eliminate Concerta. But anything is possible going forward.
I explain most of this in this post. Did you see it? I linked to it from the beginning of this post, where you are commenting.
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
It might be that the generic you got in 8/18 would qualify as one of the “use tries.” If your MD documented your family’s poor response to that generic in case notes, that can probably be added to the exception form. If your MD did not document it, remind them. In writing.
good luck
Gina
Does anyone know of any health insurance provider in the US that will cover named brand concerta at least 50%??
Can’t find it anywhere. I think United health care is the only one but its need to be an HMO, through an employer. My employer has Florida Blue and the denied my appeal. This is all so crazy.
Any updates would be great. $1200 for a 3 month supply out of pocket is insane!!
Hi Zach,
You’re right. It’s all insane.
Health insurance providers tend to provide different things, at different prices.
For example, employer-sponsored insurance terms are decided by the employer. Even with the same insurance company, there can be extremely different benefits.
But maybe readers will have a suggestion for you.
My suggestion in the meantime is this:
1. Get the formulary list from your pharmacy-benefit manager.
2. See if any MPH (methylphenidate) brands are covered….e.g. Daytrana, Quillivant, Quillichew, etc..
3. See which MPH generics are covered.
4. Start trying alternates.
good luck,
g
I have anthem blue cross blue shield PPO and after fighting a bit, with the script sent in by his physician stating that the generics available are not authorized generic with the same delivery system as name brand, patient unable to take due to adverse effects. They covered it! It cost me $8.00 out of pocket. I’m still shocked and have a feeling I am going to have to continue to fight for the same result. Not sure if that helps or not.
Wow, Kristi. You lucked out!
Good for you,
g
I have Blue cross PPO employer provided insurance and they are allowing prior authorization approval for brand because of the shortage. Now mine still cost $120 a month with the approval, but I was calling 20+ pharmacies a day to find out no one had anything, brand or generic.
Maybe your insurance has an exception policy due to the shortage…
After 2 denied prior authorizations, we were approved on appeal. We have a Blue Cross administered through Express Scripts. The appeal focused on concerns specifically about switching from one methylphenidate ER formulation to another. It was detailed with regulatory and scientific references, that I think are pretty difficult to reason against (not that insurance is reasonable, perhaps we just got lucky 3rd time around). For many of the reasons articulated by Gina, it is probably healthier to work through the bureaucracy to get coverage for the brand than to experiment with a switch. Of course, that takes time and it still ends up costing more than just generic. The headline of our argument is as follows. Hope this helps others.
• The sensitivity of ADHD / methylphenidate treated patients to PK profile is such that the UK health authority has issued a recent (2022) alert related to switching methylphenidate formulations: (Quote
from link: Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations| GovWire News:)
“….caution should be used if long-acting formulations of methylphenidate are to be used interchangeably due to the differences between formulations in dosing frequency, administration with food, amount and timing of the modified-release component, and overall clinical effect” …..
“Once a patient is established on a product, prescribers may wish to maintain them on that specific product.”
Oh wow, Robert. That’s so helpful. Thank you!
Last I heard about UK NHS and these generics, it was proudly announcing how many more people it could treat with the cost-savings. I’m glad to see some back-pedaling.
g
Thanks for all the helpful information. It has helped me out in the past few years. I just found out today that patriot pharmaceuticals no longer exists. I don’t know the specifics. The representative was very vague with me. I think it is relatively new news however, he confirmed that they are no longer producing generic medication. My son has been getting the generic Concerta, after he had issues with other generic brands, I found this wonderful piece of information you provided and was able to advocate his needs because of the information you shared. I appreciate all of the work that you’ve put into helping mom’s like me who have no idea what they’re doing. If you know of any other authorized generic brands for Concerta, I will keep my eyes out for your amazing advice. It’s unfortunate that I can no longer get his generic concerta through patriot as it has worked well for us. Just wanted to give you a heads up if you are not already aware.
Hi Kristi,
You might want to check out my most recent post. I believe I linked to it at the intro to this one.
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
It contains some guidance as you might want to proceed now.
Unfortunately, none of what you share is news. I’ve reported on these developments starting in November, 2022. It’s just that you won’t hear about it from other ADHD-themed sites.
So, always turn here first. 🙂
good luck! I hate that this issue based in greed is causing so much heartache. It’s intolerable.
g
Do you know how I could get the actual PK data for the concerta generics? As you point out, the prescribing information for the generics is the same as the brand, so it doesn’t provide the actual concentration-time information for the generic product. While your main point is that none will be really similar to concerta, I’m hoping that with the their actual PK data, some of the generics will be at least a little more like concerta than others, and I could try to find them.
Hi Robert,
I approved your comment and provided a response days ago. Not sure what happened. But I am on the road and in Southern California, where the weather has been nuts and so has access to Internet connection.
I will re-write my response when I get time. Bottom line: I don’t think you will find that actual PK data. Because they don’t have to provide it.
If I recall correctly, they only have to show blood concentrations as bioequivalent. That doesn’t mean therapeutic bioequivalence. Entirely different thing.
g
Some small batches of Patriot Authorized Generic are still available!
I needed a refill Monday and learned about the end-of-life for Patriot’s authorized generic. So I began calling all of the pharmacies around my town (mid-sized city) and very quickly found a pharmacy chain that confirmed one of their locations still had over 100 in stock.
I spoke with my doctor and he agreed to prescribe 3 months worth at once, and I just picked them up. So if you’re still scrambling to find an alternative, be sure to call around (and make sure to ask the chains if any of their other locations have them in stock, because they can likely see how many their other stores have).
This effectively gives me three months to find an appropriate alternative.
good reminder. tx
An order for 36mg generic was called in for me on February 11th. It is due to come in stock on April 11th. The manufacturer they expect is Trigen and that’s the one that doesn’t work for me and I reported to the FDA and spoke to them on the phone after my reporting it as an inferior generic. This is Publix Pharmacy in Florida. They have Vyvanse in stock for $200, but it might need special approval. Crazy how insurance doesn’t want to cover that because it is sometimes used for binge eating disorder. So most of those who need it are for ADHD and are out of luck. SMH
Hi Susan,
It’s so stressful!
I expect some insurers don’t want to pay for Vyvanse because it’s more expensive. Simple as that.
g
Pingback: The forgotten victims of the Adderall shortage – Michael Groves
In your section 8, you note that the Ascent / Camber generic does not use the osmotic delivery system. But the package insert from Camber (https://www.camberpharma.com/wp-content/uploads/2020/08/4130-31341-Pack-Insert-for-Methylphenidate-Hydrochloride-ER-Tablets-USP-Ascent-Camber-955-08-2021a.pdf) says it does. How do you know that it doesn’t?
From Camber: “Methylphenidate hydrochloride extended-release tablets uses osmotic pressure to deliver
methylphenidate HCl at a controlled rate. The system, which resembles a conventional tablet in
appearance, comprises an osmotically active trilayer core surrounded by a semipermeable membrane
with an immediate-release drug overcoat. The trilayer core is composed of two drug layers containing….”
Hi Robert,
I know this is all SO confusing. I do my best to educate on all the details, so it makes sense. But it’s a lot to wade through.
Please read again. I did not say, as you wrote, that “the Ascent/Camber generic does not use the osmotic delivery system.”
This is what I wrote: NOTE: The Ascent generic (distributed by Camber) uses a barrel-shaped pill. It seems designed to fool consumers/physicians/pharmacists that this generic uses OROS. It does not.
The general term is osmotic delivery system. There are many types.
OROS is the patented, trademarked osmotic delivery system used in Concerta. The only methylphenidate product to do so. It’s patented by a company called Alza (later purchased by Janssen parent company J&J). That’s why Concerta pills say “alza”.
Again, this doesn’t mean Camber’s generic is “bad”. It means it doesn’t use Concerta’s delivery system and so, by scientists who understand these things, it’s truly not “bioequivalent” to Concerta. Meaning, can be interchanged without any noticeable difference.
I hope this helps
Gina
Can they use identical language and still not be OROS?
This is take directly from Ascent Pharmaceuticals Inc. insert:
11.1. System Components and Performance
Methylphenidate hydrochloride extended-release tablets uses osmotic pressure to deliver methylphenidate HCl at a controlled rate. The system, which resembles a conventional tablet in appearance, comprises an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat. The trilayer core is composed of two drug layers containing the drug and excipients, and a push layer containing osmotically active components. There is a precision-laser drilled orifice on the drug-layer end of the tablet. In an aqueous environment, such as the gastrointestinal tract, the drug overcoat dissolves within one hour, providing an initial dose of methylphenidate. Water permeates through the membrane into the tablet core. As the osmotically active polymer excipients expand, methylphenidate is released through the orifice. The membrane controls the rate at which water enters the tablet core, which in turn controls drug delivery. Furthermore, the drug release rate from the system increases with time over a period of 6 to 7 hours due to the drug-concentration gradient incorporated into the two drug layers of methylphenidate hydrochloride extended-release tablets. The biologically inert components of the tablet remain intact during gastrointestinal transit and are eliminated in the stool as a tablet shell along with insoluble core components. It is possible that methylphenidate hydrochloride extended-release tablets may be visible on abdominal x-rays under certain circumstances, especially when digital enhancing techniques are utilized.
This is taken directly from the prescribing information for Concerta by Jansen:
System Components and Performance
CONCERTA® uses osmotic pressure to deliver methylphenidate HCl at a controlled
rate. The system, which resembles a conventional tablet in appearance, comprises an
osmotically active trilayer core surrounded by a semipermeable membrane with an
immediate-release drug overcoat. The trilayer core is composed of two drug layers
containing the drug and excipients, and a push layer containing osmotically active
components. There is a precision-laser drilled orifice on the drug-layer end of the
tablet. In an aqueous environment, such as the gastrointestinal tract, the drug overcoat
dissolves within one hour, providing an initial dose of methylphenidate. Water
permeates through the membrane into the tablet core. As the osmotically active
polymer excipients expand, methylphenidate is released through the orifice. The
membrane controls the rate at which water enters the tablet core, which in turn
controls drug delivery. Furthermore, the drug release rate from the system increases
with time over a period of 6 to 7 hours due to the drug concentration gradient incorporated into the two drug layers of CONCERTA®. The biologically inert
components of the tablet remain intact during gastrointestinal transit and are
eliminated in the stool as a tablet shell along with insoluble core components. It is
possible that CONCERTA® extended-release tablets may be visible on abdominal
x-rays under certain circumstances, especially when digital enhancing techniques are
utilized.
Is the delivery system still patented by Alza?
Hi Amir,
Shew! I’ve seen some sociopathy in my day but Big Generic really takes the cake. The more I learn about this industry, the less inclined I am to want any generic of any type.
Thanks for pointing out that Ascent uses the EXACT SAME WORDING TO DESCRIBE its osmotic system — but it is definitely NOT OROS.
Note that it does NOT use the patented term CONCERTA….e.g.
Janssen – Furthermore, the drug release rate from the system increases with time over a period of 6 to 7 hours due to the drug concentration gradient incorporated into the two drug layers of CONCERTA®.
Ascent – Furthermore, the drug release rate from the system increases with time over a period of 6 to 7 hours due to the drug-concentration gradient incorporated into the two drug layers of methylphenidate hydrochloride extended-release tablets.
Same for the last sentence.
Seems to me the non-“Concerta” parts could be read generically, as applying to any osmotic system that roughly has those characteristics.
These two-bit hustlers know how to exploit every possible loophole to the nth degree.
A pox on all their houses.
Gina
Due to the adderall shortage I was forced to find an alternative medication for my adhd. My doctor switched me over to methylphenidate XR. The pills appeared reddish-brown with a capital M surrounded by a square and the number 54 next to it. Curious about the manufacturer I did some googling and “Mallinckrodt” popped up. Any updates on this particular generic since 2016? Is this the same generic trash as 7 years ago?? Do you know of any reliable tactics of exchanging stimulant medication for a different formulation if already filled. I know this is unlikely, but hoping there might be a way.
Hi Shelly,
I wonder why your doctor didn’t at least try to keep you in the amphetamine class, if that’s what you’d settled on as best for you. Mydayis is essentially Adderall in an extended-release formulation. There are savings programs, last I checked.
As to your question….yes, that’s Mallinckrodt. I can’t imagine it’s any different. That’s one of the two generics downgraded by the FDA as not bio-equivalent.
All that’s different, really, is the Trump’s FDA chief, who reversed the decision and pushed through these generics.
I don’t think you can exchange stimulants. Never heard of it, anyway. Once you pick it up at the pharmacy and open it, it’s yours.
That typically doesn’t that you have to gut it out until your 30 days (or whatever) are up, not if it doesn’t work for you. Much depends on your prescriber and your insurance plan, though.
good luck
Gina
I have good news and bad news from my family’s latest adventures.
1. The good news is that Patriot authorized-generic Concerta doesn’t seem to have been available at such a wide variety of pharmacy chains in years as it is right now. If you’re about to fill, call around and ask about the NDCs Gina’s listed — you might be surprised how easy it is for you to find. Call pharmacy chains who’ve told you before that they’d stopped ordering Patriot because it was so expensive. Lots of them are ordering it this week.
2. The bad news is that places that had stopped carrying it seem to have all ordered it because they can’t get their hands on any other generic Concerta nor on the brand-name Concerta. So if you’re NOT about to fill, the remaining supplies of Patriot Authorized Generic Concerta are about to FLY off the shelves of almost every pharmacy serving almost every single Concerta patient everywhere, because it’s the ONLY Concerta of ANY sort in stock at many places.
Wow, that is very strange. Thanks for the report from the front line.
This will no doubt vary by geography, type of pharmacy, and pharmacy chains/warehouses.
But seems it’s worth a try.
Name brand is available just fine. My pharmacy has been ordering it for me every month and shows up in a few days from date of order. Literally just filled it Tuesday. No problems at all.
Good for you, Jackie. Unfortunately, not everyone is as fortunate.
There’s endless variability store to store, chain to chain, insurance pharmacy benefit, etc.
g
To add to Jackie’s comment, I find that when I call around and ask about “methylphenidate ER” I often get slammed first off with “ sorry on back order, no idea when we get some”. Only if I pursue and ask if they have brand Concerta do they say “ oh yeah but insurance won’t cover it “ ! This even when I’m calling a random pharmacist who has no idea about my coverage! Often they actually do have it, the other days call actually confirmed they had some *right there on the shelf*! So weird! And to reports of Patriot being available places as of a week ago I had not gotten that sense at all in my flyover-country lands, but just filled anyway so I guess out of luck in any case . I’m getting tired of the idea of being jerked around for my kid so we’re starting the search for acceptable alternatives. But I do want to keep up with any “ class actions “ — indeed why don’t we do one of those ?!?! I mean seriously ….
Anyway, good luck and cheers to everyone!
Hi M,
There’s been a big shift from Concerta brand being covered fairly widely (definitely not comprehensively, though) to being covered rarely. Maybe that’s what the pharmacists mean.
What would be the basis for a Class Action suit? I don’t think there is any.
Trump’s FDA chief pushed through these Concerta generics in 2017….making them “legal”….after some of us worked very hard to have the first two downgraded — and succeeded. But that was 2014.
Mega-mergers also happened during the Trump administration that likely would not have been allowed before and after. When I saw that two 800-pound gorillas — CVS and Aetna — were merging, I knew no good would come of it. It came as no surprise when CVS rarely (if ever) filled prescriptions with the Concerta authorized-generic. Walgreen’s did. Sometimes other pharmacies. Not CVS. Wasn’t as profitable as the junk generics, I figure.
Elections have consequences. When we don’t know what’s happening (or what HAS happened), we tend to blame all wrong parties.
Good luck in your search. There are many other options out there.
g
Hi Gina !
Any thoughts or comments on “Relexxii” as an alternative to Concerta ? It seems to have been “approved” in June 2022, and it is shown to be in the same mg doses as Concerta but it is not a Concerta generic? Seems to be connected to all these different LLCs owned by the same acquisition fund Avista, Vertical Pharma and Osmotica both? Looks like a weird series of money moves and that is what it is of course, but the recent “ approval “ of something that looks like a Concerta generic but as a new brand feels like we are about to see another work-around on coming off-patent for a medication that has a distinct mechanism of action? I don’t see it even as available yet on GoodRx for instance in anything but the 72 mg dosage? I’m so confused! Thanks for any help you can offer here! Cheers…
Hi M,
“Weird series of money moves” is right! 🙂
One doctor friend tells me that the 72 mg Relexxii is bioequivalent to the Concerta 72 mg. Maybe that’s why it’s the only one you see?
Why not the other doses? I have no idea. Stay tuned.
And yes, Relexxii is a brand, not a generic. The generics have generic names (in this case, methylphenidate ER; they’re known mainly by their manufacturer’s name.)
Mainly, I am letting folks know there are many other methylphenidate options, some of them brands with no generic (e.g. Quillivant).
good luck!
g
Thanks for that info Gina and the wishes for luck—we’ll need it !
So strange . If it’s the same as Concerta then why is it allowed to get new drug RLD status ?! My insurance formulary doesn’t even list it which isn’t surprising because it was just approved in June 22.
The FDA orange book shows all the same mg dosages as Concerta, and a branded approval for all done in June 22.
https://www.accessdata.fda.gov/scripts/cder/ob/results_product.cfm?Appl_Type=N&Appl_No=216117#
The 72mg version has been marketed by Vertical Pharmaceuticals as a cool way to —get this — cover two non ER 36 mg doses! Did they get special RLD brand approval for that? It seems to have been sold as 72mg but without a brand name ? I can’t really tell here because they are claiming it is the “ first and only er 72 mg” ?
https://www.methylphenidateer72.com/
So now Vertical Pharmaceuticals and Osmotica have both been bought by Avista and so I wonder if Vertical actually did have a “real” OROS type action that they “gave” to Osmotica to use to get Relexxii approved as a new RLD?
This seems like a giant work around to the idea that medications go off-patent at some point so consumers can benefit from lower costs.
It’s like somehow someone creates decent action OROS tech outside of ALZA and gets the FDA to approve its use in essentially re-producing Concerta and claiming it is a novel agent?! Could this have been a long term play in getting all those garbage generics approved in the first place?! Oh see the generics for *Concerta* don’t work so here we are creating the “next generation” Concerta!
Good questions, M.
I’ve been puzzling this with an ADHD specialist MD, and we’re still scratching our heads.
Waiting for more info….all we can do, I guess.
g
Hi again, ugh, NOW I realize that *Trigen* merged with Vertical before being taken over by Osmotica ( dizzying this M&A stuff and frightening when done with companies whose products have such profound effects on peoples lives !) so I am not hopeful about this “Relexxii” product because iirc people did not find the Trigen generic action similar to the Alza in the Concerta! Unless Osmotica has come up with something better than they used to have, the “new agent”approval for Relexxii in dosages that look just like Concerta looks like a “replacement” for the whole product and the combo of that with the rumors that Jannsen is moving away from the adhd market and the fact that they are closing the Alza plant they run in Vacaville
https://www.fiercepharma.com/manufacturing/janssen-laying-off-four-dozen-employees-as-california-plant-slated-for-closure
A sale to another company of the same Alza tech would be one thing, but my fear is that they have decided none of this matters to the patients, and maybe they’ll just force us to transition to a whole different product. That nobody will pick up the same tech because J&J owns Alza. Trigen/Osmotica/Vertical (now I realize the three of them were bought/ organized under a “Alora” llc for a while recently or maybe still? How that relates to Avista partners who knows; lord each of these transactions means money changing hands that doubtless is more behind the outrageous prices we pay for pharma than money they actually spend in R & D ) maybe knew Jannsen was wanting to “ leave the space “ and got RLD approval for their inferior tech and that’s what we will be left with?
I have to say I’m not hopeful about someone else putting out a decent generic for Concerta and I wouldn’t doubt that with all this PE money parked into the scene that Alza tech will not be licensed to anyone for adhd products, certainly not anything affordable. I can imagine a number of behind-the-scenes “ agreements” among the players here to make it all stock price / profit margin “win-win” for the corps and not good for us people .
I do realize that we’ve been weirdly lucky with the authorized generic for years , but it feels like this moving *any* osmotic tech to a new RLD and leaving the slew of non OS generics for us if brand is not covered for us is what is in the works . Which gee if generics had been pulled for not being therapeutically equivalent and now they approve a new RLD that is the same thing as Concerta just with an inferior OROS ?! This would be fascinating to watch play out if it weren’t so horrific for patients .
Good luck to us all!
Wow, good sleuthing on the Alza plant. I mean, bad news, but good data.
Big Generic pays absolutely zippo on R&D. They just slide in on the path Big Pharma has paved, exploiting loopholes all the way and fattening pockets.
When I was first trying to figure out what was going on…back in 2013 or so…I called a pharma patent attorney. He explained that the first two generic cos – Mallinckrodt and Kremers-Urban — were “brilliant in exploiting FDA loopholes….GENIUS!”
I’m fairly jaded in this regard but even I was shocked….repulsed. All I could mutter out was, “Genius….if you’re a SOCIOPATH.” Good grief. These people are absolutely detached from any concern about consequences for others. It’s only their greed and dominance that drives them.
Specifically to your point: “It feels like moving any osmotic tech to a new RLD and leaving the slew of non OS generics for us is brand is not covered for us is what is in the works.”
That is exactly the problem. And it’s what we fought in 2014, only to have Trump’s FDA Chief break it all over again.
Consumers CAN file an FDA Medwatch complaint. That’s how we did it before. In revisiting this with the FDA two weeks ago, I was assured they are paying attention to the complaints. We need to get on it. Easier said than done when people are scrambling for Rx that keeps them functional, much less able to take on anything else.
good luck
g
I wish I didn’t feel the need to keep digging but it’s my kid I’m trying to help and I am a digger by nature ( PhD in psych, not clinical though! Probably should have done something more archives based —my own untreated adhd keeps me hyper focused on searching for answers sometimes !)
As I am trying to research other Concerta like meds, I looked into Adhansia XR and I see there had never been a generic version approved it seems and the manufacturer—Adlon Therapeutics, a subsidiary of Purdue —has discontinued it as of July 22 🙁
https://adlontherapeutics.com/products/
They say this was purely “a business decision” and not anything about effectiveness or safety . Thanks pharma!
Looks like they may have declared bankruptcy maybe part of paying for Purdue sins in other domains?
So, hmm, maybe shortages of everything are also being driven by these products sitting around after being “pulled “? It’s so unpleasant the lack of concern for the patients!
So now on to checking on Aptensio for us, to try, given that the action is maybe easier-to-reproduce-in-a-generic extended release capsule? I’m trying to find ones that have claimed duration similar to Concerta and we are working with a primary care physician who is great but not a specialist in these things.
Probably after we do a trial of a Concerta generic to most likely file a medwatch because we’ve had a non-authorized generic before but it was years ago and was able to get the authorized again.
I suspect this stunt with FDA Chief Gottlieb created havoc all around — and not just with ADHD medications.
It’s massive.
But yes, at least two new ADHD Rx came from Purdue, as I recall, and Adhansia is one of them.
It’s great that you can do preliminary research like this, but unsolicited advice…it’s easy to get lost in the weeds, trying to read the “tea leaves” regarding mechanism of action, etc… When really what needs to happen is trial and error, unfortunately.
You probably know this, but one way to start separating wheat from chaff is to think about the profile your child best needs — that is, more oompph in the morning, a steadily ascending rate, etc..
good luck,
g
Thanks again Gina! Even for the unsolicited advice 😉 !
Any advice on where to look online for clues on course-of-day profiles? Adhansia was appealing on paper because it’s duration on a well known adhd website that gives length of action seemed to be among the longer ones and it’s long duration that seems most needed for my kid ( who is essentially young adult now but Only done meds for the last bunch of years) . It wouldn’t be terrible for quicker morning kick-in but beyond that the only complaint I’ve heard is crash at like 8 to 10pm, which really, what more can you hope for lol? They started with a pediatric rec of Concerta and it was good right off so haven’t ever had to do trial and error yet but yes I do appreciate that this is what will ultimately determine what will be best!
Anyway thanks again for all you do!
Cheers!
You know, there’s always the option of a second dose, even if the prescriber has never heard of such a thing.
My niece asked her doctor for a second dose, for her 12-year-old, who was crashing in the afternoon, and the doctor said, “You can’t do that because of the DEA!”
Wrong-oh. But typical.
You can always look up the product label for each brand. But when it comes to getting its generic, it could little to no resemblance.
BTW, my course on optimizing ADHD-related sleep and medication.
https://ginapera.adhdsuccesstraining.com/view/courses/course-2-physical-strategies
g
Hi KSK,
Yes I hope you have continued luck getting Concerta and paying a lower cost. We are in Massachusetts and we cannot make use of the coupon. I was debating paying for brand, but since it is not in my insurance’s formulary, I think that even if we reached deductible they wouldn’t cover anything. We’ll see where this takes us. I’m kind of curious now to have my daughter try another methylphenidate brand. I like what I read about Jornay PM. Thanks for sharing. And yes, thanks to Gina. I’ve been following her blog for years. To be honest I wish we didn’t need to become such experts on this. If only patients needs came first.
My insurance is only covering Quillivant because there’s not another liquid extended release available at the moment and it’s just been 2 months. I don’t know how long it’s going to last.
Most of my researching starts right here with you, Gina. Thank you.
Hi Suzanne,
Happy to help! good luck!
g
My daughter’s been on Concerta Authorized Generic since about 2010. So whenever it switched to Patriot was when we would have noticed we no longer received the ALZA pill. Lord knows I can’t remember the year but we know it was under Trump. However I don’t know if the bum generic we received was TEVA or something else. It was whatever CVS gave us. Makes me wonder then if I answered his question correctly as, yes, at one point she would have received the Activis/TEVA Authorized Generic which was fine, until it wasn’t. But for most of the time after that we were able to get the Patriot Authorized Generic (ALZA). Try to explain all that to some stranger on the phone who I could barely understand for his accent. In any case I know insurance will try to screw us because that’s what they do. If not, then pigs fly and hell has frozen over and drug companies care about people.
Hi Kathy,
Patriot is a Janssen subsidiary. When the previous deal expired (with Watson-Actavis-Teva), the AG was distributed by Patriot.
Teva then went forward with its own Concerta generic. A “true” generic, not an authorized-generic (brand sold as a generic).
The DEA tightly controls stimulant Rx. I bet you could ask your pharmacist to check your history and see what you got in 2017.
good luck,
g
Hi Kathy,
I will say that Gina has been a Godsend with all of this! And even that doesn’t cover how much I have respected and followed her research and sound advice. We ultimately had our doctor (this is for my son) go through the prior authorization route. He stated that the generics caused great sensitivity with adverse reactions to my son that prohibited him from taking them. The prior authorization was approved for the brand name Concerta for 1 year. However, the cost was still a bit high. My son takes both 36mg + 54mg per day. So a 90 day supply for each strength, was $180. ($180 x 2 = $360 per 90 days / 3 = $120 per month) We then went to the Concerta website and downloaded their savings card. The Concerta Savings card brought each strength down to $30 for a 90 day supply!!!! Meaning, $20 per month for both strengths. Now…… I have no idea how long this will last. Especially with the Concerta savings card, and I suppose I should read the fine print now so I’m not left scrambling when this ends. But for now, this will do. And, believe it or not, this was through our local CVS too. (I’m still scratching my head over that one as we’ve never had much luck with them.) But yes, it is possible. $20 per month for the brand Concerta through CVS. Fingers crossed that we’ll be able to maintain this status for the next year. Good luck to you and anyone else who reads this – GINA is amazing!!!!
HI KSK,
Thanks for the update! I’m so pleased my tips have worked for you and your child.
I, too, am surprised it was the local CVS. Must be a particularly nice branch manager! Or even CVS is getting an avalanche of requests.
Did you get the 90-day supply at the local pharmacy? Not a home-delivery? That’s unusual! Though I imagine it depends on the state and the policy terms.
Happy for you!
g
Hi Gina –
Yes, 90-day supply through our local CVS! Again, I have no idea how long this will last, so I’m going to keep my fingers crossed. This has been such a roller coaster!!!
Thank you again for all of your advocacy, suggestions, ideas, and research. You really are a very special persona and I appreciate everything you have done for the ADD community!!!
Victory to the people! 🙂
Yay! I’m happy for you.
The public has no idea….taking ADHD rx is an “easy fix.” HA!
You’re most welcome. I’m happy that my work has helped you. It’s why I do what I do!
take care,
g
I returned the call to TEVA. All of his questions regarded TEVA’s generic and honestly I don’t know if my daughter ever tried TEVA. She may have. All I know is when the other generics became available we got whatever CVS gave us. I’m assuming TEVA is what Optum Rx prefers? At other times through my local independent pharmacy she tried Camber and I think Trigen. Anyway he asked me about adverse health effects and I said her mood, attention, concentration, sleep, appetite. He asked me when she last tried TEVA. I guessed and said 2017. All I know is that when the mess started I did everything to find the Authorized Generic and I was successful. Now I wait. I get the feeling they will say she should try TEVA again since it has been 5 years. Okay fine. She is willing to try. But if no good we’ll go back to the exception process or try another methylphenidate. Wouldn’t it be wonderful if Concerta Brand came down in price? I don’t know why they don’t. They’d get a lot more sales.
Kathy – I’m pretty sure the TEVA formulation hasn’t changed since 2017. That would have required an entirely new approval process.
And I agree that it’s a mystery….why Concerta brand doesn’t come down in price. Janssen is losing unimaginable numbers of customers.
Perhaps Janssen has already sold it.
g
Although, wasn’t TEVA/Actavis the provider of the Authorized Generic right before it switched over to Patriot? Kathy might’ve lucked out and actually received the AG in 2017. Trying to remember when it went to Patriot, maybe early 2019? Not sure.
Hi Ann,
Yes, the Janssen/Watson-Actavis-Teva agreement expired at the end of 2017.
So. yes, good point, Kathy might have received the AG.
I try to emphasize using ALZA to identify the pill, not the distributor’s name. Makes things easier—and more accurate! 🙂
g
Kathy,
In looking for other methylphenidate products for myself, I searched for the extended release profiles or pharmacokinetics and found the graph for Quillivant is similar to Concerta. My insurance is paying for it and so far it works for me.
Good luck.
Thanks, Suzanne.
I updated my 2013 post last November, on Quillivant and Quillichew.
As I point out, there are savings programs. But given how few policies seem to cover brand these days, that might not matter.
Still, worth a try.
https://adhdrollercoaster.org/adhd-news-and-research/a-new-ritalin-extended-release-liquid/
Gina
Teva core is a hydrogel matrix. Concerta is a tri-layer core. The hydrogel matrix is not osmotic release. We tried my son Teva and it was not a good fit. It did little to control his symptoms. Everything in my area is back ordered … we plan on trying Camber and/ XLcare generic whenever it is available. Their profile seems similar to Concerta… tri-layer core and osmotic release. Anyway hoping these generics are a better fit for him.
I have talked with my daughter’s doctor about requesting Concerta Brand with our insurance through their exception process. We have Tufts HMO with Optum Rx for pharmacy (used to be CVS Caremark). I had a message on my answering machine today from TEVA Pharmaceuticals regarding Methylphenidate. I will call tomorrow but it seems strange I’m getting a call from TEVA. What do they have to do with my insurance or Concerta? Is our insurance trying to push the TEVA generic on us? I’ll update tomorrow when I call them back. I’m feeling AAAAARRRRRGGGGGHHHHH!!!!!!!!!
Kathy
VERY INTERESTING, Kathy!
This isn’t the first such incident. I have a feeling that Teva is overstepping its bounds—and pharmacies are encouraging it.
If it was CVS, well, anything goes with them. (Optum Rx and CVS have partnered.). I avoid them.
Absolutely, Teva’s generic is being pushed on you, and I bet you’ll hear that it’s “just like” Concerta. It isn’t.
Conflict of interest, it seems.
g
g
I was able to get brand approved by my insurance. I called my insurance and spoke with them, asked them what needed to be filled out and submitted. They directed me to a Prior Authorization form on their website. I filled out most of it (the specifics about there no longer being an authorized generic and specifics on what the other ‘generics’ caused as far as issues.); sent it off to my doctor who filled out there little bit (diagnosis codes, their provider info, ect.) I got approval within 2 days (my insurance quoted 3-5 business days). I have approval for Brand Concerta THROUGH 2039 (provided I remain with the same insurance obv.) I then downloaded the savings card from the Concerta website, since I hadn’t met my deductible yet (FYI if you process through GoodRX it DOES NOT hit your deductible). So that saved me another $150. Once I hit my deductible this year it will be a Tier 3 medication at $50/month with my insurance… maybe its $30, I forget. The savings card should cover all of that either way.
My advice, call your insurance and ask what the procedure is for a prior authorization for a medication and where to find that form. Fill in what you can yourself, and send to your doctor to finish and submit.
Wow, good for you, Jackie!
Yes, I included that very advice in my latest post on Concerta:
https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
g
What insurance company do you have? Was name brand Concerta considered a plan exclusion with your insurance plan?
I’m in the process now of an internal appeal. My claim got denied automatically since it’s a plan excluded drug. However I filled out the the form they have, wrote my own detailed letter, and my doctor also wrote one as well. I have Florida Blue insurance, if it’s not covered it’s 1341 dollars for a 90 day supply lol.
Hoping my internal appeal gets approved! And I can get reimbursed.
Thank you for your reply in advance!
Hi Zach,
I have a local insurance in NYS. Concerta brand was not part of my insurances formulary. Only generics for that medication. (Same for Adderall, though Vyvanese would be covered).
Anyway. Where you went wrong was getting the meds FIRST and then trying to appeal. You’re 100% going to loose that appeal.
What you need to do is ask them the process for PRIOR APPROVAL BEFORE you get your prescription. They will have a specific form for that (you can likely search it from your insurances website). That needs to be filled out by your doctor (I helped with my insurance and pharmacy info as well as what I remember about reactions to previous genetics to make it easier on my doctor). That needs to be submitted and then your WAIT for approval before getting your meds. They *should* notify your pharmacy directly once it’s approved. They told them about 3 days before I got my letter in the mail.
Stress on the form that there is NOT an adequate generic any longer since they discontinued production of the authorized generic.
But you’re not getting back anything that you paid for non covered meds. I hope you do. But I doubt it.
If they do grant prior approval, it will be billed as the highest tier of meds for your plan.
Also I hope you got the savings card from the Concerta website. That would have saved you $150 at least. Maybe triple that as I think it might be $150/month.
Thanks for your reply Jackie! Maybe I wasn’t completely clear with my first response. I did not place a prescription first. I submitted all of that stuff before hand (while I had 40 pills left of the Patriot) and it was denied, pre authorization etc. So I had to then start a pre service appeal process.
However the appeal process does take a while and I had to get a prescription, so I have to move forward with paying for the concerta during my appeal or I will not have any medication. After speaking to my insurance they did mention if appeal is approved I could get reimbursement. However my most important goal is to get it approved so I don’t have to pay astronomical amounts each month for name brand.
I remain hopeful! God bless!
I came across this post whilst looking for info on my current “magic” generic and how to make sure I stay on it. My previous one was literally as good
as taking nothing at all and the current one is literal life-changing magic.
Imagine my surprise to discover the one that did NOTHING for me was apparently the real Concerta (the Alza pill) and the magic one that has changed my life is a supposedly inferior generic!
Have you heard of this happening before?? I did notice when I first started stims that I noticed a big difference between immediate release Ritalin and the Concerta – Ritalin was magical and I didn’t understand why Concerta, purportedly the same medicine just released at a steady dose, was ineffective. Until I got downgraded (to NDC 13811070910, I believe Tiegen makes it) and my life has changed completely. I mean I am literally a different person on it. The only way I could even get by on the real Concerta was by taking 5mg immediate release Ritalins a couple times during the day to top up – even though i was at 54mg. With the non-Alza generic I don’t have that issue.
I know brains are complicated and you aren’t a doctor. But it seems a bit crazy that the “real stuff” did zip zilch zero for me, and the “cheap substitution” turns me into a different (better!) person. So I’m curious if you’ve heard of this happening before.
Hi Annie,
I understand your confusion. And I try to clarify in pretty much every article I’ve posted on generic Concerta.
The unfortunate truth is, I know more about this than most doctors.
Each stimulant has a certain “profile” — that is, the rate at which the methylphenidate is released.
Some start with a large amount and go a bit higher before wearing off somewhat abruptly.
Some start with a small amount, gradually go higher, and gradually taper off.
Many possibilities.
Concerta’s profile works very well for MANY people. But it doesn’t work well for everyone. Same is true for all the stimulant choices.
The problem with the Concerta generics is that they work nothing like Concerta works. That is the problem. Generics should be “bioequivalent” to the brand. These are not.
Big Generic exploited loopholes that FDA scientists wanted to close, thanks to Trump’s FDA chief.
So while that generic might work well for you, it doesn’t work as Concerta works. That’s a problem for Concerta users who are forced to accept these generics as a good substitute.
Bottom line: These generics are not bio-equivalent to Concerta. That is the standard for generics, an they don’t meet it. It’s all a manipulation.
I hope that clarifies.
G
Gina,
Thank you for your reporting. I called Janssen and they said they don’t have any information on the issue of the discontinuation, but if my doctor or pharmacy calls they can give them more information. Who did you speak with at Janssen who confirmed that Concerta Patriot is being discontinued?
Thanks!
NR
Hello,
I provide this as a free public service. If you don’t know me or my work — or my record for accuracy — please learn more.
I barely have time to deal with this ongoing saga, much less substantiate my sources to readers who don’t know me.
best
g
Here’s a link to patriot’s discontinuation on the FDA drug shortage list. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Methylphenidate+Hydrochloride+Extended+Release+Tablets&st=d&tab=tabs-2
Thanks, Josh. It’s in the post, too.
G
I never throw away medication except liquids. Every dose I skip I save so that when the psychiatrist’s assistant forgets to call in my prescription or the medication is out of stock and I have to wait an extra week for it or whatever, I have a buffer for when I need it. I’ve saved all my opoids I’ve gotten for past dental procedures and they have come in handy when recenty the medical community decides they want to protect the public and not prescribe pain medication despite the fact you have a case of the shingles or you’ve thrown your back out. Absolutely rediculous. I have a particular short-acting ADD med I can get away with one instead of two quite often. Too much government regulation on medication. Do what you can to protect yourself!
Hi again Gina, I’m in the weeds of it now lol! Looking at 2 things : 1) orange book TE ratings. You can see the “event” presumably from 2017 when allllll these Concerta generics got given AB ratings! I saw a press announcement from Amneal pharma dated 2018 saying they were looking at approval for an AB rated Concerta generic. Looking at orange book currently though, their entry is listed as BX! Could it be that FDA is doing it differently post -2017 ?! A couple others also listed as BX haven’t checked their provenance.
Oops ! 2) was the press release from Amneal about an AB rated Concerta that turns out to be BX now .
Hi M,
Yes, as I wrote, when Trump took office and named an FDA Chief, that chief overrode FDA scientists’ concerns about bioequivalence. 2017 is when it all started happening.
Gut you don’t need to reinvent the wheel piecemeal. Just scan my Concerta posts over almost a decade. 🙂
Search on the blog for Concerta.
I explain it ALL.
To your point here, see 5#. Background: Why This Clown Car of Concerta Generics?
https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update/
g
Yes thanks so much Gina I have looked a little at that and will continue to do so–there is so much to explore and I appreciate so much all your work! What I’m wondering about is whether the Amneal situation might reflect a change *back* to how things were before the clown-car! That is, Amneal announces to investors –hey guys, good news, we are about to put out an AB rated Concerta generic! That was in early 2018. Gottlieb was maybe still in, maybe out, don’t know. Then, hmm, something happened apparently because it’s not listed as AB now in Orange Book. Hmm. Maybe the FDA with *new* applicants anyway started actually requiring what they had been requiring? Gottlieb did over-rides on specific generics, right, not changing the whole AB approval process, yeah? Thanks again for all your work!
Hi M,
Unfortunately, my time is extremely limited. And unlike the scads of “ADHD experts and advocates” online, I don’t take pharma industry support. This has been a huge undertaking for more than a decade.
I have to prioritize my time to focus on what I consider the most salient facts for readers.
That is, how can we deal with this right now AND how can we submit FDA MedWatch complaints. https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1
From what I can tell, Big Generic is a bunch of unconscionable slimeballs.
I can’t see how whatever happened with Amneal makes any different right now. But that’s above my pay grade. If you can figure it out, great!
Gottlieb was FDA chief May 2017 until April 2019. How exactly he finagled this giant gift to Big Generic is beyond me.
I’m happy to know whatever “inside baseball” you learn that might be useful to readers.
tx
cheers
g
Maybe the problem is that Teva isn’t licensing OROS, which is really the secret sauce. Their patent is supposed to expire in 2024, so maybe others will be able to develop their own version of OROS. In this case, I think the brand company is being stingy with something so valuable that would make all of our lives easier.
Hi Joe,
Yes, that’s the point I’ve made in my MANY posts on this topic. OROS is what makes MPH Concerta. Without it, it’s just more Ritalin generics.
I don’t know what is up with Janssen, and I am hoping that we see more affordable Concerta in 2023.
In fact, Janssen made the brand/authorized-generic available LONG after the patent expiration. I can’t think of another example where that happened.
The problem here is Trump’s FDA Chief and his love for Big Generic. They created this mess. It was all going fine until that happened.
g
I’m definitely wondering if something is happening as of Jan 1st? After two years with insurance requiring branded only, we received notice that we are back to generic only. I will be able to fill my sons prescription (assuming they have it) just before the end of the year, so we’ll be ok for a little while, but what happens after that makes me nervous.
Hi Deborah,
Yes, everything is shifting.
A flood of cheap generics was bound to upset the whole situation. Janssen seemed to have struck deals with certain pharmacies/insurers to supply the brand.
But now….it’s a different ballgame. We’ll see…
g
Hi Gina, thanks for all you do!
Am I incorrect in believing that J&J owns Alza? Bought it years ago?
Oh gosh, M. You’re right! And that’s a great point.
I don’t know how these subsidiaries work….if Janssen would still have to pay Alza to use OROS.
I am hoping 2023 gives us more clarity on Janssen’s game plan. If there is one. To make Concerta brand more accessible to more people.
thanks so much for reminding me of that!
Gina
J & J also owns Jannsen.
Thanks, Angela.
Yes, J&J owns Janssen. That’s why I suggested that a boycott of J&J products might be in order.
Removing the product is one thing. Giving longtime customers no heads-up? Quite another.
thanks,
g
Curious if anyone knows more about the Ascent (Camber) Concerta generic specifically. My 7-year-old son had been getting the 27mg barrel-shaped capsule for several months. After trying various methylphenidate formulations, this was the first one that has worked REALLY well with no major side effects. However, since August it’s been difficult to get a full fill, and now all my local pharmacies that carry it can’t get it in stock at all. I worry it may be discontinued, but my research hasn’t turned up anything.
We then got the Trigen generic from another pharmacy, and that was just awful for him. And that experience led me here!
Thanks to this extremely informative post, we tried the Patriot generic, only to find he doesn’t tolerate that well either (decreased efficacy, new signs of depression, and he generally doesn’t like how he feels on it). We may try Brand Concerta, but I don’t have high hopes given how he responds to the *authorized* generic.
So following all that, my question: has anyone else had success with the Ascent/Camber generic, and have you found another generic, or other formulation, that works similarly?
Hi Jess,
FYI – the brand Concerta IS the authorized-generic. Same thing. Same manufacturer. Same everything. So if your son did poorly on the brand, no need to try the authorized-generic.
Your difficulty in getting Camber generic might be a general end-of-year supply issue. As I noted in the article here: https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
Perhaps you could ask your pharmacy why they couldn’t get it. Or call Camber.
It’s really hard to get useful information based on individual user experience. Everyone’s neurochemistry is different. What is great for one person might be horrible for another. For example, I know people who absolutely cannot tolerate the Camber generic.
You might want to search for “Camber” amidst all the comments on this page.
Sadly, the only reliable option is trial and error. It might be that even a older formulation might work well with your son. e.g. Metadate (now in generic). Unlike Concerta, it has a faster “ramp-up” in the morning. That’s useful for some school children and others who need that profile.
good luck!
g
Thank you, Gina! That was my understanding about brand vs. Patriot generic, so thank you for confirming.
I took your advice and called Camber – apparently their version is currently under DEA review, so they haven’t been able to ship any out for months, and there’s no indication when/if they’ll be able to ship it out again.
We just tried Metadate CD with no success. It seemed very similar in effect (for him) to Ritalin LA, which he also did not tolerate. Will keep at it and report back if I learn anything useful.
Hi Jess,
You’re most welcome. Sorry to hear about the Metadate….. this is all just so sand-pounding frustrating to witness.
But wait….Camber’s generic for Concerta is under DEA review? Is it possible that’s a typo, and it’s under FDA review?
If so, I am VERY much interested in that. It might mean that there still might be hope — to turn around this awful mess created by Trump’s FDA chief.
tx
g
DEA was definitely what the Camber representative *said*, whether she misspoke or not, I can’t say – it was surprising for me to hear too!
I’m curious if this might be the case for the many other generics on “backorder”. Like others have reported, only the brand is currently available at all the pharmacies I’ve spoke to in my area, and maybe this is why?
Wow, Jess. That’s very strange.
There is a known supply issue, with raw ingredients for stimulants. I mentioned in recent reports on medication availability, including this: https://adhdrollercoaster.org/adhd-news-and-research/janssen-bombshell-ends-concerta-authorized-generic/
The typical end of year shortages (due to arbitrary limits of raw material set by the DEA). The surge in adult ADHD diagnosis since COVID began. So many generic companies fighting for a piece of the MPH pie. The fact that MANY of these generics are made in India, so perhaps COVID-related supply chain issues. It could all be playing a role.
tx
g
I’m am with you on the camber. I had such a wonderful experience on it and have been trying to find it and I can’t. It says OSM tab which is basically the same as the Eros but not the same :/
Just FYI – there is a significant difference between a standard osmotic delivery system and OROS.
Gina
This is so frustrating.
My pharmacy (walgreens) kept telling me ‘its on backorder no need to do anything’ (Patriot authorized generic). Well its been three weeks, and as we know above, its discontinued. I asked them to order brand for me. And reached out to my insurance to start the prior authorization. My insurance doesn’t cover brand Concerta (or Adderall, I know they are different, but seems they don’t cover Brand ADHD meds). First I had to chat with CVS Caremark (not CVS Pharmacy) who were useless. The woman puts through a ‘dummy claim’ for brand and tells me ‘It’s not covered’. Yeah lady…. that’s why I’m calling….. for you to tell me what is needed to get it covered with a prior auth. I finally hung up, she was useless.
Found the form myself (thankfully I’m also a provider, of DME through) so that helped me navigate to what I needed. Filled out what I could, and sent it off to my Dr. to finish, also asking him to update my prescription to Brand Concerta. *rolls eyes*. should take 3-5 days to get approved. But also have the issue there seems to be a shortage of BRAND at the distribution center for my pharmacy.
I also haven’t met my deductible yet. so that’s fun. I downloaded the Savings Card. Has anyone ever used it? I cant really see what specifically it does. I know it can be used with my Insurance. Has anyone used it and what did it save you?
IF the meds actually show up I guess I’ll have to have the person at the pharmacy play around with which option ends up being cheaper.
Hi Jackie,
The Concerta Savings card terms are at the website:
Eligible patients pay an initial $4 per fill at participating retail pharmacies and receive up to $150 off their out-of-pocket prescription costs, with a maximum program benefit of $1,800 or 12 fills per calendar year, whichever comes first.
As it stands, it seems that people whose insurance does not cover brand Concerta at all cannot use this.
I’m hoping we have a lot more clarity, too.
g
So I may or may not be able to use it.
I am getting a prior authorization for Brand Concerta to be covered under my insurance for this refill, so I wonder if that will make a difference in then allowing me to use the card..
We’ll have to see. I can always take a 30day supply and then see what my insurance allows next year. I also have a way to petition my insurance to include Brand Concerta in their formulary, especially seeing as there is no longer an authorized generic, that gives me a strong case for them to at least offer it as an option, even at a higher tier co-pay.
It looks like they added Vyvanse since last year to their formulary. (I know its a different medication, but that’s a good sign as it doesn’t even have a generic version.) I would be interested in trying it as I have heard good things, but it wasn’t covered so I didn’t bother.
Hi Jackie,
The two classes of medication work very differently in the brain. And within those two classes, the different formulations also work differently by releasing the active ingredients at different rates, etc..
The only way to know is to try it, unfortunately.
As for your “strong case,” I hope it works better than reports from many others. Policies often stipulate that if a suitable generic is available, that’s what you get. With some, generic Ritalin, metadate, and other generics are considered perfectly substitutable.
g
I have the savings card and it has worked for both myself and my son in the past 2 weeks, and it did save us $150 on each 30 day prescription. We have commercial insurance, I don’t believe it will work (but could be wrong) with government-supported insurance plans such as Medicare, Medicaid (MA), state government plans.
Hi Gina,
So if our insurance can cover the actual brand or find some way to get the brand name (not authorized generic) product we should be okay?
Just want to confirm Im understanding the article that only the production of the authorized generic made by Janssen subsidiary Patriot will be discontinued. But Janssen will still continue to produce the brand version? (Which will obviously cost us, patients/consumers more $).
Trying to determine how freaked I should be – if we are losing the Alzo OROS delivery system all together or needing to find out a way to get the more expensive brand name/non authorized generic version of the pill.
I started on Concerta ER a couple of months ago and it has been life changing. I went through a whole roller coaster of provider issues and taking Adderall IR in weird doses till the provider stuff got settled ( and dont get me started on supply issues!). Plus I cant take capsules and I think Concerta ER may be the only “tablet” ER out there, but Im not sure. And now this shocking news 🙁
Hi PM,
I can only imagine how it feels…to be given something that’s “life changing” and then be told it’s going away.
But know that there are many MPH formulations, and it might be one is good for you — perhaps even better than Concerta. (Though it is really a well-performing choice for many people.)
You ask: So if our insurance can cover the actual brand or find some way to get the brand name (not authorized generic) product we should be okay?
YES. Correct.
It’s important to understand….the authorized generic IS the brand. It’s made on the same production line, in the same facility. It is indistinguishable from the brand.
It’s only the MARKETING that makes it difference—and the name on the bottle. Patriot (a Janssen subsidiary), not Janssen.
That is, it’s sold as a generic. The brand sold as a generic is called an authorized generic (sometimes a branded generic).
I don’t know what you mean by Concerta ER, though. Concerta is just Concerta. Maybe you are in Canada or UK, where the name is tweaked a bit?
good luck!
g
Hi Gina,
Thank you for response!
Regarding the Concerta ER its just that its an extended release versus immediate release (which is redundant for Concerta)
Trying to find something new (if brand wont work) is a frustrating process that Im not looking forward to because its not a simple process (this isnt a question/issue directed at you Gina just noting as another thing on the list for this whole awful mess). In trying to find a new med it usually takes some time to try it out and that there might a minimum quantity that has to be subscribed (like, you have to get a minimum of 5 not 2 for example). And how soon refills/new fills can be given too. Plus add in availability/shortages and wading through generic vs authorized generic vs brand, and provider vs pharmacy vs insurance. So (i assume) in any medication switch its going to take some time, like months not weeks to find an alternative. And that means a lot of emotional/functioning up and downs over those months as meds are swapped in and out to see what works or not.
And lest I forget, from my own experience, ive seen how ADHD and women’s hormones interact which means sometimes the med you thought worked well when you tried it at the start of the month isnt your top choice by the time you get to the end of the month. You just dont know how its all going to work out (or not) until youve tried it for some time – which means it wont be a quick process to switch.
You are so right, PM. I am extremely mindful of all the factors you mention. Extremely.
And have been for decades. That’s why I cover these issues, as an uncompensated advocate. It’s that important.
That’s also why I am again taking up an effort to get these junk Concerta generics downgraded by the FDA. If you’ve tried one of them to ill effect, you can join the effort! https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1
good luck!
g
YES to being a woman and the changes with hormones!!!!
Me, being of child bearing age, and on *continuous* birth control (IE: I can ‘skip’ cycles. But eventually my body goes: ‘you’re having this cycle now whether you want it or not’ LOL): I DEFINITELY notice a difference in my medication effectiveness during my ‘cycle week’. Meds become useless, so I’ve lately decided to skip them that week all together (so thankfully I have some *extras* during this shortage).
It seems to be tough getting *ANY* meds right now. A friend of mine also has ADHD. He takes aderall. And he hasn’t been able to get it for about a month already. And we’ve still got all of December.
I guess I’m fortunate to have skipped my ‘cycle’ weeks periodically as well as the occasional ‘day off’. Or when I was super sick a few months back. I probably have a month if ‘backup’ meds.
Not to self; continue that in years to come *just Incase*.
They got me! Well I thought I was in the clear but I just got notice that my insurace will no longer be covering the brand Concerta, only generic (which as Ive now learned from this blog and my research is not really the same/doesn’t exists). So now I have to see what paying out of pocket is or if my provider can have it be covered as a necessity. Or something….
Urgh!
Ps. The reasoning given by the insurance is that this switch saves money. Which makes me wonder if either Janssen is upping the brand price for the insurance or the loss of the authorized generic means the insurance cant balance out the cost for plans that cover the brand brand.
Pps. The real crux of this whole thing is the Alza delivery system- if you can only get that from one manufacturer/medication theres no way anything else can be equivalent – unless its made with that.
Ppps. I cant help but feel this another slight to peoples view of ADHD/mental health medications. I assume if cardiac patients or insulin patients had issues with constantly having to change medications or having medications that made themg feel awful it would not be okay. But since we can all still “function” ,according to these industries, its okay to do this to us.
Hi PM,
Sorry to hear you got the rug pulled out from under you. So distressing.
Of course it saves money. It probably even makes money – for the insurers and pharmacies. These generics are made for pennies, often in poorly regulated Indian factories.
Yes, it does feel like a slight to people with ADHD who depend on this medication to function. The recent dust-up about insulin prices is one example.
But the larger issue is the far-left demagogues screaming about “cheaper drugs!” and the GOP gift to Big Generic in 2017.
As usual, the people in the sane middle get out-shouted. And, given that “news” these days is increasingly what social media manipulators tell us it is, there is no coverage.
Only me. One of the few in ADHD world online (and elsewhere) that has rejected all pharma support.
Note that a pharma-backed website that many people seem to think “serves” the ADHD community has said nary a word. Why would they? Wrong pharma.
I hope you find something that works better — and boycott all J&J products. (I’ll post about that soon.)
cheers
g
My pharmacy, Costco in Durham NC, said they had no methylphenidate except brand name Concerta, the generic for Daytrana, and the liquid quillivant. So I was sitting in my doctors office and called to make sure. Yes, they still had quillivant and could also still order it. Doctor electronically sent the Rx, right then. Three hours later I got the “out of stock,” message. They called me and said it would be in again on Friday afternoon. Then yesterday at 5:30 I got the next text that said, “out of stock.” Doctor was about to try Vyvance for me. Is that available? I’m away for the weekend and will deal with it on Monday.
Hi Suzanne,
Many things are happening at once.
—COVID-fueled high diagnoses rates and new prescriptions.
—The end of the year always means that we start running short on raw ingredients. The DEA establishes that and has not kept up with the legitimate need for these stimulants.
That’s why I suggested, in my other post, trying the less well-known MPH choices…Quillivant, etc.
Vyvanse is an amphetamine. It’s a different class of stimulants. Response depends on personal neurochemistry.
g
I was just informed by Patriot that they will no longer be the authorized distributor. As of this past Tuesday.
Not sure how this will impact availability re. an authorized generic but not looking good at least short term.
Thanks again, Tim. I appreciate your sharing that news here.
I just wrote a new blog post.
g
Well, I thought I had until January to do some research, which I have started, and discuss this with my doctor to choose an alternative to the Concerta authorized generic. But my pharmacy (Costco) is out and can’t get it. They actually have NO methylphenidate except for brand Concerta for $700. Called around and no one else in town has any either. Actually Costco has 10 (5 days worth) and I’m getting them. I guess I’ll save them for important days. I’m also a teacher of children who take methylphenidate. We need to all write the FDA. I’m beside myself. Will have mashed potatoes, chocolate, and ice cream for dinner.
Hi Suzanne,
Are you sure…no methylphenidate AT ALL? And Costco can’t order it.
Writing the FDA at this point seems futile. So many companies have exploited this, I can’t see the FDA reversing it.
Elections have consequences, and the White House FDA Chief of 2017 gave us this mess.
g
I just found this out today as well after I called three different pharmacy chains to see if they had any in stock. Looking for answers and what to do now.
Hi Dee,
I offer some tips in the post.
Cheers
Gina
Suzanne, I was told the same thing last Friday – all methylphenidate is on back order – all generic brands, all doses. So I’m having the same supply issues all of a sudden and am in a panic. It is not on the FDA’s drug shortage list, but I told my pharmacist to get on the horn and file a report. I also sent an email to the FDA and wrote to my Congressman.
Try the alternates maybe? Including the ones I listed in the post.
Gina,
I asked again when I picked up my 10 pills. My Costco can get no generic, oral, methylphenidate. They can still order Quillachew and the generic for the transdermal patch. The pharmacist checked a few other places and so did I. I’m in Durham, NC.
Suzanne
Wow, that’s interesting. I guess COVID has pushed raw ingredients past the annual limit allowed by the DEA. Seems they should have gotten the memo.
Might be worth trying Quillachew or the patch.
g
Question: If Patriot will no longer be the authorized distributor, then how does that affect ordering the Rx authorized generic by the NDC number? Isn’t the NDC number attached to the specific Patriot-authorized generic brand? Or do we continue to order by the NDC number and it will be fulfilled by the next authorized distributor? (Whoever that is… UGHHHH!)
Di –
NDC number will no longer matter, come January 13. Janssen is withdrawing the product as an authorized generic.
Patriot is a division of Janssen, Concerta’s manufacturer.
g
I also spoke to Patriot. Ended. I spoke directly to J complaint department. They told me that the company had received 0 complaints about the tablet.
Hi Kara,
What type of complaints about the tablet were you expecting Janssen would report?
The only complaint is that the authorized-generic is going away.
g
I am an RN of 35+ years, have extensive experience in “Utilization Management” which, in lay terms, is “claims Processing.” I have followed this website, associated blogs, and just this August (2022) had my PCP prescribe the authorized generic. Long story but my life was derailed in Jan 2021 when I had to take generic Concerta. I have a Medicare D plan with Highmark (BCBS). Without going into the complexities involving Medicare Plan D, I will describe a suspicion I have in hopes that maybe someone can help or direct me to whom/where I can investigate.
Issue: as soon as the authorized generic was filled (August, September, & now October ) the PRICE [which had been the exact same contracted rate (cost) w/CVS-Highmark from 6/2021 through 8/5/2022], went all over the place w/Oct more than 3 times higher!
Suspicion: CVS entered or submitted authorized generic in some way that allowed for increase amount vs. regular generic?
Question: How/where do I find out if contracted rates (under Medicare D) regs) between pharmacies/health plans can change at anytime without any notice? What could be happening with CVS and/or the Healthplan regarding this?
For anyone who may have to pay a percentage of the “COST,” (which is the contracted rate not -retail cost- w/o coverage) this is like Russian Roulette. I am in a financial crisis and cannot get my medication.
Dear Dawn,
Look on the bright side: At least the authorized-generic is available. That’s huge.
Now, what does that mean in the context of Medicare? I have no idea. I know that one fellow using Medicare recently wrote to me, and he did get it. But I don’t know what kind of plan, supplemental, etc.
When “Big Generic” unleashed these crappy generics, it wreaked havoc with the Concerta “landscape.” It’s been a constantly evolving picture of adjustments. For example, Janssen re-introduced its savings program. (I suspect it doesn’t work with Medicare but don’t know for sure.)
As to your question….I don’t quite understand all the particulars. But I do understand this: I don’t trust CVS farther than I can throw ’em.
But maybe it was the way in which your prescriber specified your Rx? Details matter. That would be the first place I’d investigate.
If you’re not wedded to CVS, I’d try to go elsewhere.
good luck
Gina
There are more complaints than just availability. I am trying to find the capsule form in either brand or generic. Even if I have to pay the $780 out of pocket for the capsule (I’ll have to buy 1/2–which voids the rest of the rx)
The tablet doesn’t have the same release system. For me, it is useless. I might as well take a pill of flour. I am not the only one. There are multiple complaints from others online (search why concerta stopped working) and several articles. J says there have been no complaints. That cannot be true.
Hi Kara,
I believe you are confused. If you read this post, you’ll understand that Janssen does not make any of the “true” generics — the ones causing all the problems.
Janssen makes only the brand — and the brand marketed/sold as a generic through marketing deals. Called an “authorized generic.”
So you are complaining to Janssen about another company’s generic.
I have covered this since 2014 — the only person to do so — and got the FDA to downgrade the first two inferior generics.
There’s much to this you are missing. Please read the post for more info.
g
Interestingly, we seem to have had kind of the opposite problem – my daughter first got prescribed concerta meds in 2020 and was put on a round white (I think) pill that worked Perfectly for her. She didn’t need all day every day, just something to give her a little boost to get her through the school day. Now that pill is apparently no longer AB rated so we can’t get it through the military pharmacy we use, and I naively never wrote down what the exact prescription was, so I’m having trouble seeing if it is still available any other way. Without telling us they simply refilled her meds last time with the 24 hour barrel pills by avkare and they have been Terrible. She can’t get enough sleep and has a stammer now where she repeats words over and over, and when we don’t give them on the weekend she is 3x more adhd than normal. But, she also can’t function in middle school without some sort of adhd med. We are reaching out to her Dr to talk about options since apparently she didn’t know about the switch either (a different dr on the team processed our refill last time), but I don’t know what we are going to do until we get something figured out. Hopefully her teachers will be understanding.
That circular pill might be the Amneal brand. It worked really well for us too, even though it’s not AB rated anymore. I called Amneal and they are manufacturing it again but have not released it to distributors yet – maybe mid-October they said. We switched to Camber and it’s been okay. We also had a terrible experience when the generic brand switched. The government really needs to tighten generic manufacturing regulations and monitoring.
Hi AB,
A little history, as you can read about in the post: “The government” was absolutely helpful when I first started looking into this, in 2014 or so. A FDA representative suggested that I open a MedWatch complaint about the first three inferior generics. I did, readers followed through in reporting their adverse experience, and those inferior generics were downgraded by the FDA.
Then Trump and the Republicans took over, appointing an FDA with more ties to industry than to science or regulatory bodies. He pushed through dozens of generics — many of them over the objections of FDA scientists. And that is why we are dealing with this now.
“Government” is us, and who we vote for. :-). Not a “political” post. Just the facts.
g
Hi Caitlin,
Can’t your pharmacy find that order and the manufacturer? It should be on record, somewhere.
I would press your doc and pharmacy to remedy this ASAP, not to wait. The sleep deprivation alone is a huge problem, and one that might linger if she ever gets better Rx.
It might be that even Ritalin LA would be better than what you have. And that would probably be easy to get.
But going forward, if you cannot find the generic you prefer, maybe try the brand/authorized-generic.
Good luck
Gina
Wanted to say thank you for this article and comment section. I referenced it years ago when none of the brick-and-mortar pharmacies in my entire (large) city would order the authorized generic anymore. I ended up switching to an online pharmacy with great success for many years but now they have TWICE sent me the wrong generic even after confirming, in writing twice, that they would only send me patriot pharm’s generic. Beyond frustrated and tired, having had basically zero meds these last two months. I don’t dare take it, last time I took a non-authorized generic I tried it for two weeks and felt like I was losing my mind. I’m going to call Patriot today to not just tell on this pharmacy that is falsely claiming to send their product but also raising as much alarm/advocacy as I can to try to find the right meds.
Hi Jamie,
Good for you!
I hope that online pharmacy has expedited shipment for the correct Rx after those screwups.
Is this a big outfit, like an Express Scripts?
g
Sadly no, my call with them just led to them confirming that they *cannot* order from patriot because their wholesaler doesn’t supply it. So it looks like I’m starting from scratch all over again. It was with Capsule, who had been great for years without issue. The fact that they didn’t accurately tell me this months ago just adds to the frustration. Looks like I need to do some research on places like express scripts? I was going to take a breath and then call Patriot to see where they are/can recommend. Capsule did spend a lot of time trying to tell me the generic I got is an exact match, which it is not. What a mess!
That’s too bad, Jamie.
My understanding is that Capsule and others like it (e.g. Alto) are not warehouse pharmacies (e.g. Express Scripts). They are Silicon Valley startup-type “disruptors.”
I would go with the established national home-delivery pharmacies — and when I say home-delivery, I mean via UPS or USPS. Not driven by car to your house.
https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/?trashed=1&ids=674712
good luck!
g
So … not being aware of the changes by the previous ad-monstrous-inistrstion, I allowed Walgreens to fill my 90 day prescription with Camber tablets. They told me that it *is* an osmotic delivery system and the drug fact sheet appears to indicate the same … can you tell me any more about this Camber product? I currently have a tablet soaking in some vinegar to dissolve the medicine so I can look at the “shell,” if one exists.
I had terrible problems with the previous round of generics – the non-osmotic tablets were unusable. I had severe headaches, tremors, and agitation and it was very clearly attributable to the change in medication. Since then, I’ve been vigilant about getting the Patriot product, but when asked this time, I thought I was safe by insisting on the osmotic delivery. Apparently not.
I can’t think of anything more vile than messing with people’s medication – particularly psychotropic medication. Greedy, vile, amoral monsters.
Hi Felicity,
I’m with you on the “monsters.”
When I was first trying to figure out, back in about 2014, what the HECK was going on, I called a pharmaceutical patent attorney.
He said, “These generic companies have exploited a loophole — it’s genius!”
“Genius,” I said, “if you’re a sociopath.” Gah.
As to your question…..
No, your pharmacy is wrong…. osmotic delivery system is a generic system. By contrast, Concerta uses Alza’s sophisticated, expensive, patented osmotic-delivery system, called OROS. Two entirely different things.
I’ve encountered this false claim from many pharmacists, including at the home-delivery warehouses. They have just swallowed whole the line that Camber fed to them.
This is a long article, with lots of details, so maybe you missed my references to the Camber product:
1.
NOTE: The Ascent generic (distributed by Camber) uses a barrel-shaped pill. It seems designed to fool consumers/physicians/pharmacists that this generic uses OROS. It does not.
2.
OROS™ is Concerta’s patented extended-release technology. It is owned by a company called Alza and licensed 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.)
Some of the new generics use other osmotic technology. As a result, some pharmacists mistake “osmotic technology” for the proprietary OROS™ from Alza.
NOW, it’s possible it might work for you. But if it doesn’t, at least you’ll know why — and not go chasing other rabbits down pointless holes.
I hope this helps
Gina
I check your wonderful site (thank you!) a few times a year for updates. I tried probably 9 or so months ago to find a pharmacy that would be able to order the Patriot brand to no avail (probably tried 10 small and chain (CVS, Walgreens etc), so I am currently paying $100 for a 3 month prescription for my son at CVS. $30 per month to have a sane household isn’t a bad deal in my mind, but would still love to save the money. I am in the San Diego area if anyone in soCal or Cal in general has found a Patriot distributor I’d love to hear about it! Thanks!
Hi Tracey,
A few thoughts:
— Have you considered home-delivery? There is typically more choice than with the storefront pharmacies.
https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/
— Still…. $100/3 months of brand Concerta is not bad.
— Maybe the situation has changed since 9 months ago. COVID messed with supply chains in ways that are only now starting to get sorted.
— To be clear, you’re not looking for a Patriot distributor. You are looking for the Patriot generic of Concerta. Sometimes word usage matters to pharmacy technicians. “Distributor” means an entirely different thing.
— Did you try submitting a script from your prescriber that states “Patriot generic only”?
— Did you try calling Janssen?
I hope this helps.
Gina
Wow, am I understanding correctly that you are paying only $30 per month for BRAND name Concerta?! The only way you may pay less is if your insurance gives you generics (including Patriot) for $10 or $15.
Just by way of comparison, I’m getting the Patriot generic here in Northern VA for $85/month, and thrilled to get that!
Hello Tracey, I echo some others here that $100 for three months is a bargain in my book. I faced a $102 / month bill for 30 until I took the card from the manufacturer to my local Walgreens. Gina recommends it above in No. 4. I got my name-brand Concerta for $4 this month here in Florida- wow this was a godsend since I am losing my job and I want to get another one which Concerta will help 🙂 BTW: local Walgreens pharmacist said that they tried to go nationwide to get alza patriot and they could not find it anywhere – they took an extra week to call for me and checked in twice to let me know they were still working it – so I don’t know what is happening elsewhere but I believe they really tried this time.
Hi Sue, Yay! The card worked for you!! $4. Wow. I’m so happy to know it worked for you!
g
Hi Tracey!
Ann at Walgreen Community has been very helpful. I believe they are even able to overnight deliver the medication, though I’ve never done that. They have been incredibly accommodating!
Walgreen Community Pharmacy on 1487 E Chevy Chase Dr
Glendale, CA 91206
+1 (818) 638-0135
Trying to reply to Jill….
Yes, I’ve seen GoodRx prices close to that for 30 pills. However, my son’s dosage is 72 mgs, so he needs 2 of the 36 mg. pills each day, which is 60 pills per month, so double the cost. Sure wish they made a 72 mg. tablet!
Also, just FYI, I’m not the same “Ann” who asked about updates on July 12th. I have added my last name initial just to differentiate us.
Hi Ann W.
And a 70 mg tablet is not quite enough?
g
Is there a date which shows when this was last updated? I don’t see one.
Hi Ann,
I keep apprised of the situation and update as needed.
You can always check the most recent comments, too.
As far as I know, nothing has changed.
Gina
I was reading about your comment about Patriot Concerta. Have you tried RX Gold? My insurance is terrible but with RX Gold I pay $34 for Patriot Concerta.
Good luck.
Hi Jill,
Thanks for that tip! I see that it’s part of the GoodRx program.
https://gold.goodrx.com/
g
For the life of me, I can’t figure out how to reply to the proper person.
Anyway, Gina, I’m not sure why you mentioned a 70 mg tablet. As I’m sure you must know, Concerta (and the Patriot Authorized Generic) comes only in four tablet sizes…. 18mg, 27 mg, 36 mg, and 54 mg. Or did they add a new size recently that I’m unaware of?
Hi Ann W,
argh! Sorry. I am too tired. :-0. In the middle of preparing Course 2, on sleep and medication, and I was explaining how amphetamines work. Had Vyvanse on my mind!
Gina
Ann,
I take 54mg in the am and 18mg in the afternoon. Each around $32-$34. Less than the $90 I was paying.
Best of luck.
Jill Clifton
No worries Gina. 🙂 Knowing how busy you are, I figured it must be something like that. Hope you can catch some good zzzz’s tonight!
– Ann W.
Thank you! I get ZZZZs. If I didn’t over the years of this course creation (on SLEEP and medication), I’d be dead by now. 🙂
g
Great and helpful article. This really is a clown show, and yes, the national corporate chain pharmacies (that’s you, CVS) are not here to help. Thank you – I hope I can get back to where I need to in terms of the medication that has done so much for me over the last ten years, without having to take out a second mortgage.
I hope so, too, Ronald!
When I learned of this several years ago, I knew no good would come of it.
https://www.modernhealthcare.com/article/20181128/NEWS/181129943/cvs-health-and-aetna-close-70-billion-merger
g
Hello Gina,
Thank you, first, for the resources.
I am having trouble with my insurance, which is gov. insurance, approving the brand. They don’t want to approve it until I’ve tried (and not tolerated) the generics.
This is upsetting, but, I’ll do what it takes and try what I can get. So far I have been prescribed the Camber generic, and will be starting it soon. However, I’m trying to see if I can access the Patriot authorized generic.
I explained to my Psychiatrist and the pharmacists alike, but they are all clueless and confused about the topic. I contacted Patriot at 215-325-7676 and from my experience it just ended up directing me to leave a message for them to get back to me. Is this new, or is there something I missed with navigating the phone tree to speak to someone directly?
My goal is to at least speak with someone there to see if they would work with my local pharmacy to get Patriot in there.
Thanks again,
Love
Hi again,
Just remember….your insurance does NOT need to approve the brand.
All you need is to have the MD specify “Patriot generic only”.
I realize it’s not always so easy. Just to clarify on that point.
Forward your psychiatrist this article.
I’ve given up on big-box retail pharmacists. They are complicit.
You might have to try Patriot a few more times. No doubt they’re busy and understaffed.
g
Hi there! Thanks for this post. I usually take the 36 mg from Patriot, but I recently moved to a new area and I got my prescription filled at Walgreen’s as usual but they gave me the Trigen pills instead! I talked to my doctor about it and he said that it was likely all in my head and there are virtually no differences between the Patriot and Trigen pills, so I am very grateful to this post for explaining and clearly validating my negative experience with Trigen.
Luckily I’ve been able to get mostly back to Patriot, but for my last prescription they gave me pills from Dr. Reddy’s Labs. They look identical in shape to the Patriot 36 mg pills except these are red and say RDY 36 on them. So far they have been affecting me pretty similarly to Patriot except I can feel the effects of these pills waning slightly earlier than Patriot’s. I can hardly see any valuable information about these pills online so I was just wondering if you’ve encountered these yet and if you have any thoughts on these? There’s a chance these may be a viable alternative to Patriot, for me at least.
Hi Elena,
Good grief……is your doctor stuck in the 1950s? Where doctors were Gods and women were “nervous” and “hysterical”?
That is appalling.
Trump unleashed a boatload of inferior generics for Concerta. It’s impossible to keep track of them all.
Since learning about Rx manufacturing processes in India and elsewhere, I’m cautious. Another Indian generic company, Aurabindo, has been called on the carpet by the FDA for all kinds of infractions.
I don’t see problems with Dr. Reddy on the same level as Aurabindo, but there’s this:
https://www.bloombergquint.com/markets/us-fda-flagged-quality-issues-at-dr-reddys-duvvada-site-say-brokerages
The issue with these overseas manufacturers is that they are “approved” by visiting FDA officials. That means they can quickly put up window dressing, etc…
My blog post on that topic is based on the book “Bottle of Lies”:
https://adhdrollercoaster.org/adhd-news-and-research/generic-drugs-bottle-of-lies/
So, Elena, I don’t know what to tell you. If that generic is working for you, and it’s impossible to get the Patriot-Janssen at an affordable price, that’s your call.
I’m sure it uses nothing like Concerta’s sophisticated delivery system. None of these inferior generics do. That was the point…..they could exploit the “ADHD market” and make high profit on simple pills. Cheap ones.
Good luck!
Gina
Has Actavis been approved as an Authorized Generic”? My insurance states that my Concerta is only to be filled with an Authorized Generic.
They had been using Patriot until my last time I got my prescriptions filled.
I’m really confused. I also could tell a difference between the two.
Hi Jill,
No, Actavis does not have an authorized generic.
It’s not something that is “approved.” Authorized generics ARE THE BRAND. They are just marketed as a generic (for various business reasons).
Are you sure your insurance states that “my Concerta is only to be filled with an Authorized Generic?”
Are you sure it’s not simply generic?
It sounds like you lucked out in getting the Patriot Authorized Generic. Now you might have to make more of an effort — getting your MD to specify that on the script.
This post provides all the details.
good luck,
Gina
I called the number above for Janssen and the person in speaking with is very confused and has no idea what patriot pharm is, even after I explained it to her. Somehow I’ve been routed to a Johnson and Johnson savings program help line. Does anyone have any advice for making the phone calls successfully?
Katie, what are you looking for? The authorized-generic?
Did you call the number for PATRIOT in the post?
I can’t access that now so cannot provide it.
g
Sounds like you hit the wrong options in the menu. Yes the Jensen number will bring you to J&J. Every time I have called they have known what I was talking about. But listen to the menu and just choose customer service. NOT the savings card.
They have always taken my information and filled out a ‘case’ with reference number and sent that on to the woman who handles this at patriot.
I’ve tried the direct number a bunch of times and left messages. The only way I have been called back is through the Jensen number however.
Thanks for clarifying that for Katie, Jackie.
g
I had an appointment with my doctor yesterday and she sent in my prescriptions specifically for Patriot (no substitutions/medically necessary.
My pharmacy sent me a text saying that it will be ready on Monday.
Thank you for your help, hard work and dedication.
Victory! Good job, Jill!
I appreciate your noticing my work. 🙂
Gina
Oh God thank you. I have been off my meds since November. I was taking one generic manufactured by alvogen that seemed to agree with me and then one day I picked up my prescription and it was different. HORRIBLE. I spoke with multiple pharmacists before one would tell me the manufacturer of that pill, Lanett co.
I called my drs office and explained the issue and they said they would figure something out and never got back to me so I made an appointment and went in and my doctor told me that I wants taking a generic before. He said I was taking name brand. I said no and he asked me to describe the pill. He says yup that’s concerta. Ok… Maybe I was?
He submitted the prescription as name brand only and before I even got home the pharmacy called and said we will fill this but just know it’s gonna cost $500…
Ok so I DEFINITELY was never taking the name brand.
I’ve been calling around pharmacies and back and forth with my doctor trying to track down the alvogen with no luck.
They just switched my prescription to a pharmacy that carries camber and I’m nervous to try it.
I’ll try calling patriot tomorrow and see if I can find a pharmacy near me.
This has been a nightmare and no one that should be able to answer my questions has been able to so far. Thank you for this.
Hi Katie,
I’m glad you finally found me!
It’s true…plenty of MDs and pharmacists don’t know the difference. They will “gaslight” us until the cows come home. Is it gaslighting, though, when they are truly clueless? Or are they clueless because they are lazy, don’t care, or …..
I have higher standards. Because I know too well what your experience has been.
In future, you can just look on the bottle. It should have said “Lannett”.
Camber is another generic. They deceptively made it look more like Concerta.
https://www.camberpharma.com/products/methylphenidate-er/
I find it sick and greedy and hope they rot beneath their stacks of ill-gotten money.
good luck!
g
Hey there, any luck reaching out to Patriot/Jensen and if so, what was your process/what number(s) did you call? I’ve tried calling Jensen with no luck (they don’t seem to know what I’m talking about) and when I call Patriot it only allows me to leave a message.
Hi there,
Looks like you have to leave a message. Perhaps they are short-staffed….who knows.
Just call that number in the article. That’s it.
g
Camber has got to be one of the absolute worst generics on the market. And I’m not referring to the fact that the tablet immediately dissolves inside your stomach within 30 minutes, and lasts – at most – an hour and a half.
The thing that really just *gets* to me is how a group of people (Camber Pharmaceuticals) decided it was worth the money to make their tablet resemble the authorized generic brand made by Patriot, and as if that wasn’t enough, they THEN went on to drill a fake hole in the side of each of their tablets, a hole which does absolutely nothing.
I was recently switched from the authorized generic by Patriot to Camber, and the difference is infuriating. I cannot believe these generics are allowed to enter the market. It is unbelievable.
For me, I NEED the slow release mechanism that only the authorized generic can provide. Trigen comes close, but not close enough. My first day on Camber was an absolute disaster. Heart palpitations, feeling faint, falling apart (mentally) at work. And to be frank, I used to be a speed addict – for years – in my early twenties. My doctor and I had worked tirelessly to find a medication that could help my ADD, but also one that I would not feel inclined to abuse. Patriot Concerta is the only one. All the other generics make one feel *high* for a few short hours, and that sensation haunts me. To be thrown back into that dark abyss simply because a pharmaceutical company wanted to save a few bucks, it makes me want to vomit.
Thankfully, I am being switched back to Patriot via an early refill request from my new doctor through Walgreens, and should be back on it in a few days, but these last few months (I recently moved, and had been given a 3 month supply of Camber) have been an utter disaster, emotionally speaking.
I’m thrilled to be able to go back to the Patriot brand, but I feel nauseated thinking about anyone else who could be switched generics like I was. Getting 36mg (or any dosage) in the span of an hour as oppose to 12 hours seems outright dangerous to me. What about children? I’m a 27 year old male, but how would a change like that affect a 12 year old child who takes the medication? That is what scares me the most. I’ll be writing to the FDA (although I doubt it’ll do much good) about Camber, because it is unacceptable.
Hi Ethan,
I hear you. That’s why I’ve taken up this mission, first to get the initial inferior generics downgraded (success!) and then to help people now.
I’ve notes in many other places in this post and in the comments…..this is NOT the fault of the FDA. The FDA cooperated wonderfully with me when I opened the MedWatch complaint in 2014. It heeded the many complaints filed by my readers and others. AND it downgraded those generics. In other words, no one would be forced to accept them as an acceptable generic for Concerta.
But elections have consequences. A Republican kleptocracy put a crony capitalist in the FDA chief spot — and HE overrode FDA scientists’ concerns about bioquivalence.
Yes, I will get “political.” Because this isn’t political. This is heinous theft and barbarity.
I can’t imagine it will ever be undone. Too many companies involved now.
As I said, elections do have consequences. This is what Republicans do in the modern era.
good luck
Gina
Dang! Just found this page and am going through the same as you right now (27f). Started at 27mg Patriot. Upped to 36mg Patriot. God send for me, absolutely perfect dosage and I too have abused stimulants in the past during late high school/college for focusing. My last 36mg script was Mylan and I had to stop taking because the god awful headaches. Told my pcp and he said the generics wouldn’t cause headaches and my dose was too high. He dropped me back to 27mg, picked it up yesterday and it’s Trigen. Exact same issue. I took one pill at 3PM and by 9:30/10:00PM I was in bed with such a severe headache I couldn’t even watch tv. Called my pcp today and asked to resend the prescription with specified Patriot only so he did. Get a call from the pharmacy and they said they can’t order Patriot but they can fill Janssen for $400 WITH my insurance. No way. Called around, found a pharmacy that can fill Patriot but now I have to wait to try to get both my pcp and the pharmacy on the same page. I feel like if I’m paying to see a doctor and people in the pharmacy have proper training then as the patient I should not have to be doing all this work. Both my pcp and the pharmacists acted like I was crazy for explaining the differences in the manufacturers. I have a very high metabolism and very high tolerance to medications as well. If I’m struggling with these generic versions I don’t understand how it works well for others. I know everyone reacts differently to medications but these generics suck so badly I don’t see them ever performing that great. I guess if I had never tried Patriot to begin with I may have never known there was a better option though so maybe that’s why some people stick with the others. I’ve been sorting this out for three months now and am severely struggling as a stay-at-home first time mom to a 9 month old but I’d rather not take medication then be crippled by the headaches at the end of each day.
Hi Hannah,
You and your baby deserve better.
It’s CRAZY that we have to be this pro-active. But it’s the situation we’re in now.
It’s also CRAZY that one of the few ADHD voices online who has NEVER accepted pharma support is the one doing this work, uncompensated.
But there ya go. Lots of crazy. 🙂
Good luck!
g
I noticed something different with my alza 36 mg today. I busted the capsule open to find the yellow part of the pill was just the part that sealed it under the white outside layer. The entire half of the medication is white. Has the medication been altered or am I receiving a placebo?
Hi Brian,
I’m not sure why you would open the capsule. You know you’re not supposed to do that, right?
Brand Concerta has a tightly controlled production process. FDA standards are high for brands.
If you have brand or “authorized-generic” Concerta, you don’t have any problems.
g
Hi,
I followed your advice and contacted Patriot directly. Turns out they have a small division especially to watchdog pharmacies they have contracts with who are not providing consumers with the Patriot brand generic Concerta. I told her where I lived in NYC and she told me which pharmacies to go to and if they tell me they don’t carry it to contact her and someone from Patriot would reach out to Corporate (of the pharmacy) and they would make sure all the pharmacists know how to order it. I was lucky because by the time my prescription was sent, they must have already followed through because the pharmacist told me they would order it and have it within two days. For anyone reading this in Manhattan, Rite Aid in the east village (on 1st Avenue and 5th Street) now carries Patriot.
I’m glad my advice worked, Patty. Good for you!
Gina
Hi! I have been calling Patriot, but they told me they are not able to tell me which pharmacies carry the Patriot brand, and basically told me I didn’t have any option besides calling pharmacies. Do you remember how you were able to speak to that division?
Hi Sarah,
If you’re calling the number in my post, you’re calling the right number. Don’t press any of the other options. Just “customer service.”
That said, this is a situation in flux. It might be that things are changing. Or, it might be that you should call back at a different time and hope to speak to someone more helpful.
good luck
Gina
Thank you so much Patty, I reside in NYC as well and have to change insurance companies, they will not cover Concerta and I was having a panic attack, Thank you so much Patty and Gina!!
Hi Gina,
Thank your for all the valuable info. I’m in California and I’m running into issues with getting my pharmacy benefit manager (PBM) to uphold an approved prior authorization (PA) for brand name Concerta. I had previously tried the non-authorized generic Methylphenidate ER and had an adverse reaction so my doctor submitted a PA for brand name Concerta.
Now that the PA has been approved, my PBM is charging a penalty of $331 in addition to the copay for choosing the brand name drug over the generic form. Is this legal if the PA specifically states Concerta? My plan typically has me pay 35% of the cost if the drug is non-formulary. With the penalty, I would have to pay $404 each time I fill my script which is basically retail price!
Hi Layla,
Is there some reason you opted for the prior authorization and the brand Concerta….instead of the authorized-generic?
Sorry I can’t help you with the legalities. You want to read your policy very careful. That might be spelled out.
g
Hi Gina,
My son has been on the Concerta authorized generic for a few years now, and things were going well since last summer, but now apparently there is a manufacturer backorder on the Patriot authorized generic. I’ve had to call every pharmacy in the city the last two months to find one with product on-hand. My son has been out of medication for about 2 weeks now, and pharmacies either can’t order it, or won’t order it because the insurance reimbursement isn’t enough to be worth their while. For example, a bottle of 100 tablets of Patriot costs ~$820, but my insurance only reimburses the pharmacy ~$83 per 30-day supply. While the other generics only cost ~$40-50 per bottle. I don’t blame a small independent pharmacy for not wanting to lose $600 just on one patient. I don’t know what else to do at this point.
Keep up the good work.
Hi Chris,
Do you have a home-delivery benefit? That might be your best bet.
Otherwise, maybe try one of the Concerta generics. Maybe it will work for your son. Or, try one of the other methylphenidate products.
I think something might be better than nothing.
Good luck!
g
I’ve had the same conversation with my local indie pharmacy. I understand there to be three options: authorized generic, for which they pay a lot but insurance and patient pay a little; generic, which is cheap for everyone; or brand, for which they pay a bunch but insurance and patient pay enough to make it worth it.
I’ve never asked them to order the authorized generic because they’ve done me a lot of good over the years and I feel bad. I went through the prior authorization process with my doctor/insurance, which allows me to fill the brand Rx if my doc writes “brand necessary” on it. For this I pay a $50 copay instead of $10.
If you have a similar insurance situation and can afford it, it may be worth looking into getting brand. Independent pharmacies are much more willing to keep it in stock, from my experience.
However, I will say this month I had troubles. My usual pharmacy said they had supply chain issues. All of their suppliers were showing 0 inventory of brand Concerta.
I found another local indie (I haven’t found a chain that stock brand, and those that would be willing to order it at all seemed reluctant and promised “at least” 7-10 business day turnaround time) who had enough in stock this month. I don’t know what will happen next month. I asked my doc to rewrite my Rx for Ritalin LA but she didn’t want to change my meds just because I was nervous about a supply chain issue.
Hopefully it all works out (for all of us). Getting these meds filled can feel so frustrating and time consuming and just…demoralizing. But I definitely echo Gina’s sentiment that something is usually better than nothing in this case. What a production number though!
Thanks for the reminder, Jaclyn.
g
Hi Gina I am so glad that someone is carrying the torch in relation to the differences and the ramifications of taking the generic Concerta’s ! The information that you provide is the most accurate and straightforward that I have read ! I had an ADHD clinic for 30 years ! Certainly I’ve gone through a lot of the pros and cons of the various types of methylphenidate-based medications ! I decided to come out of retirement to take on a few of the more difficult cases that the GP’s could not sort out ! In my letter to the doctor I would ask them to prescribe Concerta without substitute OROS only ! I would also ask the client to check the pill itself for the letters ALZA ! Basically I guess I did not or chose not to deal with any generics ! And of course I gave co-pay cards to those who may find the extra expense a burden ! Thank you so much for the work that you were doing and I guess I’m just asking if this strategy would still work or might they find a way to circumvent these instructions ! Thanks a lot ! Gary
HI Gary,
I’m not just carrying the torch. I built the torch and have kept it lit since 2014.:-)
I opened the original FDA MedWatch complaint that resulted in the first two inferior generics getting downgraded.
Now there are too many to fight.
It’s more than just checking for Alza now or asking not to substitute. For most people, that means they will be paying a brand price, and it will usually be high.
The co-pay cards work for some folks, depending on insurance, but they don’t work in MA or CA.
These instructions still work, last I checked, which was last week.
But they must be understood and followed carefully.
Good luck!
g
WOW, this is a very dense informational page. I began treatment for ADD with Concerta when I was 9 years old. Even then, in 2005, it was a nightmare getting the OROS. But I had learned to invoke ‘Actavis’ at every pharmacy until I got a hit. Went back to school this January, now im 28, and so the concerta became necessary again. HOLY. SHIT. I cant get what I need at all its looking like. The time release on these generics are so poor as to almost be a detriment. If you dont know, there are about 4 or five ways to control the release of a medication into the body, and all of them fall short (with methylphenidate and a great deal many other medications, confirmed by a pharmacy doctorate) because they go from fast to slow. That is, the amount being released at the end of the time, is less than the start or some peak between. Membranes, fast to slow. Variable dissolving layers, complete joke. Prodrugs that use metabolism, mostly fast to slow, but you only ever get the one choice so… Even complexing, whereby the drug molecule is stuck, 3-? many times, to a larger central molecule. The result gets called a complex, and through digestion/metabolism each of the drug molecule breaks off and becomes available, is pretty much fucking fast. to. slow……..do you see the problem? the glaring tell that reveals a bloated and corrupt but unopposable and inextricable thing known only as..pharmaceutical. But let us not utter its name, for it is unholy and terrible. yea. hiding its OROS treasures like a vicious dragon.
Hi Chris,
Hey, I’m all for pharmaceuticals. Seems you are, too.
In this case, however, it’s “Big Generic” that’s sociopathically exploited loopholes — allowed by a sociopathic White House administration, in 2017.
Many people are succeeding in getting the authorized-generic or brand. Some can even use Janssen’s Concerta savings program.
But it takes a few extra steps.
In my experience, home-delivery pharmacies are the best bet.
good luck!
g
You’re right, thank you for the clarification. Big Generic is indeed the only winner here.
UPDATE!
(That may also be of some help to you all)
I had spoken with my pharmacy before my last Doc appointment. I gave them the NDC over the phone to ask if they could order it (CVS Pharmacy). They said yes. Then I asked them specifically what it had to say on the script so I could tell my Doc.
She stated it needed to say
“Patriot Pharmaceuticals Generic ONLY (NDC CODE for your dosage)”.
Spoke with my Doc, and he was happy to put that on the script for me. YAY!
So here’s the interesting part that may be SUPER helpful to ya’ll.
I go to pick up my script Monday, checked, they got the wrong one (BS Trigen). I checked at the counter so OBV I didn’t take it. I also informed them that my prescription was very specific, and that wasn’t the correct thing.
Spoke with the other girl where you would drop off a script, turns out she was the same girl I spoke with to check ahead of time. AWESOME!
So she checks. APPARENTLY depending on what input field the Doc writes the specifics in the electronic prescription, they CANT SEE IT ON THE SCREEN! Once she actually PRINTED the script, there it was under “MD Notes:” written clear as day. They would never have seen it without printing! (seems like a flaw in the system to me)
She’s ordering the correct one and I should be able to pick it up Wednesday. BUT she said if you get your prescriptions submitted electronically they need to write that info (NDC was SUPER important) in the SIG part of the electronic prescription, not the MD Notes, so its seen ON SCREEN, to them.
She also said I can call once he sends the script (he usually does it right then and I get a text from CVS its processing that day), and remind them to get the right one.
Anyway, thought this would help ya’ll.
Hope they get it right Wednesday. It’s on order.
And that they accept the GoodRX, lol
Hi Jackie,
That’s very. kind of you. Thanks for sharing your knowledge.
That IS a very important point — about the pharmacist not always seeing the specifications. I had the same thing happen at Walgreen’s …. thought I noted that somewhere in here, but maybe not. I should write an update.
I have to say, that sounds like a rare CVS. I hope they come through for you.
Again, thank you!
Gina
Anddddd I get here and ‘it didn’t come in’. And their invoice says ‘restricted’. Though first she said backordered.
She’s calling their supplier or something. I have a call into the patriot number above. But it’s almost 6pm. So I won’t hear from them till tomorrow. Their voice mail stated it manufactured and fully in stock and shipping to all wholesalers. So. ♀️
I told her I would call the manufacturer directly as well just to show I’m not letting this go.
Absurd.
Hi Jackie,
I was afraid of that. 🙁
Personally, I wouldn’t waste energy with CVS.
I’m sure she’s doing her best — but running into corporate. And sometimes, it’s a matter of what your insurance will allow.
Maybe Walgreen’s or other. Or home delivery.
g
Yeah my next option is to send it to Walgreens.
I’ll wait to hear from Patricia tomorrow.
Both are convenient to me, though I have never gotten a prescription at Walgreens before.
I also asked them about name brand. Though my insurance doesn’t cover it, I downloaded the savings card direct from concertas website.
I asked if they could run it through to tell me what I would owe and she said ‘we need to have a prescription for that’. Like… you have one????
I’ve got some of the Trigen left though they don’t do much. So I’ll be no worse off for another week or so.
I have found mushroom supplements and ashwagandha to be useful as well.
Yes, CVS typically has not been a great bet.
g
Hi Jackie,
I had better luck with a local independent pharmacy rather than a big chain. Patricia gave me a list over the phone of ones nearby and after double checking, I had the doc send the prescription there. Price was about $71 with insurance. Good luck.
Jackie,
I am having the exact same issue with trying to order the patriot pharma version. They also claimed that they will fill it from then until today when I tried to pick it up and it said restricted as well. Please let me know how it goes with Walgreens.
Daniel,
I called the phone numbers listed above for help from Patriot.
She said CVS will NOT get it.
She gave me a list of local pharmacies, she also said she has a contact with RiteAid. And that Walgreens is 50/50.
If you call the numbers above they’ll take down your contact info and city/zip code and they will be able to tell you which has ordered them in the past.
I’m checking with the grocery store pharmacy tomorrow. The small mom and pop she gave me isn’t in a good area, so I’m trying the rest of the first.
New update:
Was able to get the 27MG last month from a local grocery store pharmacy. They actually HAD IT IN STOCK. But. I got the last of the bottle. Lol. He was upping me to 36mg for this month anyway.
So I send it in. Literally 2.5 weeks early as I knew they would have to submit extra stuff. Apparently the local grocery store pharmacy changed their wholesaler beginning of March… to the same one as CVS. Just my luck. AND…. Corporate refuses to order it.
My pharmacist was trying to help but corporate literally went with ‘no it’s too expensive.’ So… I contacted corporate. With a STRONGLY worded email (because you can’t call the corporate pharmacy department). We’ll see if they get back to me.
So I went to my local Walgreens. Asked if they could get it, they said yes. It was listed as in stock with their wholesaler Ameri-something. Had my script edited and sent AGAIN (my poor drs office). Just spoke with them and they put my on hold and said YES they can get it and it should be here Friday or Monday. HORRAY!!!
And, as I haven’t met my deductible yet, I’ll stick with GoodRX, which last time dropped it from $178 to $38. If they make me pay the $178 it’s fine, but I’ll take a $140 savings any day.
Here’s to hoping that this is the last time I have to do this as I should be sticking at this dose (it’s the one I was on as a kid/teen for like 15 years.).
Random updates:
It’s been 7 weeks and I have yet to hear back from CVS.
Local grocery pharmacy corporate called me back, but I missed the call at work. They didn’t leave a phone number. (Shocker) but said they would ‘try again’. Bet they don’t.
•Ask who your pharmacy wholesaler is! If it’s Cardinal (CVS, and apparently my local grocery) they likely won’t bother, so don’t waste your time.
•Use the NDC codes.
•And FOLLOW UP. Every time a script has been sent I have CALLED (or stopped in) to verify what it says so I know I’m getting the right thing. Better to be proactive then to wait for it to be ‘ready’ and then it’s not the right thing and you’re waiting longer to correct it.
Yes, Jackie, about the follow up.
In the South we call it “bird-dogging.” I’ve been bird-dogging my husband’s Rx for 20 years. lol
g
I’m so tired of fighting to get the right meds every month. My family is tired of it to because I meltdown every time and they hate to see me go through it.
I’m about ready to look at other options. How do the other MPH formulations compart to Concerta, especially in terms of duration? I’ve been on Concerta pretty much since it hit the market and I love it. I was on all the Ritalins back in the day as they came out. They worked but I hate the multiple does and ups/downs through the day. When the Concerta debacle first started I tried Adderall. Didn’t really work. I took dexadrine before Concerta and it was an absolute disaster. Even did Cylert back before they realized it could kill you.
Thank you so much for all the work you put in to this. I don’t know where I would be without it.
Hi Erinn,
I know. It’s a slog, to put it mildly. It’s exhausting for me, too. 🙂
It’s really impossible to compare MPH formulations. So much depends on the individual neurochemistry.
Some people report liking some of the Concerta generics BETTER than the brand. Because that release profile works best for THEM.
Concerta’s patented OROS delivery system is pretty darn hard to beat. But it’s expensive. That’s why the inferior generics don’t include it.
Here’s a list of new’ish MPH choices from the link below -— I try to get first-hand reports but there are so many choices I can’t gather sufficient data worth considering.
New stimulant formulations approved since 2010 include MPH extended-release oral suspension (Quillivant XR), MPH extended-release chewable tablets (QuilliChew ER), multilayer-release MPH (Aptensio XR), MPH extended-release orally disintegrating tablet (Cotempla XR-ODT), AMPH extended-release orally disintegrating tablets (Adzenys XR-ODT), MPH delayed-release and extended-release (Jornay PM), and MPH multilayer-release 16 hour (Adhansia XR) .
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412159/
You might check out any savings programs and see which looks most promising. And to see if there are insurance formulary restrictions. Process of elimination, in other words.
Good luck!
g
I am right there with you. Tired of the monthly battle and my wife is tired of hearing it, too. I was on Ceba Ritalin for years until discontinued. Next, adderall for 5 years causing me to loose my mind and my 20+ years old business. Brand/authorized generic Concerta works great for me but tired of the constant battle.
Yes, I too would be interested in hearing from those who have experience with other long-acting MPH formulations. Especially curious about Aptensio XR (came out in 2015 and has a generic) and Adhansia XR (came out in 2019, no generic yet.) Also Focalin XR (unique among the others, as it is a single isomer, i.e. not racemic.) It has generics made by multiple companies, but I don’t seem to hear much about this med from actual users.
Hi Ann,
Focalin sort of came in with a big splash, years ago. But its popularity has tapered off. Can’t explain why exactly. But often reality seldom measures up to the hyper.
I understand the curiosity about others’ experiences with these other Rx. But in the end, those don’t matter. What matters is how your individual neurochemistry reacts to them. And that happens only with trial and error.
good luck,
g
My daughter was just diagnosed and prescribed Metadate CD. That didn’t last long enough, so she was switched to Concerta . She’s taking the Camber generic and she’s doing so well. She’s so happy, focused, and relaxed, but still energetic and passionate. Her mood and energy level is very consistent throughout the day, She’s also sleeping better than she ever has. Since the Camber generic is working so well for her, is there any reason to switch? Or is it OK for her to continue taking it since she’s doing so well?
Hi P’s Mom,
I’d say there’s no reason to get the brand/authorized generic unless/until there is a problem.
Again, there is nothing “wrong” with these generics. They just don’t work as Concerta does. For millions of people who might be forced to accept the generics, that is a problem.
You say she was “just” diagnosed. I’ve seen some newly diagnosed folks do well on one of these generics…only for it to become more problematic over time. So, it’s something to watch.
good luck!
g
Thank you for the advice everyone.
Regarding my switch to Adderall last month – it has been great for my waistline – I am not hungry at all. But with three hours of focus, it doesn’t do much for my ability to work.
I am almost at the point where I go back to my meditation three times a day and aromatherapy et al. I do much of that anyway but it is so difficult when I know that the Methylphenidate Alza formulation was working for me. The only thing I did notice was that I had terrible cravings for food especially carbohydrates and I read somewhere that this can happen so I did gain a lot of weight the last couple of years.
Has anyone else had this issue? My doctor told me that it should have made me lose weight not gain – indicating that I was imagining things but… I don’t think so since I find I have those cravings as I come down off the methylphenidate in the evening even when I don’t take the ER ( I also have been given the 10 mg tablets) and otherwise I don’t usually eat at night.
BTW: regarding Vyvanse – I was on that in 2020 when this happened before with the camber junk and it worked so great until week 2 when I got headaches and found my blood pressure shot up to 139/180 so I do not want to repeat that 🙁 unless it was a fluke – at this point, I am almost willing to risk it…
Hi Suzanne,
Unfortunately, most prescribers don’t understand much of the complexity around ADHD.
Could be many potential things happening here. I doubt you’re imagining things.
Some people actually GAIN weight on a stimulant. Why? Because, for the first time in their lives, they can TASTE food and can focus on enjoying eating! That’s just one potential explanation.
As for why you are craving crabs — if I’m reading this correctly, you’re craving them when the methylphenidate WORE OFF — could be a self-medicating attempt to get back that focus.
Vyvanse and Concerta are entirely different drugs. There’s no reason to think you could substitute Vyvanse for Concerta, especially when you had that bad reaction the first time. Maybe a “fluke” if you were also consuming caffeine, for example, or maybe it amped up anxiety. Amphetamines can do that sometimes.
You have MANY choices beyond meditation and aromatherapy. Look into some of the other methylphenidate products.
good luck,
g
Gina,
You mentioned Vyvanse in your Feb. 8th response to Suzanne. Since that is in the Amphetamine class of meds, just as Adderall is, does that mean that it is Adderall ONLY (vs. ALL the other Amphetamine based stimulants) that you are warning about? Curious to hear what your opinion of Vyvanse is.
Thanks,
Ann
Hi Ann,
Vyvannse is dexedrine in an extended-release delivery system.
Adderall is mixed amphetamine salts — dexedrine PLUS.
So they are both in the amphetamine class but very different.
g
Talk to your prescriber about alternatives for your ADD medication. Adhansia has a coupon for $15 per 60 pills and it is very similar to Concerta.
I can get a few hours (if that’s all I need) from Dexedrine, which is usually pretty affordable.
Vyvanse is my daughter’s and my favorite ADD medication. Best for longest focus for us. Unfortunately it is not off patent yet, so it is too costly for us at $275 per month (each) with the coupon. Your plan may be better. Or you could qualify for assistance from the manufacturer.
I think there is a big difference in Adderall vs Ritalin type meds, but I’m not a doctor, which is why you should discuss with yours.
Good luck!
Thanks, Susan.
If readers could always “talk to their doctor,” I wouldn’t have to answer so many questions — and educate about medications in my first book. 🙂
There is a huge difference between Adderall and Ritalin and other MPH drugs. There is also a difference between Adderall and other amphetamine drugs.
cheers
g
I started taking Concerta in 2006, it changed my life. Concerta opened a door I didn’t know was there. I was able work and be productive in a more efficient way.
At the time I was only able to get Concerta from a private psychiatrist because Kaiser didn’t want to prescribe Concerta or agree with the diagnosis, but finally did convince Kaiser Perm. to prescribe in 2007 because it was that crucial for me to hold a job. I was able to work steadily and successfully until 2014 when I told my doctor I was getting a divorce.
He immediately prescribed Wellbutrin in conjunction with the Concerta. I specifically told him I was not depressed and did not want to take antidepressants. I explained I turned into a sofa zombie for a year and 1/2 back in 2003 and it almost ruined my life. He said your getting a divorce you need to take Wellbutrin. Like an idiot I started taking that, what a disaster and my entire personality changed. I couldn’t protect myself, lost friends and couldn’t see the big picture. I winged off the Wellbutrin and got back to normal around 2017 and was able to make money again.
In 2020 I lost my Kaiser insurance and was without Concerta for about three months. I struggled to be productive and efficient. I found a private practice that would prescribe Concerta which cost $185.00 for 15 minute zoom call every three months plus $320.00 for only 90 tabs of Concerta.
In mid 2021, went back to Kaiser Perm. with affordable Care Act super happy and grateful $67.00 verses $900.00 in 2020. My October 2021 Concerta refill was not working and I was sleep a lot. I’ve been having difficulty doing everything and contacted doctor to complain about the Camber 214 pills that don’t work. I requested Patriot and I was told Kaiser doesn’t stock it. I told them I’m worthless and can’t function so they prescribed Adderal which I don’t want, but if it’s better than Camber 214 , I’ll take it.
Again, another generic Pascol, version of adderal. I’m doing a little better, but don’t know how long I can last financially if I can only work 3 hours before being tired again. I need to make some phone calls and figure out how I’m going to get the real Concerta. I’m glad I found your blog because providers don’t listen or understand how important this medication is for people who live with these issues.
Dear Elena,
I’m horrified at your story. I wish it was rare. It’s not.
KP has been a DISASTER for so many adults with ADHD. There’s a reason they are constantly being fined millions of dollars for their deficient mental-health options.
I assume you live in California? That means, unfortunately, that you cannot access the savings program https://www.concerta.net/coupon.html
The next step might be to try one of the MANY other methylphenidate options — Aptensio XR, Quillivant XR, Quillichew RX. I think there are others.
These are newer products so they often have savings programs, too. Just check their websites. Typically the product name plus .com
I don’t know if Kaiser will work with you on this. It might be that you’ll have to go outside Kaiser.
I am extremely apprehensive about these virtual “ADHD clinics” that are popping up. I suspect they are little more than Adderall mills. But if you can find one that’s decent, maybe that’s a better way to get the Rx you need to function in life. It will cost something but maybe not as much as you paid with the private practice and paying out of pocket for Concerta? You’d want to check out their Rx choices on the front end, of course.
Best of luck to you. You deserve so much better. <3
g
thank you for sharing. This is my life. Been on Adderall for one month now I get about one hour really good focus three hours at the outside and then I’m awake the rest of the day because it makes keeps me awake. As you say it’s better than nothing and definitely better than that Camber stuff that made me so unpredictable and I’m still trying to catch up from how far I got behind last fall. Hope it works out better for you.
Hi Suzanne,
There are many more choices beyond Adderall and Camber Concerta.
Genetically, some people do better on one class than the other. Adderall is generally not a substitute for people who do well on Concerta. Just the opposite.
There are other MPH choices, and there is also Vyvanse.
g
Question. What are some of the issues y’all experience with the sub par generics?
As I’ve said before I’ve been off meds for about a decade. Prior to that I was on name brand Concerta (as generics didn’t exist back then, or they kept me on the name brand as I had been on it so long). Anyway.
I’ve been on one of the ‘crap’ generics for about a week now. Trigen.
I was pretty well self managed off meds for 10 years. Or thought I was with certain parts of my life. But was failing miserably with others. Hence the start of treatment again.
Y’all. The parts I was managing before, are SO BAD now. I’m forgetting STUPID things. Like I was making a dip, some cream cheese fell on the floor. I grabbed a towel to clean it. Put the dip in the microwave. Proceeded to clean the front of the microwave. Tend to my plants. Stir dip and continue microwaving. Load dishwasher. BEFORE I realized I still didn’t clean up the cream cheese. And had stepped in it twice.
Putting papers in the wrong spot and unable to remember them. And like WEIRD places.
Completely forgetting things that have happened. Like why the dogs leashes are in a different spot, when I SWORE I took them off after their walk. But apparently my s/o did.
Hi Jackie,
Whatever others experience on the Concerta generics might have little to do with what you experience.
From the examples you provide, sounds like that Trigen generic is messing with you!
It’s a long shot but, is it possible that you were doing these things before but only noticing them now that you’re back on RX?
g
I considered that. But I have NEVER not cleaned up something that spilled right away. Like ever.
Pre this med, I would put the dip in the microwave and while that was cooking I would use that time to clean the mess.
Yes, Jackie. I figured as much. As I said, a long shot. 🙂
The erratic delivery of that generic might be worse than no Rx for you.
It’s entirely possible. They certainly have affected readers in various negative ways.
g
Hi there, thank you for this helpful post. We seem to be in the minority – my child cannot take any version of Concerta with the Oros technology because he has a separate medical condition that is contraindicated with Oros.
Instead, we have been depending on one manufacturer – Amneal – for a true “generic” that doesn’t have the technology. It’s the only one that works for him and now that manufacturer is on back order. He was given Actavis once and it was hell for 48 hours almost like he wasn’t taking the drug at all. So I agree with your point #1 above – AVOID ACTAVIS (now Teva)! I was hoping someone could recommend another manufacturer for the generic that we could try. Someone mentioned Camber worked for them? Other options from our pharmacist include SpecGx and Lannett…it’s so upsetting that we can’t trust companies to make quality drugs…
Hi ADHD Mom,
Oh boy, that sounds like an even trickier situation to navigate.
I wish I had some great advice for you.
Yes, “Big Generic”…at least a few bad actors…have cynically exploited bioequivalence guidelines for their profit. And, not being political just factual, Trump’s appointed American Enterprise Foundation FDA chief had nothing but disdain for FDA scientists’ concerns.
When the Concerta generic mess first started, back in about 2014, I was trying to figure out…what is happening here?
I called a pharmaceutical patent attorney, to see if he could explain how it was legal. He explained how Mallinckrodt and Kremers-Urban had “brilliantly” exploited the loopholes.
I felt my blood run cold. “Brilliant? If you’re a sociopath.”
g
Thank you so much for this article and blog. I’ve been taking Concerta or authorized generic for 10+ years and seem to have issues every time insurance changes or pharmacies begin to have issues ordering the Patriot brand. Last year I had luck with my insurance plan plus the Concerta Brand coupon to get brand Concerta for about $60/30 days. Insurance changed this year and now brand Concerta with the coupon is upwards of $200/30 days… so generic Concerta it is! Called my local CVS (located in the Midwest) and had my doctor write the script as you described and to my surprise they apparently have the Patriot Brand on special order, arriving Monday or Tuesday. Per my insurance, it should be only $90/90 days for the generic. I’ll believe it when I see it but I’m staying hopeful. Based on what I’ve read on here, it sounds like this would be one of the only success stories at CVS. Fingers crossed! Thanks again! I look forward to the day where we can just order “Generic Concerta” and it won’t be automatically filled with some subpar substitute. May never happen but it’s reassuring seeing people like you fighting for us.
Hi Jon,
Congratulations! I bet it works!
So much depends on location, pharmacy benefit manager, insurance limitations, and a few other things.
g
Our prescription woes are a sign of the times. One of my meds was a nice tiny pill. The next generic was bigger and bitter. The next one was huge and extremely bitter. The pharmacy only filled for 30 days when my Rx was for 90. Another pharmacy lost all my refills when transferring. Last two coupons I tried were rejected. Got on three-way phone with Adhnasia (a good alternative to Concerta for $15 for a supply of 60 pills) call to straighten it out. It’s like pulling teeth to get a break on the cost of prescription medicine. I pay $900/mo for the crappiest bronze plan with an $8,550 deductible. 95% of the time I have the meds redone under the GoodRx card, giving me a better price than my healthcare plan – that’s crazy. And lately they don’t have anything I need in stock. I’m tempted to try the new Mark Cuban mail order prescription service but they have no ADHD medication.
The only luck I’ve had is with independent pharmacies. The one I use is able to order Patriot for me and they put it through CVS Caremark which pays the generic benefit. I talked to the lovely owner of the pharmacy giving her my great thanks and my concern she might be losing money. She said she was not. It is still a pain every month procuring it correctly each time. It’s for my 19 yr old daughter and like one of you said, the process each time is too much for her to deal with. Call doctor. Make sure they send this script only to pharmacy A. Call pharmacy A to make sure they filled it. Then ask them to check if they filled it with Patriot which they usually don’t (they don’t note their own notes) and every other time they have to reorder. No way my ADHD daughter can do all that so she chooses to not take the meds some days to stretch it out. Then of course, meltdowns happen and she’s very hard to deal with.
Katherine, I am a prescriber of Concerta. Many of my patients have found that some of the bigger pharmacies are willing to order Patriot generics; that seems to vary by pharmacist, not the chain. I’m sure it takes some extra work by the pharmacist but they do not appear to be limited by contract on which generics they can use. Safeway and Fred Meyer are the most agreeable here in the Pacific NW. Rite-aid pharmacies can/may be able to order it if specific wording is used on the RX; the contact person at Patriot said she had spoken to RiteAid corporate office and was told to use this wording – “PATRIOT GENERIC IF POSSIBLE; PLEASE FILE EXCEPTION AND ORDER DIRECTLY FROM PATRIOT IF NECESSARY”.
Whether any of this works is anyone’s guess, the rules change often. Good luck!
Hi Dave,
Thanks for the field report!
I hope all is well with you.
g
JACKIE, I have blueshield and they are contracted with cvs Caremark. You can go to any pharmacy you like, also to get the authorized generic follow what the post say to ur doctor ask them to send in script with patriot brand only and that did the trick for me at Walgreens in California.
Thanks for helping Jackie, Robie.
It’s so hard to keep up with this rapidly changing landscape. A few weeks ago, readers reported that Walgreen’s would no longer fill these prescriptions. But I’m sure much depends on the region and the insurance policy parameters.
The agreements insurers make with pharmacy benefit managers (e.g. CVS Caremark) vary a lot among the different policies.
Cheaper policies will have less choice, for example.
g
Well now I’m all worried as I just found this AFTER I got my new prescription filled.
I was taking Concerta (or the AZLA one) as a child through college. That was 10 years ago.
I’m just getting back on meds. My insurance (through CVS Caremark) doesn’t cover Concerta. So I got a generic.
Obv it looks different, so I googled the writing on the pill (TL 707). And what got me on a hyperfocus rabbit hole was that the drug facts said ‘24hr’. Concerta is 12hr correct? Thanks google.
So how was I given a 24hr when the name brand is 12hr!?
Of course I already paid and picked it up. I was having to call my insurance anyway tomorrow because I don’t think they processed it right, but now I’m worried I paid for something that I might have an issue with and didn’t know because ‘generic is the same’. But the release is the important part of Concerta.
I’m also going to call the pharmacy because if they gave me a 24hr for a 12hr that can’t be allowed???
I’m going to be stuck with these until my next evaluation in Feb (where they might change my dosage). Maybe it’ll work fine. But if it doesn’t I’m going to be pissed. And of course even taking this is freaking out my anxiety. Like I’m going to have to wait till a day off to try it because I can’t have it mess up my work.
Hi Jackie,
You might want to subscribe to my blog. Subscribers learned about this years ago. 🙂
Googling this is likely to bring you down MANY rabbit holes. For example, there is no 24 hour Concerta.
Everything you need to know is in the post.
What you have is the Trigen generic.
https://www.drugs.com/imprints/tl707-26501.html
Take care,
Gina
That’s what I thought.
However this says that brand is 24hr.
And I’m still worried about the release speed. I’ll have to wait and take it this weekend when I’m not at work incase it causes any problems.
https://www.pillsync.com/pill/1583953007084_746783/ROUND_GREY_TL-707_24-hr-methylphenidate-hydrochloride-27-mg-extended-release-oral-tablet_Trigen-Laboratories,-LLC
Jackie,
There are all kinds of junk websites claiming to offer information about medications. One makes an error, and the rest that copy it make the same error.
There is no such thing as a 24-hour generic Concerta…..or anything else.
It’s best to consult reputable sites, such as this DailyMed function of the U.S. NIH.
https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c45dc1de-adfa-4b3c-a7dc-cffbc8eac74f&version=43
G
I know everyone reacts differently, but I thought Trigen was the most inferior of the Concerta generics. It barely affected me and was useless. I filled out an FDA report and was called by then and discussed how it didn’t work for me. I stopped using CVS because that’s all they dispensed at the time.
Good luck!
Hi Susan,
It’s not a case of everyone reacts differently. The Concerta issue is that the generics do not perform as Concerta performs.
For some people, who don’t do well on brand Concerta, this might be a good thing. But in general, this is a bad thing.
Yes, the Trigen was one of the original three offenders. You and many other ADHD Roller Coaster readers who had poor results followed the call when I asked you to file a FDA MedWatch complaint.
We succeeded! The FDA agreed! The FDA downgraded those three generics as not substitutable for brand.
Yes, bad actors such as CVS continued to substitute it, illegally.
Then Obama left the White House and Trump came in. He appointed an American Enterprise Fellow as FDA Chief, not a respected medical figure as is traditionally done. New FDA Chief Scott Gottlieb ignored FDA scientists concerns about bioequivalence pushed through dozens (if not hundreds) of generics. That included several Concerta generics. Last I checked, there were 15.
g
Susan,
Oomph. I took it for the first time today and honestly I don’t Really feel anything… I’ve been I medicated for approx 8-10 years. So I should feel *something*.
You’re saying different pharmacy’s will bring in different generic forms? Like CVS vs Walgreens?
My insurance is a local private insurance but prescriptions are CVS Caremark. But I don’t think that means I *have* to go through CVS pharmacy. However when I called CVS Caremark (to make sure claim was processing correctly) they said they could only pull up the Trigen in their system.
Jackie, pharmacies have different distribution agreements. Some might have access to the authorized generic while others push one of the inferior ones. Profits.
To understand more, please read the post.
g
Gina,
I read the entire post before commenting in the first place.
The problem is how to even get through to these people. I was on the phone with CVS Caremark insurance for an hour.
They can’t even look up meds by NDC to tell me if it’s covered. It ONLY shows them the Trigen in their system. And to ‘talk to my doctor’. What difference will my doctor make if the insurance can’t even pull up an NDC?
I don’t know what to tell you, Jackie. CVS Caremark tends to be the worst actor.
When CVS was allowed to buy Aetna a few years ago, it marked an unprecedented merger and a huge conflict of interest.
It is now the 800-pound gorilla.
Perhaps look into one of the other methylphenidate products.
Good luck,
g
I’ve had good luck in the past by asking to talk to one of their pharmacists when calling ExpressScripts or Caremark about getting the authorized generic. They will have more access to look up the NDC info and understanding of the mechanisms involved.
Thanks, Patrick. Yes, asking to speak to a pharmacist or pharmacy technician is a good idea.
Except in the case of CVS Caremark….when I spoke to a high-level pharmacist, he tried to convince me that the Trigen generic was exactly the same as Concerta because it used the same osmotic release system. Which of course it doesn’t! He wasn’t interested in learning that he might be wrong, either.
g
Well I’m day one on these meds. I can always give them a fair shake and see what happens. Right now I don’t see any affect.
What really bothers me about this whole thing is that its medications for ADHD. We already usually have the executive dysfunction making starting this hard in the first place. But then add in RSD (which I definitely have) and that makes asking even harder for fear of the turndown. So it makes it extra hard because we need these things to help us do what we need to do to get the thing we need. Its a circle.
Like I cant do the process to get the right meds without having the help from the correct meds. lol
I’ll start with giving this a fair shake, though my hopes aren’t high. Then up dosage as directed. If it doesn’t change help with the higher dosage quickly, then tackle making sure I get the right stuff. And work with my doctor on that. There’s LOTS of pharmacies in the area. And ALL take my insurance as its the local large insurance.
I’ll stay privy to this post and reach out if I need more help. I see there’s a number for calling Patriot, so I’ll use that resource if needed as well.
Yes, it bothers me, too. That’s why I took up the mission to get these inferior generics downgraded.
Unfortunately, elections have consequences. Lots of them.
good luck
g
I had a good experience to share with the list in case it helps others. After calling the pharmacies I usually use to get my child’s Patriot prescription and coming up dry, I called Patriot Pharmaceuticals directly at 800-631-5273. A person answered the phone and took my name, phone number and email address and said she would pass it on. The next day Pat, a lovely person from Johnson and Johnson, called me back. She told me all of the pharmacies in my area that have or can get the Patriot product. She even called the regional Harris Teeter manager on my behalf. That hasn’t flowed down to the local stores yet, sadly, BUT I was able to have the prescription filled at one of the independent pharmacies she mentioned. She also said it was okay for me to post about my experience on this site. Good luck!
Hi Cathy,
Thanks so much for the update. It seems that perhaps COVID-related issues made it harder to get through for a while.
I’m glad to know the help line is back in action!
g
Pat is great! She did the same for me. Called the pharmacy manager at Publix headquarters and I am able to get the Patriot generic with no problems. It’s wonderful when you can find someone who actually does their job and cares about their customers.
If you can get the Patriot anywhere and at a decent price, you are very fortunate. After leaving Walgreens for their incompetence, now my Publix Pharmacy messes everything up. Gave me inferior Concerta generics and won’t order Patriot. They messed up a Vyvanse coupon worth four x 30 pill free fills. And they messed up an Adhansia coupon good for 60 quantity at $15. At least Adhansia later got me on a three way call with the clerk who messed me up and made her fix it! Now I have a great alternative to Concerta for a lot less money. Good luck everyone!
Hi Susan,
I have definitely suggested that possibility: If possible, use inability to obtain Concerta to try another medication, especially among the ones that offer savings coupons.
You might luck out. Or might not. It might be worth a shot, though.
g
Unfortunately the coupon doesn’t work if you are a senior with Medicare insurance. I’ve been using the GoodRx coupon though. Saves me about 50%. Also Publix pharmacy carries the Patriot generic if you ask for it.
Thanks, Fred and Lisa, for lending support.
g
I will no longer at least for this year have to jump through hoops to get my medication. This year my employer switched health insurances from Blue Cross to United Healthcare, and apparently United only covers the brand name of Concerta, so I will be on the brand name early next week. I was pleasantly surprised. I didn’t know they covered the brand name. It’s been years since my employer has been with United, and before the last switch to Blue Cross, which I think was in 2018, I had been on the brand name of Concerta. I will be paying $35 for the medication (brand name) due to my insurance copay. YAY!
Hi Aaron,
It’s like winning the lottery! Congrats! 🙂
g
Our insurance is this way as well. Make sure to check out the Jansen coupon program. It covers up to $150 of what your insurance doesn’t (as long as you aren’t in an eliminated state). You’ll pay $4 as long as you qualify. https://www.concerta.net/coupon.html
Thanks for the reminder, Deborah. It’s in the post, but so are many other details. 🙂
g
I agree Deborah and Aaron. CVS Caremark did this for my daughter’s prescription all of 2021. Provided the brand and I used the coupon. I held my breath all year . I was told it would be the same this year. I agree it’s like winning the lottery Gina.
Really?!?! My employer just made the same switch! Hooray! There may be ONE good thing about UHC. But, in all mid- fight over my other meds getting covered at all.
Congrats, Erinn.
I’m thinking that Concerta manufacturer Janssen is really fighting back against this slew of cheap (in quality, not in price) generics.
g
Hi Gina,
I’ve been posting comments here back since 2016 and do not enjoy this roller coaster. Earlier this year, I thought my Kroger had finally figured out how to get around Cardinal Health (their supplier) sneakily substituting a different generic despite specifying Patriot and NDC number. So grateful that I still make them open the bottle every time I go to pick up, bc last month, they initially filled it with regular generics (even though there’s a notation on our file that we only want Patriot). Ultimately, I had to accept only 23 pills of the Patriot bc that’s all they had left and the pharmacist said that she really wasn’t allowed anymore to make special orders for me.
The previous year 2020, my pediatrician (who is so supportive) wrote prescriptions for the brand name Concerta only, but then the new year our insurance evidently made a new rule that even a doctor’s note couldn’t override it and the brand wouldn’t be covered. Not looking forward to finding out what insurance changes take place for next January. I am so so tired of having to fight every month over this.
hi there,
I hear you. It’s an ongoing pain in the rear.
On the one hand, we’re fortunate to have had the authorized-generic for as long as we have had it.
On the other hand, Trump’s FDA chief’s decisions mean that the generics we are forced to accept are in no way “bio equivalent” to the brand’s complex delivery system.
Elections have consequences.
good luck!
g
So glad I found this article. I always check my meds – my doctor and i realized that the non-alza was actually making me fatigued and totally unfocused and feeling general malaise last year so I insisted on alza and it was like majic i was myself again. When I went in tonight and already left the counter i realized it was not the correct formula but that cambor you are all referring to. I returned to the counter of course to discover “oh well” “too bad” can’t return and then to be told “well you know this is what we gave you last month too” – my hubby picked up that script and i have been feeling very very ill since october – i have been blaming myself that i was lazy and needed to just wake up and get to work – but i literally was falling alseep in my chair every day, in tears most days and so many other symptoms. tonight – I called every pharmacy within in 25 miles including little independent ones – and my insurance – no one has patriot and I was told “well cambor is the preferred everyone is clamoring for it so no one is ordering patriot now, sorry cant get it” I read that someone else was experiencing anxiety now with the other – yes yes! I have been having almost daily panic attacks and I cannot control them – I never had anything like this before so I going to stop taking it altogether – I am thinking that this cambor stuff is actually exacerbating my condition. I have only just found your site but I am so thankful that you are doing this research – I had to report one of the genrics in 2016 to the FDA because it caused a psychotic break that caused me to be on suicide watch for 24 hours – this is serious stuff and to mess with peoples medication is seriously dangerous,
Hi Suzanne, I’m glad you found answers here.
good luck!
g
Everything here makes sense. I was just given a different generic without the OROS. I’ve been having bad anxiety again! Feel like I’m spiraling back. I can’t deal with this. I need my correct form of medicine!! An actual generic equivalent to concerta.
Hi Amanda,
How clever of you to find my blog post! 🙂
Be sure to note this to your MD, including the specific generic. This might help you make your case to your insurance company when your prescriber specifies “Patriot only” on your next prescription.
good luck,
g
this does not work anymore. “not in service” 215-325-7676. Trying to get my pharamacy to order the correct generic
Hi Ryne,
Thanks for alerting me. I’ll make a note in the article.
It shouldn’t be necessary for your pharmacy to contact Patriot in order to order it, though.
good luck,
Gina
If you live in the southeast states you can get your authorized generic for Concerta at Publix pharmacy. Tell the pharmacy manager that you need a prescription exception to get the Patriot generic. If you have trouble then contact Pam at Patriot and she will get it fixed.
Called two Costco pharmacy today. They both said they have stopped selling the Patriot brand authorized generic. Costco website still claims they sell authorized generic. Anyone able to get it filled from Costco in last few weeks?
You can still get it at Costco if you are a member but they will not honor the discount drug card prices like Good Rx or any copay prices through your health insurance. The price is listed as $104 for a 30 day supply on the Costco website. The Good Rx price for generic Concerts I have found is $30-40 but of course that is not the Patriot price since I can’t find it anywhere.
I checked my local Costco today and they did not have it. However, I was able to find it at a local Harris Teeter pharmacy (a Kroger company).
Three months ago I was prescribed methylphenidate ER and felt an immediate positive reaction. Several months later I feel it is not working. I suspect that the first month I received the Patriot generic but my most recent refill was not Patriot. The Concentra savings program can’t be used for folks on Medicare and the brand drug is almost $500/month which I can’t afford. My wife was thrilled when I started on the drug now she says that she is ready to divorce in me. So thanks Trump for replacing regulations that protected the public.
Sad but true, Fred. It truly boils my blood. How dare they.
I encourage you to gather a bit more data.
For example, ask your pharmacist to check the records for which generic you received. Also, think about any dietary changes you might have made that could affect efficacy.
good luck,
g
Hi Fred, Sorry for your experience. My daughter requires the Patriot version of methylphenidate. Every month, I call around to pharmacies to see which one is stocking Patriot that day and the have her Dr. quickly send the prescription there. Sadly, it isn’t ever the same pharmacy twice in a row. The savings are worth the time I spend on the phone though.
I understand, Susan. But facts are facts. 🙂
If we don’t know why something happened, we are vulnerable to demagogues explaining to their own purposes. And too few Americans understand what happened. They’ll just blame it on their insurance company, their pharmacy, the person currently in the White House. That kind of ignorance gives carte blanche to more predators.
I’m sorry that your family has experienced a disruption in healthcare coverage. That is so scary—and expensive.
Yet, even with the ACA, many GOP-dominated states exploited that to deny their own state’s citizens healthcare coverage. To foment anger. Many employers, too, exploited the ACA to hide their own cutbacks on insurance plans—blaming it on the ACA. These are just facts.
With less stonewalling and obstructionism, maybe we could have avoided the impact on individual citizens.
take care,
g
Hi Fred, yes, I have been getting Patriot Pharmaceuticals Methylphenidate HCl ER Tablets from costco for over a year now with no problems. This month, Costco told me they no longer sell Patriot Pharmaceuticals Methylphenidate HCl ER Tablets. I called two different Costco locations. I am wondering if you have been able to purchase any in the last few weeks?
My son was taking now what I guess is a true generic, and I filled it at the pharmacy I use this month and was provided the Alza one, which is not working the same at all. So I guess for us we actually need to not authorized one. This is all so frustrating now I’m wondering what type I’m taking??
Thank goodness for Pam at Patriot. I have not been able to get Patriot for over a year. I had just given up and was taking Camber 72mg. Camber would one day feel like I was taking no medication and the next day I would feel overmedicated. I feared what It was doing to my heart. That was it, I could not take it any more. I called Patriot and they could tell me what places are getting in orders of Patriot generic. I went and worked with one of those pharmacies and my doctor and I worked hard to get it the script written the right way. Because I went to a place that orders Patriot in they understood better the situation as many people are preferring the Patriot (obviously).
I still have problems getting the right brand every time I go in, it is first filled with Camber. But I always always check the brand every time, and they go into the back and re count the pills in Patriot brand. Literally the most annoying thing but its better than not getting the right brand! And it’s just something with the online Kaiser ordering system. Nothing I can do about it as thats the only way I can order it. Because I work with this Pharmacy now they will order the Patriot ahead of time so I just have to remind them I will only take Patriot and will not pick up any other brand.
I feel so lucky. Almost 2 years of medication problems I finally feel like my life is getting back on track. It was a really dark time, I’m just glad I graduated school before all the medication problems started because I would have failed my last semester if I had the Camber meds.
Hi Christina,
Good for you.
I’m glad my work has pointed you in the right direction.
Gina
Do you have Pam’s phone number. She called me and left a voicemail but didn’t leave a callback number. Using caller ID I then called her back but the person who answered said there was no Pam that worked there.
Hi Fred,
Sometimes the Caller ID shows the wrong number, when it’s coming from a big company, customer support departments, etc..
Even if it was the right number, there might be lots of employees who don’t know a Pam.
This is the number I included in the article: Patriot Pharmaceuticals customer service at 215-325-7676
good luck,
g
Thank you for the article and leaving the comments open! I thought I would share my October experience for anyone having trouble (central TX for reference)
About two weeks ago I asked CVS to order the patriot brand ahead of them getting my prescription, and got an “okay it’ll be here Monday”. Looked online before picking it up, and they filled my no sub. prescription with Camber.
CVS says patriot is on backorder
Costco can only order actives (sp?) right now
Walmart can try to order, but they can not guarantee it will come in
Sam’s club was unable to order
Walgreens had it in-stock and can order it (apparently, waiting for my doctor to cancel CVS Prescription and send it to Walgreens so I can pick it up, could be another camber situation)
Hi Bree,
Thanks for that report.
Walgreen’s has historically been the most reliable in this regard. More recently, reports came in that Walgreen’s could not order it.
Of course, the thing we have to remember is that even pharmacies with a national presence might have different regional policies.
As I’ve said before, home-delivery pharmacy might be the best bet now.
good luck!
Gina
Has anyone heard about the Lannett generic of Concerta? Lannett apparently bought Kremers/Kudco and from my research could not provide the data the FDA needed for bioequvalence. They are now providing the Andor generic (which they say is AB rated). Am asking as I know someone who recently have an issue with the Lannett generic. Lannett was allowed to keep manufacturing the BX rated version of Concerta until 2019.
Hi Anne,
In 2014-15, Kansas City pediatrician Kristen Stuppy, MD, and I led the effort to get the KU and Mallinckrodt genericis downgraded.
We succeeded. You can read the details here.
https://adhdrollercoaster.org/tools-and-strategies/victory-concerta-generics-downgraded/
Then the Trump White House appointed an FDA chief who overrode FDA scientists concerns about generics of complex-delivery system drugs, such as Concerta’s OROS.
It’s all a hot mess. The main thing to know: NONE of the generics have OROS — Alza’s patented osmostic delivery system.
That means they do not work like Concerta. Period.
Some people might like some of these generics better than Concerta. But that’s an entirely different issue.
g
I have had success at getting Patriot at Costco.
First, I took the information regarding how the prescription should read (Methylphenidate HCl Extended-release tablets, 36 mg, NDC 10147-0686-1 ONLY) to my prescriber and told them to write exactly this on my prescriptions.
Next, was Costco. Costco has an authorized generics program. https://www.costco.com/authorized-generics.html?&reloaded=true. I contacted the pharmacist. He didn’t believe me at first, but then I pointed him to the Costco site above and he said he could order it for me.
It’s been about 4 months, and both my daughter and myself have been able to get the prescription filled by Patriot. We pay generic prices with our insurance.
It was a bunch of hoops. But, it has been working so far.
Kudos, Sarah!
I’m glad my work has helped you save money and hassle!
I’ve found that the Costco availability varies by region. It’s always good to ask, though.
And folks should know…you needn’t have a Costco membership to use the pharmacy.
g
Hi Sarah, have you been able to order from Costco recently? Both of stores around me claim they no longer sell.
hi, thank you for the info. I get a refill and it’s by Camber and there is no alza on 18mg Pills, do I have the right to refuse it?
Hi Ravi,
Sorry, no. Thanks to the Trump White House, that is a “legal” generic.
g
Ravi, As long as you are still at the pharmacy and have not yet paid for the prescription, you can say “No thanks” and walk out. Once you’ve paid and left with the meds, they are generally not returnable, even if unopened.
Keep searching until you find a pharmacy that will fill the prescription with the Authorized Generic, which WILL have the alza imprint on the tablets.
Best of luck!
Hi Ann,
Thanks for helping Ravi.
I just want to clarify….if his prescriber has not specified the authorized-generic, and if his insurance requires a generic, it might be all he can get.
But of course, you always have the right to refuse to accept before paying for it.
g
All was good until last week Walgreen pharmacists told me that this medicine is on back order. They ordered one bottle but was never shipped. It has been 2 weeks and I am told the manufacturer is not sending it, are not obligated to send the order.
Also I am told that because it is a control medicine, they can not order a supply even though they know there are regular patients who need it every month. The pharmacist told me every time they have the prescription they can order it and not in advance.
The question is: is this medicine on back order? If yes, why and for how long?
Hi Vida,
There might be multiple definitions to “back order” — none of them to do with available supply but only to the various business relationships involved.
I checked the FDA shortage notification page, and see now methylphenidate products in shortage.
https://www.accessdata.fda.gov/scripts/drugshortages/dsp_SearchResults.cfm
Did you call Patriot?
g
Walgreens in CA state they cannot get it anymore. They have little remaining stock in their warehouses. The pharmacist was able to provide 18 and 36 mg tablets instead of 54 mg to keep with patriots, however, by next month this won’t be possible. I tried calling patriot and could not get ahold of anyone. Walgreens says they can still order it, but it’s not getting stocked in their warehouse so I was told Walgreens May phase it out.
Thanks, Michele. Yes, our local Walgreen’s couldn’t get the 54 mg, either.
I suppose the store can’t afford to keep subsidizing. Big Generic is making out like thieves. A pox on all their cynically inferior-generic houses.
g
Is is only a shortage? I think something is happening at Walgreens.
My Walgreens had been special ordering the Patriot “generic” pill for my daughter and even had her name on the bottle in the back. We would check carefully when we picked her prescription up and sometimes it was filled with whatever generic they had but they would quickly fix it. Two months ago, they had a sticky note on her prescription bottle that indicated there were only 20 pills left in “her” bottle, and corporate would no longer let them order more even if the specific NDC was prescribed. So, we had the pediatrician write her last prescription for those precious 20 pills. Perhaps corporate won’t let Walgreens order Patriot any more.
Now what? We can’t be at the mercy of whatever generic the pharmacy has that month. I’m going to try to get the pediatrician to allow me to do Express Scripts though I expect resistance. But its exhausting to chase around the medication each month – call the dr. to send prescription – check carefully at pharmacy – call and call the pharmacy to make sure its the RIGHT generic… I’m thinking that although Concerta works for my child, it may be time to change medications.
We cannot use the coupon that Jansen provides because my insurance will NOT Pay for the name brand at all, so Walgreens couldn’t apply the coupon. (No insurance coverage – no discount).
Agree – a pox on the pharmacy manufacturers with their dangerous “equivalent” medications. (And thank you for this website. It has been so helpful to my Concerta Chase.)
Hi Monica,
Yes, as I commented previously, I imagine Walgreen’s has been taking a huge financial hit helping customers get the authorized-generic for so long. It’s really not the store’s fault. It’s been the best pharmacy, consistently, throughout this years-long mess.
But there are limits to financial losses.
We’re about to try Express Scripts, too. I phoned yesterday, and it seems not to be a problem. We’ll see, though!
And, of course, the terms of insurance policies do vary.
It definitely might be worth you trying one of the newer MPH formulations. The thing is, when Concerta works, it works very well, and it’s hard to substitute.
But you might not know until you try something else. Maybe over a 3-day weekend…or just a weekend. Might be enough to get an idea.
Good luck!
I went through a process with my pharmacy changing manufactures every month. The first month was from Patriot… yay! Then the second next month was Northstar… I threw a fit and asked for name brand and I was told it was $150 so I gave up and accepted that it was OROS technology which I see now is not true OROS. The next month the gave me Lanett Comany…I paid for it without checking and didn’t take any of these cheapo pills. The next month they gave me Ativis/Teva…but I checked first and asked for them to order Northstar and they said it was not available to order. After reading this I called back and asked to order Patriot and they agreed and said it would $15! Lets see if it comes in.
I was told Price Chopper corporate wont allow ordering the brand generic no more where I live NE PA. I have to chase the 36mg brand generic of Concerta. PC had it for a while and now no. It happens all the time.
Dear All ( and in particular Ms. Pera),
Thanks so much for this site and all the information.
We are in California, and trying to get the Authorized Generic 54mg for our 13 year old. I have called a number of pharmacies and they can get the find and procure the Authorized Generic (having the NDC number is key, and they look it up by the 11-digit billing code, the number without the dashes and the 0 added before the last number). But here is the issue, if anyone has any insight into this, I would be most appreciative:
When they run the insurance as a test, it says it is covered at a $10 co-pay. But whent he script actually comes in, they say it is $350. The pharmacy I really trust says even at $350 they are going to lose money.
So, how does this work? The pharmacy has to purchase it first, then bill the insurance, and the insurance only pays $10? So the pharmacy has to pay up front?
Second question: I can find a GoodRx coupon which LOOKS like the correct pill is being covered (they have images accompanying the coupons). BUT, only the 36mg and 18mg are the “alza” stamped pills. Will my doctor be able to get us 30 of the 36mg and 30 of 18mg so that we get the correct 54mg dosage (the picture for the 54mg is NOT an “alza” pill)? Is this ok to do?
Finally, maybe those GoodRx images of the pill that go with the coupons are not indicative of what you will get, if anyone has experience with that, please do let me know.
Thanks to everyone,
Daniel
Hi Dan,
It seems you are in that No Man’s Land — between the pharmacy and the insurance company. It might be helpful to try escalating this with your pharmacy benefits manager. Ask for clear answers and for a contact person you can call upon as situations arise.
This is a rapidly shifting landscape. The sheer number of these inferior Concerta generics flooding the market has kept insurers and pharmacies scrambling.
Sorry I can’t explain “how it works”. I suspect it varies widely according to the pharmacy and the type of insurance coverage you have. Chain pharmacies have certain deals with distributors that smaller pharmacies might not have. Then again, smaller pharmacies might have more choices in what they can order.
I do know that details matter. If your prescriber is submitting the script electronically, you’ll want to be sure it specifically requests the authorized-generic in the correct language for the pharmacy’s ordering system.
It’s too bad you live in California and cannot use the Concerta.net brand savings program. 🙁
Have you tried using a home-delivery pharmacy? Their supplies are typically greater, with greater cost-efficiencies.
Re: Your question about GoodRx coupons Technically, it is okay to combine the 36 mg and 18 mg in order to achieve the 54 mg that works best for your daughter.
There might be two issues:
1. Depending on your insurer, this might be seen as two stimulants daily and thus not allowed.
2. Concerta’s outer coating starts dissolving immediately. It might be that the two pills together (30mg and 18mg) produces a different response than 54mg pill does.
re: GoodRx: Sorry, I’ve never used GoodRx. I do notice that this GoodRx article is a bit dicey on authorized generics being bioequivalent. So if you’re able to speak to someone there, you’ll have to use very precise language.
https://www.goodrx.com/blog/authorized-generics-what-are-they-exactly/
I hope this helps. Good luck!
g
Thanks Gina,
I appreciate it. I am going to meet with my local pharmacy today to see what is up. If there is any relevant information that you have not already covered, I will post it to the group.
Take care,
Daniel
Thank you so much, Gina.
I started on Concerta last year in September. In the beginning, it gave me my life back. I was able to shower everyday, brush my teeth, floss, make my bed. I excelled at work, got promoted, repaired relationships with my parents, everything in my life was looking up! That is, until November when I lost health insurance and had to switch from Walgreens to CVS.
I was switched from the authorized generic to trigen’s subpar generic, and my life completely fell apart. I would not go into to much detail, but it sent me into a very dark place. CVS refused to order the authorized generic for me! Even though my doctor had specified that the authorized generic was medically necessary. I ended up needing to switch my doses from one 54mg tablet to two 27mg tablets twice daily to help spread out to doses. It was hell! I felt high on trigen. I absolutely loathed that feeling, particularly as someone who is in recovery (2 years!).
Recently, thanks to your article, I was able to FINALLY get the authorized generic (through Walgreens) by specifying the NDC number on the prescription. And, it has been a night and day difference! I am back to my real self, thank god. I don’t think I would have been able to get the proper generic had it not been for this very informative article. So, thank you again. So many people in my life did not take this seriously, and I began to feel like I was going mad. Thank you for helping all of us.
Aw Ethan, you went and made me tear up. 🙂
Seriously, thank you. This is exactly why I do this work, completely self-funded. No pharma support of any kind.
If it weren’t for hearing from readers such as you, I would have run out of steam a long time ago.
I’m so happy for you — and kudos for persevering, despite no one else supporting you in your perceptions.
I see the opposite a lot in my local Adult ADHD group. Folks acting like they are beggars when it comes to treatment, taking what they can get and not asking for better. They’ve gotten used to being pessimistic about change.
I work to empower them, because dang, it’s your life that matters. Not some MD’s or PhD’s ego!
Rock on, Ethan!!
g
How were you able to convince Walgreens to special order it and run it through your insurance without charging an arm and a leg? I called about 7 different pharmacies. Nobody was willing to special order the authorized generic with the exception of a super small local pharmacy that is charging me $314 cash price. They are losing $90 and it’s ridiculous that they won’t just charge me the difference.
I called Costco and they apparently special ordered the drug for someone, but won’t ever be doing that again. I’m assuming they lost money. It’s just incredibly unfair.
Hi Paulina,
Did you ask the pharmacy to “special order” it? If so, that might be the problem.
As I write in the post, the idea is to request that they “order it as an exception process.”
Might not make a difference.
Yes, it feels very unfair when a White House administration allows this sabotage of medication that people need. Elections have consequences.
g
Walgreens just called me and said the request for Patriot got kicked back. Don’t know if it’s because they aren’t allowed to order it anymore or if it’s not available, but could be at some unknown future date. School starts Monday. My son runs out of meds then. And if he can’t get his filled, I can’t get mine. So grateful for the NDC’s here! Then all the pharmacies can more quickly tell me they can’t order it. Grrrr!!!! Fry’s (part of Kroger) said not only do they carry Patriot, they have it on the shelves! Even better than Walgreens!
Hi Erinn,
I imagine Walgreen’s has taken an enormous financial hit, serving its customers with the authorized-generic. Probably can’t keep it up for ever, especially the least profitable stores.
But glad you found another source!
g
Gina,
Thanks for all you do to help!
I agree with you on how unbelievable it is the difficulty of getting affordable prescription medications. The Affordable Care Act has made Healthcare very unafforadable for my family. Prior to the ACA we had $0 generics = now my generic Concerta is over $150 monthly through insurance and a bit lower with GoodRx, which I have to get the pharmacy to recalculate every month.
I’ve contacted my state and federal representatives who do nothing and keep getting reflected (not by me).
I encourage everyone on this forum to contact their representatives and let them know how the cost and access of prescriptions has become a problem.
And don’t forget to report any inferior generics you encounter as I have done.
Hopefully this situation will get better if we all speak out.
Hi Susan,
I’m not sure you can blame the ACA on your increased healthcare costs. If you get insurance through an employer, it’s more likely that the employer made choices that create most costs for you. Some employers did that and blamed the ACA to hide their actions.
Moreover, other things have changed. Including the Trump administration’s appointment of an FDA chief who pushed through dozens of generics — as a gift to Big Generic — over the protests of FDA scientists.
Sure, report the inferior generics. But, with the Trump White House’s actions, I cannot see that the FDA even now, under a Democratic administration, will legally be able to downgrade the huge number of very cheap Concerta generics flooding the market.
g
I have posted here before and continue to cross my fingers every single month when I go to the pharmacy. (My mom’s insurance will only give her 30 days at a time, although I am able to get 60 days at a time myself.) It is getting increasingly difficult to get the Patriot manufacturer as everyone here has been experiencing.
I urge you to do what Gina says and file a complaint with the FDA. https://www.accessdata.fda.gov/scripts/medwatch/. There is a new chief of the FDA under Biden and I am hoping that decisions made by Scott Gottlieb regarding generic ratings will be reversed if enough attention is brought to the issue.
For those of you who live in Massachusetts like I do, you are ineligible for the Concerta savings card. Are there any MA (or CA) people who have had luck getting the card accepted using a mail order pharmacy in another state? My insurance uses CVS Caremark but only their “special order” medications can be used with manufacturer savings cards. Unfortunately the brand name of Concerta is not considered “special order.” However, I did call Janssen and learned about the MA law that prohibits the use of the Concerta savings program. https://www.mass.gov/info-details/mass-general-laws-c175h-ss-3#updates-
I am working on finding out who to file a complaint with regarding this law, which prohibits savings programs when there is an AB rated generic available. When I find out, I will share it here.
Thanks, Emily. Good point on the savings card. Good for you, for taking action.
As the lead person in successfully getting the first two generics downgraded, I’m all for consumer action.
Truthfully, though, I cannot see how the FDA can — after such a long time and with almost 2 dozen Concerta generics — reverse this. There would be all kinds of hell to pay.
I’m willing to let somebody else lead that fight. As a non-compensated advocate, I’ve definitely done my time! 🙂
g
I just found your site today but have leaned pretty much ALL that I’ve read so far the hard way firsthand. I take 2 36mg (72mg) and only the Alza 36 works for attention. The others all work for appetite suppression and other side benefits, but only the OROS works on me for attention!
So my pharmacist (Walmart through McKesson as a distributor) hooked me up with Patriot when it came available and I was special ordering it. But then last winter they implemented a new “system” that now prohibits special orders of controlled substances for some unknown reason. So the pharmacy’s special orders are now just systematically ignored.
So then I go to Walgreens and after some initial resistance agree to special order the Patriot. However I work for Walmart and so my insurance has been difficult to use a non-Walmart pharmacy. In MayI paid $36 for 60 36’s. In June $46; July $60 and a note in the system for Walgreens to see saying I’m SUPPOSED to pay full price of some $600+. So now it appears there’s nothing but artificial barriers on all directions to getting Patriot!
Talked to my Dr, who has said that “only osmotics work” (not mentioning OROS specifically), so he’s at least amenable to my requests. But he suggested going to a fairly new single 72mg osmotic; a big blue round tablet. I’ve taken it for a week… seems a no-go; appetite suppression: yes; attention: seems a no!
So like all the rest, I’m just looking for a way to get the 2 36mg “Alza 36” tablet I need a day just to do my job effectively and live life normally (not “shut down”; I’m “primarily inattentive”).
I look forward to digesting your info if I can get my focus to hold long enough! 😉 Cheers and thanks for what you’re doing!
Hey Darren,
You’re doing fine as far as being on top of it!
This is a complex phenomenon, and it boggles the minds of some — especially when they’re taking a Rx that doesn’t work for them. What a double-bind mess!
Did you see the Concerta savings program? It’s not valid in MA or CA, but if you don’t live in either of those two states, it might be an option?
https://Concerta.net
good luck!
g
Gina – Thank you so much for this post, it has been so incredibly helpful.
Like others, I’ve been stuck with the Trigen (Osmotica) and Camber (Ascent) generics and felt terrible in comparison to the Patriot product. I called 16+ pharmacies in the St. Louis area and all of them told me they’re no longer contracted with Patriot, so I wouldn’t even be able to go through any form of exception process to order it (shame on you Costco for having the ability to order authorized generics specifically highlighted on your webpage but then refuse to do it). I called a Patriot representative as noted on this page and she was so kind & provided the names of pharmacies that have ordered in the last month in the STL area (which was not very many). Thankfully she said Express Scripts can process these requests – as long as you request it specifically! Luckily they are my pharmacy benefit manager so fingers crossed this process works. She stated she anticipates it becoming more and more difficult to find Patriot Concerta in the upcoming future as many contracts between wholesalers/pharmacies were just carried out and Patriot is no longer a preferred brand anywhere with all of the other generics flooding the market. Good luck to everyone in the same position!
Hi Claire,
Thanks for the field report.
Did you check out the savings program? https://Concerta.net
It’s a real shame. And really a disgrace.
In these pharmacies’ defense, I’m sure ordering patriot is a big money loser. Patriot/Janssen just can’t compete with this bevvy of cheapo inferior generics on the price point.
good luck,
g
Claire,
If you haven’t called a CVS pharmacy, I would recommend you do that or try a local pharmacy. The CVS nearest where I live will order the Patriot generic, while Walgreens and Walmart will not. This means I have to have health insurance next year (luckily my health insurance from last year rolled over to this year and I’m covered despite not signing up for health insurance through my employer back in December). I have to insist I get the Patriot Pharmaceuticals generic every time I call my psychiatrist.
Claire- will your insurance cover the Brand if your Dr requests it? If this is an option for you with your insurance, the Concerta coupon program from the manufacturer pays $150 of what your insurance doesn’t cover. If your copay on brand is less than $150, you pay $4. Just putting it out there in case you missed the posts where Gina mentioned it.
I just called the Costco in Tukwila, Washington, and they said they keep the Patriot brand in stock routinely as their preferred generic. So maybe it varies by Costco location? I have not actually filled a prescription there, but that was what they said on the phone for what it’s worth. Good luck to everyone (and let’s never again make the mistake this country made in 2016).
Thanks, Pam — and Tukwila Costco!
Best I can figure, it’s regional. But also sub-regional sometimes, depending on store customer base maybe?
g
Wanted to share my story in case it helps anyone.
1. I actually started on Camber generic way back when, before I knew anything about generics. It worked decent for me.
2. I moved and ended up getting the authorized generic from the local grocery chain’s pharmacy (Hannaford – they’re lovely). I ended up having to increase the dosage, because the AG seems to dispense more smoothly and/or over a longer time frame for me. (At the time, I did not know that it was because of the different brand of generic.)
3. Now, I’ve moved again and chose Costco because they claimed to have an authorized generic program, listing Patriot specifically in their documentation. I was aware of this post, yet was really thrown off because they filled Camber instead (it looks so similar). They say they are absolutely unable to order Patriot.
4. I’ve now called a half dozen other pharmacies in the KC, MO area (including Walgreens) and everyone has said something to the effect of “we cannot order anything other than our preferred brand of generics.” Given other posters, I think some of that might be bull$*!#, but things change.
5. I’m going to call Patriot and see if they identify an actual distributor or help me figure out an exception process, I’ll check in if I can figure anything out.
Side note on compromise/relative effects: I might end up just accepting the Camber, since I’m only here for a few months – but if so, I will be getting it at a lower dose than the AG. I’ve now (accidentally) tried Camber, Trigen, and Patriot generics. Trigen was horrible and I submitted a medwatch report for it, but Camber is… fine. The AG (for me) was a very smooth experience, while I can feel Camber “kicking in” and “wearing off”, but otherwise it is not the worst.
Thanks, Zane, for that report.
In the pharmacies’ defense, this slew of non-bioequivalent generics knocked everyone for a loop.
Walgreen’s couldn’t keep taking the hit forever, I imagine, and well-served the ADHD community for a long time.
The brand now has a savings program.
Things change.
At least the Camber worked okay for you. I won’t give that company any credit, given that it obviously sought to deceived customers that a produced that superficially looked like Concerta, was.
g
My local Harris Teeter, a Kroger company, carries Patriot. Perhaps you have a local Kroger store (City Market, Harris Teeter, King Soopers + others) where you live that would carry it.
Thanks so much for this. I was about ready to quit Concerta and then found your article. Switching to Patriot made a big difference for my daughter. For the St. Louis area I’ve had success with Mercy pharmacies filling the prescription.
HI Laura,
I’m glad you found my post!
g
Hi,
I am experiencing a reverse “issue”. Im on a new insurance that will only allow me to have the brand name version of concerta. I have previously been taking the Camber generic. I take my first dose tomorrow and am having a hard time finding information on how exactly the two differ. Do you have any information on this?
I am nervous about taking my first dose of the brand name, fearing that it is going to hit more intensely in a way that is more harmful than helpful.
Hi A,
It’s impossible to predict how you will do on the brand Concerta.
You might do better. You might do worse. It all depends on your neurochemistry.
The medication is the same — methylphenidate. The difference comes with the delivery system — how fast, how much is released into the blood stream, how quickly and at what rate does it wear off, etc.?
The only way to know is to try.
good luck,
g
I have switched from the Brand to the Camber generic and do not notice a difference. Hopefully you won’t either. If anything I would think the Brand would be “smoother” because of it’s delivery design.
When you put the Brand in a glass of water, the medication squirts out one end of the plastic capsule as if squeezing toothpaste out of the tube. It squirts out slowly over time.
When I get my next refill of the Camber, I’ll drop one in a glass of water and we can see if it delivers the medication in the same fashion. I’ll post a picture here.
Hi Tom,
That’s great, you don’t notice a difference. But in either case, is it working? 😉
Concerta’s OROS is very sophisticated. It’s not just that it “squirts out slowly over time.” It does so at a steadily ascending and descending rate.
Camber lacks the mechanism to do that.
g
Thank you for telling me what to look for with the Concerta generic. My insurance company quit paying for brand name Concerta at the beginning of the year. Since I have a high deductible Health plan, my cost was about $250/bottle even with the coupon from Janssen. Wanted to let your readers know that I found the Patriot Pharma generic at my local Harris Teeter pharmacy (a Kroger company). The GoodRx price for 30 was about $67 (compared to my insurance price of $150)
Good for you, Cathy!
g
Hi Gina,
Can’t thank-you enough for all you’ve done on this topic, truly amazing.
I’ve been taking Concerta for close to 20 years and now my daughter is also on it, its been a life saver in so many respects. It’s truly unbelievable how this saga with trying to obtain the authorized generic of Concerta has been unfolding. I live in south Florida and one by one, the major pharmacies have been “phasing out” and refusing to order Patriot Authorized Generic Concerta.
In fact Costco, one of the last to join the ranks started about two months ago by refusing to accept GoodRx for Concerta, and then flat out refused to order Patriot brand Concerta, claiming that they have now committed to Camber as their supplier.
At some point I expect something will snap and perhaps the pendulum will swing back the other way, but until then, it is near impossible to obtain Patriot brand Concerta, and if you can its obscenely expensive. I’ve taken and continue to take the good old generic instant release Methylphenidate (10mg) as an “extender” and frankly, I’m considering utilizing it 3x/day in place of Concerta, at a cost of under $20/month. And this brings me to…. my question, So much of your attention has focused on Concerta (and for good reason) but if you had to “rate” the next two or three best options in the Methylphenidate class… could you…
For instance, I’ve noticed that just based on the little I’ve read that “theoretically” Focalin seems like it “should” be a great alternative, but I’ve seen little discussion of it. Perhaps taking 2x/day extended Ritalin? or is that also plagued with the same cluster in the generic space as Concerta. I ask because my daughter and I have to face reality and come up with a plan B to address the immediate term while fighting the long term battle to get access to the Authorized Generic of Concerta.
Thanks-again!
My question is,
Hi Michael,
I’m glad my work has helped you.
One thing to understand about me: I am entirely self-supported. No pharma funding ever — and you might be surprised how much one pharma “owns” so many of the “thought leaders” on ADHD online. That company determines way too much.
I do this as a public service, and it can be exhausting. There’s no way I can be a medication analyst. 🙂
I focused on Concerta only because it is so popular among millions of people with ADHD. I was around when it entered the market — and it was a real game changer. The OROS delivery system is unique, and that is why the generics are so different — they don’t use it.
In truth, we are lucky to have had the authorized-generic as long as we have. It’s an anomaly.
But with the Trump-appointed FDA chief, rules about generic bioequivalence to novel delivery system drugs (e.g. Concerta) were a non-existent issue.
I and others succeeded in getting the first two “cynical” generics downgraded by the FDA. But then ….. well, elections have consequences.
There is no way this is ever going back. Once approved….and that many approved….not happening.
Pharmacies would lose money selling the AG, and pharmacies, especially now, aren’t in the business of losing money.
BUT, did you notice in the story that Concerta now offers a discount card?
https://Concerta.net
As to your question, there is really no way to make comparisons among the MPH products. It depends on the individual. It’s possible that one of them would work better for you. But I wouldn’t bet the house on it.
The IR and the rudimentary sustained-release tend to have an up-and-down roller coaster effect. Yet, for some, it might work better.
Human genetics…all over the map. The only way you can know is try it. But preferably on a weekend when you can be, as my mother would say, “good for nothing.” 🙂
best,
g
For the past 9 months here in Florida, I was fortunate to get Patriot from Walmart and use GoodRx at around $68. This month they said they could no longer order it at all. I’ll see what else my doctor can prescribe for me. I’ll call Patriot again. Vyvanse is too expensive, Adhansia XR might have a coupon, Dexedrine is affordable. We’ll see…
Hi Susan,
Did you read the post?
Concerta has a discount coupon now
good luck
g
Yes there is a coupon that pays up to $150 toward the 30 day supply of Concerta which costs $370. So $220 is just more than I can afford. My deductible is $6000. So basically I pay $800 a month premium for a plan that makes me pay for all my Healthcare anyway. Thanks for the info though. Some people are benefiting from the ACA, but I don’t personally know of any.
Okay, just checking. 🙂
My understanding is that these discount programs are meant to work with insurance — to offset the brand fee, etc.
Janssen also has a patience-assistance program, on a financial needs basis; you can take a short quiz to see if you qualify BUT one stipulation is not having insurance:
https://www.jjpaf.org/eligibility/?medication=CONCERTA%C2%AE#step1
Yes, those high-deductible plans seem more designed for people who aren’t sick or taking medication.
You’ve probably penciled it out but for us, it made more sense to pay a little higher premium for a lower deductible.
good luck
g
I’m just putting in my two cents on the Northstar generic. I got switcherooed by my long term pharmacy without knowing and got to try this generic. It was awful. Diarrhea, headaches, more emotional, it all released very quickly, etc. I tried for 10 days to make it work but had to discontinue it due to building symptoms experienced as days passed. Went back to Patriot, no side effects, worked same as last long while. I was just shocked they can say these meds are the same and so sad for people who end up with inferior generic and it ‘doesn’t work out for them’. I did report these issues to medwatch etc.
Yep, Cat. It’s a farce.
When I was researching this back when the first two generics came on the market, I called an attorney specializing in pharma.
I asked him about the obvious false equivalency.
He said, “Oh, Mallinckrodt had a brilliant strategy, finding the legal loophole. It was genius, really.”
Shocked at the callousness regarding millions of lives on the line, I just blurted, “Yeah, genius, for a sociopath.”
It’s truly evil.
Unfortunately, elections have consequences. And we’ll be stuck with these consequences for a very long time.
Think of how many people with ADHD will be prescribed this, have bad results, and they/their prescribers opt for non-stimulants.
Disheartening,
g
Would I be correct to say that the pill labeled 214 and 726 are NOT approved substitutions for Concerta?
HI Kara,
If it doesn’t say Alza on the pill, it’s not Concerta.
That’s all you need to know.
g
Oh lordie. I was diagnosed just 3 months ago (29F) with ADHD-C, and today I received my 3rd month of methylphenidate ER, now at 27mg. I noticed the tabs were different (not cylindrical, now caplet shaped). It turns out the “Concerta” I’ve taken the first 2 months was manufactured by Northstar Rx, and this new month’s round is made by Actavis. So my only experience has been with Northstar, no true Concerta/authorized gen as a baseline.
Huh. No wonder I mentioned to my PCP that I don’t feel like it’s doing a ton and I have all these other gastro issues plaguing me the last few months (constant diarrhea, which I had some before I started the med, but really rough lately). We’ve been thinking I’m developing lactose intolerance, but your and everyone’s feedback is really making me question it. Hopefully the Actavis is better; if not, I’m hoping my pharmacy will accept authorized generic request. It’s ridiculous that there can be so much inconsistency and unpredictability with these supposed bioequivalents!
Hi Beekah,
Congrats on the diagnosis! How smart of you, right off the bat, to question and then to find my blog post. Well done! 🙂
Yes, I would not be surprised if that Northstar generic is exacerbating, if not outright causing, your GI issues.
The “real” Concerta still might present problematic issues in that regard but the fact that it is a smoother, more sustained delivery might reduce the odds.
I encourage you to educate your PCP on how to prescribe (you can download the PDF — see the link at the beginning of the post).
BUT PLEASE NOTE……DO NOT ASK FOR ACTAVIS!!! THAT IS EXTREMELY OUTDATED INFORMATION — and it will only get you another Concerta generic that doesn’t work as Concerta does.
Yes, it’s ridiculous there can be so much inconsistency.
Elections have consequences. The Trump White House gave the greenlight to many very questionable generics. Not a political statement. Just fact.
But notice how it works to anger people and cause them to castigate government.
Good luck
g
Last month, I wasn’t able to get my Patriot generic from the pharmacy I use, but luckily, the pharmacy at the store that’s closest to where I live was able to order it, so I ended up getting there. I get my prescriptions from a local grocery store (it’s a regional chain in East Texas located in my hometown), and we have three locations where I live (two have pharmacies), and they were able to transfer the prescription over to the pharmacy at the store nearest where I live, and then this month I was able to use the pharmacy I normally use to get the Patriot generic.
Kudos, Aaron!
g
I just want to thank you so much for taking the time to write this extremely detailed and well-written post. I was just diagnosed with adult ADHD and thank God I found your post before filling my subscription, so I was able to get the authorized generic. Thank you and God bless you!
Yay! And good for you, Omenka, for being a smart mental healthcare consumer!
If you had tried one of the inferior generics, to bad affect, you might have given up on the entire class of stimulants (methylphenidate).
The doctor might have then moved to Strattera (generally considered helpful for only 25% of people with ADHD, and many prescribers foil that by increasing the dose way too high) or the amphetamines.
Generally speaking, people with AHDD will respond better to one class of stimulants than the other (methylphenidate and amphetamines).
So, yes, these details are important! And, darn it, many prescribers remain absolutely clueless.
good luck!
g
I just wanted to report that when I picked up my son’s Concerta 54 prescription at CVS on 4/27/21, they unexpectedly had filled it with the Janssen (alza) brand OROS tablet. Janssen is listed on the bottle, not Patriot. I didn’t ask why, in fact I only discovered it when I was back in my car and covered in hand sanitizer. CVS had been filling his script with Trigen for the last 13 months after my health plan switched from Express Scripts to CVS Caremark exclusively. I haven’t found any news about this on the web, i.e. if it is a change in CVS policy, or an aberration. Thought you’d like to know and wonder if others have had this experience.
Hi Charles,
Congrats and count your blessings!
I addressed this in another comment somewhere.
You’re not going to see any public declarations of policy from CVS or anyone else, imho.
This is a rapidly changing issue. Janssen has obviously started fighting back against the incursion of these junk generics.
The only way to compete is to make it more profitable for the CVSs of the world. Somehow, it has, I guess.
I wouldn’t leave it to chance next time, though. I’d find out how your prescriber needs to specify this, exactly, and do it.
g
You might check with your insurance. Our CVS Caremark policy *requires* branded Concerta which is made by Jansen. Sounds like you ended up with the branded product. If so, check out the Jansen coupon program. It covers what insurance doesn’t up to $150 per fill. Saving me tons of money.
Good reminder.
Not valid in MA and CA.
g
Has anyone here moved overseas and tried to fill a Brand Name Concerta or Patriot Prescription before? I’m thinking about moving out of the US entirely. I did see Janssen has a partnership in Mexico where they plan to make Concerta accessible. Just wondering how difficult it would be to continue the medication if leaving the US healthcare system.
That’s a good question, Zach. Sorry I can’t answer it.
I would contact Janssen’s customer support line — but expect disappointment. It’s a bit beyond the standard consumer questions.
Maybe they could put you in touch with that division.
good luck!
g
I just want to say that the insurance companies are a big scam. Necessary, but totally full of dog poop. I was on brand concerta until generics were available. Then I was getting the authorized generic up until feb. 2020. I switched from cvs to costco and costco would only give me the patriot generic… now Im finding that my insurance wont cover the “costly” patriot generic, but will supply the BRAND CONCERTA for only $16 a month/30 pills… I’m so thankful to get the brand again, bur hecken confused why they price negotiation keeps happening.
Anyway. Maybe some of yall will get lucky and experience this as well…
My bad. Patriot is the brand manufacture. I was denied NORTHSTAR MANUFACTURED GENERICS.
This is all so confusing to me.
Hi Sara,
Yes, it’s confusing. I try to simplify but there’s only so much I can do. 🙂
The easiest way to think about it is this: The brand (manufactured by Janssen) and the authorized generic (manufactured by Janssen and distributed by Janssen subsidiary Patriot) are the same thing.
The only difference is how it’s marketed.
g
Hi Sara,
I wouldn’t say the insurance companies are a “scam.”
You are getting brand Concerta for $16/month. People with ADHD in most every other country, including those with “great” national health systems, would envy you.
The problem came, as I’ve written about many times in these comments, is when the Trump administration appointed an FDA chief that over-rode FDA scientists’ concerns about generics for novel-delivery systems such as Concerta’s.
g
Yr insurance won’t cover Patriot but will cover “Brand “ Concerta for $16?? What Brand or are you say a non generic Brand ? My Patriot Concerta is lighter in color, I was concerned it was changing! I went thru the Patriot hunt and YES for Costco!!
Just saw yr update !
Just wondering if anyone has tried the Camber pill, and how did it work for you. I know a gentleman “Bob” stated in December he was going to try it. It’s what we received today to use for the next 30 days!
Hi Leslie,
It really doesn’t matter how the Camber worked for others. It only matters how it works for people that did well on Concerta.
Some people might do better on these Concerta generics than they did on the brand.
The problem is that they don’t work as Concerta does.
That said, I have not heard good things about Camber.
Depends on how much you’re willing to risk go badly…..what’s on the line.
g
I had the same thing happen with Frys (Kroger)! The Lennett was on back order and I was given Camber (my husband didn’t know and picked it up) without being told. I took it 1 day and it ruined my entire day. I am going to try again this weekend and see if it was a fluke (maybe I forgot another medication the night before). This is just so sad that the pharmacy doesn’t inform you prior to pick up.
Hi Jessica,
We definitely must be pro-active.
I’m not sure how it would work, to have the pharmacy call the customer every time a generic changed manufacturer. This happens constantly with generics. It’s just accepted practice.
The difference is that the generics for Concerta work nothing like Concerta.
This is the Trump administration’s fault. Not your pharmacy’s.
g
He has his check up next week and I’m thinking about trying out Vyvance for a while. He’s 11 now, and has been on Concerta since kindergarten or first grade (I can’t remember). Some generics have worked great, others have been awful. I just don’t have the time and energy to have to call 50 pharmacies every month to see who has what. I’ve asked pharmacies repeatedly if his doctor put the NDC and manufacturer will they order it. I hear the same thing at CVS, Walgreens, Walmart and now Kroger. “We get what our supplier sends us. We can’t special order”. Going brand is not an option either. My insurance won’t cover it, and being a single mom on one income, it’s just not in the budget.
Hi Leslie,
I’ve responded to you but it’s unclear to me if you have seen my responses.
As I emphasized in the post and MANY times in these comments, it’s pointless to “call 50 pharmacies every month”.
Did you say you wanted the prescription filled as an “exception process” — also as I indicated in the post?
Did you call Patriot to ask for help on this…also as I indicated in the post?
Finally, also in the post, did you see that Concerta has a savings program?
I know this is a hassle, but so is living with untreated or otherwise poorly managed ADHD.
Perhaps Vyvanse will work well for your son. (Have you asked your insurer how much that will cost?)
But these medications are not interchangeable.
COVID has already created so many stresses for schoolchildren, perhaps it’s not wise to add another uncontrolled variable?
If you know Concerta is helpful for your son, maybe it’s better to focus on exactly what you might need to try, as I write in the post?
Good luck,
g
So today, I asked my mom if she could pick my son’s medicine up for me. Kroger pharmacy where we had been getting Patriot was about 45 miles away. She was going into town anyway, so I didn’t have to go up after work. Anywho – my heart broke to see that we now have the Chamber “brand”. I’m praying by some miracle that it works ok for us – I can’t keep calling and chasing and running into pharmacists that just refuse to help. Even my sons pediatrician doesn’t seem to take this as seriously as I feel he should. He just says “just tell me how to write the prescription and I will”. I’m almost at the point of switching to a different medicine in hopes that it isn’t like this with others. We live in a fairly rural area – so we don’t have a plethora of options.
Hi Leslie,
I know it’s frustrating. That’s why I cover this topic.
It seems that you have a willing prescriber. Maybe you should just do as he asks and find out exactly what the find out needs to write. In written form.
This would involve asking the pharmacy exactly what it needs to say. Especially if it’s in an electronic form — sometimes that’s unclear to prescribers who are used to the system.
good luck,
g
I feel like I just fell down a rabbit hole!
I was diagnosed ADHD a little over a month ago at 34 years old. I wasn’t given much information, just asked what I wanted to try. My brother takes Concerta and so I asked to try that since we are full siblings. I was not explained anything about the delivery system. I was given a generic (Lennett) and I started it. I tried 18mg for 2 weeks (last about 4 hours) and then 2x18mg (worked a little better). I tried one day so 54mg and went back to 2x18mg. I had minimal anxiety (my brother had some as well). I went to get a new months worth and was given a different manufacturer (Camber). This is when I discovered the rabbit hole!!!( My bottle was specifically written for Concerta and I was given a generic)
I tried 2x18mg Camber and it exploded my day. I requested a fill of the Lennett 36mg just because I knew it worked while figured this all out. I’ve been back on that for 2 days and there definitely is a difference between the 2x18mg and the 1x36mg.
My question is… I cut open the Camber today because I saw on here is was just an illusion. It looks EXACTLY like the Alza pills. It has the hole, the layers, and the casing. I put it in a bowl of water and it does exactly what the Concerta does.
I am beyond confused. Is that not the same? Is to a fake OROS? Is that maybe why it worked so bad because it was too much?
I spoke to my brother because he just got back on Concerta. He sent me a picture and his is Alza. He said his anxiety is all the way down and it’s much better than the “white pill” one he had before. So I assume it would work the same for me.
I just want to get my facts straight for when I speak to my psychiatrist.
And had I not been given the different manufacturer and not found this page I probably would have never known any better and just went about my day feeling good with just a little anxiety not knowing it could be better.
Thank you-
Jessica
You’re welcome, Jessica. I’m glad you found my blog — and my extended work guiding folks through this Concerta-generic mess.
Yes, Camber was very …….clever. Looks like Alza. Isn’t Alza. As I noted in the illustration (in the post).
What you can’t see, when you put an opened capsule in a bowl of water, is the rate at which the methylphenidate is released. And that’s what makes Concerta, Concerta. Otherwise, it’s just methylphenidate.
These days, the delivery system is almost more important than the medication.
As for why you received the generic, there could be lots of reasons.
For example, your prescriber did not check the “do not substitute” box. Typically, the pharmacy will fill with generic unless stipulated otherwise. Especially if those are the terms of your pharmacy insurance benefit.
Each of the Concerta generics are a little different. Each might work well for some people.
The problem is, they don’t “behave” like Concerta.
That’s why I succeeded in getting the FDA to downgrade the first three generics years ago.
Times change, though, and so did a political administration.
g
Thank you so much. That what what I thought I was understanding, but I was greatly confused when I saw the inside.
I will be taking a much deeper look into your website this weekend! The generic Lennett does work, but if it’s not what I was truly prescribe I feel I deserve to see if the Alza works better with the actual OROS. If not, I might as well try a different methylphenidate that’s not based on delivery system.
Amazing work!
Hi again, Jessica,
The thing is, there are degrees of “working.”
Ideally, new patients with ADHD should be given a few trials — different class of stimulant and different delivery system, at different doses.
That’s how you get a better feel for what’s “working” and what’s “really working” and what’s “NOT working.”
To be clear: The delivery system is central to how any stimulant works. Some are more complex than others.
Some release more at the beginning, some more toward the end (with a big drop-off), some release at a steadily ascending rate — some at a steadily descending rate.
For example, Vyvanse is Dexedrine — in a complex delivery system.
Neurochemistry differs greatly among the individuals who have ADHD, so there’s not just one fit.
If you can afford it, it probably is a good idea to try the brand Concerta (or, if it’s more affordable, as I write about in this post, the authorized-generic).
good luck!
g
So last year, I had so many issues getting the Patriot ordered when my insurance took Walgreens out of our network. CVS and Kroger tried to order it with a “dispense as written” and even included NDC codes for the Patriot. However, their distributor (Cardinal Health) would regularly substitute some other generic in the shipment delivered to the pharmacy the next day. My Kroger pharmacist would call constantly and try to get the Patriot and it was always inconsistent and I ended up driving to different Kroger locations to fill my kid’s prescription.
Until one day, there was a tech working who told the Kroger pharmacist that she had to select a “no substitutions” button WITHIN the electronic ordering system in their computer, and that calling will not work. Fingers crossed, but we have had no issues so far for the last few months. She did mention to me last month that she was relieved we went up in dosage bc they were having trouble ordering the 36mg, but there was plenty of the 54mg.
Passing along all this info bc this website has been so helpful to me ever since I got onto this roller coaster ride in 2017. Thank you!
Hi there,
All it takes is one person getting the details right!
When I read “dispense as written,” I thought that might be the problem.
There are so many permutations on what exactly will do the trick.
“Order as an exception process” is one.
In some cases, “no substitutions” means only “brand, no generics.”
It’s great to have a problem-solving tech on your team! Kudos!
g
That is so odd. My Walgreens pharmacist says he has trouble getting the 54 mg tablets! He gets plenty of 27 and 36 mg but only gets the 54 mg every 3 or 4 times he orders it! I was thinking of calling my insurance and asking if they’ll cover 2 27 mg/day but I’m not optimistic it would work and the medication dispersal would probably feel different and that’s the whole reason for getting Patriot in the first place!
Hi Emily,
It’s possible that the two 27mg pills would work just as well — and even give you a little more flexibility in timing.
You probably know that Concerta pills have an outer coating that starts releasing immediately, while the medication within the pill is released over time.
From what I’ve read of the manufacturer information, there would be no difference in that coating between 1 54mg pill and 2 27-mg pills.
The response to the two 27mg concerta taken at the same time and the 54mg concerta would be identical: https://www.janssenmd.com/pdf/concerta/concerta_pi.pdf
It might be worth a try. If your pharmacy benefit will cover two pills daily.
good luck!
g
Hi Gina,
I have been buying the brand name Concerta from Walgreens. But this month they have taken so long to refill my script. It’s taken a week! And of course, I am out of my medication. Called them last night and said it would be in after 2pm.
Have you heard of any others having to wait this long for a refill? I wish they knew what they put people through because of the wait time.
I have a 6 year old at home learning remotely. And it’s definitely not helpful for me.
Laura
Hi Laura,
It’s definitely beyond-the-call….what adults with ADHD must go through monthly jumping through all the Schedule II hoops. Just punitive.
It makes it hard for everyone, patients and pharmacies, to have such a tight window. Walgreen’s has been such a hero throughout the Concerta authorized-generic mess, too.
This is why I recommend, when at all possible, looking into any home-delivery pharmacy benefit. Why go through this torture monthly, with all the logistics, when you can do it maybe 4 times a year?
https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/
I’ve heard that some pharmacy benefits now cover a 60- or 90-day supply at the store, though. Might be worth checking into if you haven’t already.
good luck
g
Hi Gina
I can’t thank you enough for all of the work you have put into this. It has been extremely helpful. I want to report that none of the pharmacies I have been using in the LA area will provide the Patriot authorized generic. I had been able to get it at Rite Aid, but they no longer have it. I have repeatedly asked pharmacy managers if they will submit an exception request as you have suggested, but they either look at me with blank stares or simply say that they get what they get from their suppliers, and they can’t change it.
I called Patriot and spoke to a woman named Pat who was terrifically helpful. She spoke to the Rite Aid hdq and asked for permission for the pharmacy manager at the store near me to submit a request for authorization. That request was submitted and approved, and today….I picked up the Patriot generic. Pat was terrific in following through on this, and I expressed my sincere gratitude to her and the local pharmacist for their effort. I certainly want to thank you as well.
– Steve
Hi Steve,
Victory to the proletariat! 🙂
Good for you, for tracking this down and following through.
g
I can’t thank you enough for this post AND ALL the updates! My son is 24 finally has a job with benefits, but is losing his mind trying to navigate the cost of this one drug he needs. Now even this patriot generic is costing him over $100/month. He cries sometimes when he thinks about having to deal with the soaring cost of this for the rest of his life. I swear, sometimes it’s enough to make an American seriously consider moving to England, Canada, Finland… anywhere else where humanity outweighs corporate greed! Thank you for all of your research and activism on this!
Hi BJ,
I’m so glad my work has been helpful to your son.
I’m not sure why you’d want to move to England, Canada, Finland…. it’s much WORSE there for people with ADHD, including with the choice of medications.
Single-payer NHS countries, in particular, such as the UK, absolutely fail adults with ADHD. They must wait YEARS for an evaluation, if they can get one at all.
Then they risk being diagnosed with much more “acceptable” conditions.
Their choices of medications are extremely limited. For years, Australians in the NHS could only get Dexedrine! Only within the last few weeks has Vyvanse been introduced, but who knows how accessible it will be. And it’s still a huge uphill climb to get an evaluation as an adult.
For a long time, no adult could even be evaluated for ADHD who wasn’t diagnosed as a child. Nice little closed loop there.
No other country has the access to care and the choices of medications that the U.S. has. Elsewhere, it’s the government bean counters who decide what is acceptable.
So, before folks believe this slogan that single-payer is the answer, I encourage everyone to learn more about the situation. I’ve received e-mail from desperate people, for years, stuck in these NHS nightmares.
Patented medications expire. Concerta’s patent expired years ago, but manufacturer Janssen was able to forestall the first generic by making a deal with its manufacturer.
That’s how we got it for years at a generic price.
But then, we allowed demagogues to spoil the 2016 election, believing their slogans instead of examining the facts about healthcare policy. As a result, the man who took the White House appointed a Heritage Foundation fellow as the FDA chief.
He overrode FDA scientist concerns about bioequivalency with novel-delivery system drugs. And that’s when we got a slew of inferior Concerta generics. With not a thing we could do about it.
Under the previous administration, we successfully lobbied the FDA to downgrade the first few inferior generics. I opened the case and was helped by a very concerned FDA staffer.
Then we threw away our country.
Sorry to be “political” but actions have consequences. When we act on bad information — even with the best of intentions — we create a world of hurt for many innocent people.
Just as people who don’t “believe” in ADHD believe they are being kind in not wanting to “label” people. 🙂
take care,
g
Gina,
I had my local pharmacy filling the Patriot Pharmaceuticals generic because my insurance would no longer cover the brand name and one day last year I came home with a generic from Northstar RX and I noticed a difference immediately. I’m still using that pharmacy, but I now have to insist when I call my medication in that I get the Patriot. All other generics of Concerta need to be yanked off the shelves and done so immediately. The Patriot Pharmaceuticals generic is the only one that should be allowed. After I had used the Northstar RX generic, I called in my prescription and asked for brand name Concerta, thinking my insurance would cover it. Nope. However, the pharmacy I use has the Patriot, and I’ve been back on it ever since.
Shew! That’s great that the pharmacy is meeting your needs.
After all the work we put into lobbying the FDA to downgrade first two inferior generics—and succeeding!—I was just heartbroken when the new White House appointed an FDA chief who overruled FDA scientists’ longheld concerns about generics of novel delivery system medications.
There must be at least 12 Big Generic players pushing inferior generics for Concerta. And I can’t imagine the FDA withdrawing approval for all of them. But who knows….maybe those generics will die a lonely death due to shrinking demand. We can hope!
Take care,
G
Adding to the many reports of experience in the field. As of January 1, my plan, Express Scripts, no longer provides any coverage for name-brand Concerta. I called today, the first time I’ve needed a script in the new year, and asked for a pharmacist to discuss what manufacturer’s generic they were carrying for Concerta and, low and behold, I was put through to a pharmacist!
I was told that Alvogen is the generic. I then asked if Patriot could be made available because my son requires the delivery system. The pharmacist looked it up and, low and behold, yes, they can get Patriot.
I was told to have my physician write “Patriot Manufacturer Do Not Substitute” on the script.
I then faxed a letter to my physician with the new instructions.
So, that’s where things stand – I’m hopeful that I’ll get what my son needs and that it won’t break the bank. In my state, the script goes directly to the pharmacy from the physician and I never see it, which is problematic because things go wrong and I have no clue about what the actual script said. I have also been told things by the pharmacy in the past about how to have the script written, which turned out to be wrong. Now I wait to see what happens next. Gina, I keep this page bookmarked and come back often to see what’s new. Thank you for giving me (and all of us) a solid knowledge base to work from – I could not have navigated this mess without you!
Hi Linda Jean,
Way to self-advocate!! I’m happy you find my work helpful.
I hope it works. It might be enough to say “Patriot only” — without the extra words.
Also: “Do not substitute” is the phrase typically used to mean “Stick with brand, do not substitute with generic”.
But if that’s what the pharmacist said!
Still, it might be confusing to those who don’t read carefully. And, the electronic prescription forms might make it trickier, how to indicate that.
I hope it works. If not, maybe you can try those changes.
I always tried to make a human contact with the mail-order pharmacy — someone who I could call to check that things are going as planned. It’s not always possible, though.
Good luck!
g
Gina –
I wanted to offer some more experience with the Jannsen discount card. This month is the first time I’ve used the card since the new insurance year started for our plan. Normally I fill my son’s Concerta prescription for 90 days (our BCBS plan offers 90 days for the price of 60). Since we haven’t met our deductible for the year, it’s $400 for 90 days. The tech at the pharmacy put through the discount card and it came down to $250. Reading the fine print, the card pays up to $150 of your cost after insurance per fill. It does *not* take in to consideration that I was filling for 90 days. So, we opted to only fill for 30 days. In that situation it took $150 off the 30 day price and ended up costing me $32. If you figure that I’ll then have $32 each of the next two months as well, it’ll end up at right around $100 for 90 days instead of $250. Moral of the story, if you take advantage of the Jannsen discount card, calculate the cost of 3 x 30 days vs 90 days to see which saves more money. Once we meet our deductible, I will be able to go back to filling 90 days again bc my cost share after deductible is around $100 for 90 days, so the card will pick that up and I’ll pay $4 for 90 days. Score! Hope that all made sense and is useful to someone. 🙂 -Deborah
Thanks for that report from the field, Deborah!
Yes, typically the 90-day home-delivery prescriptions don’t allow any discount cards, etc.
Now that storefront pharmacies are allowing 90-day prescriptions, I wondered how that would work (or not work). Sounds like it will work for you, once you meet your deductible.
If that’s not right, don’t worry. I’m just tired probably. 🙂
Wish we could use those cards in California!
g
g
Yes. It worked for me in December on a 90 day refill. We had already met our deductible at that point and I got his 90 day refill for $4. Once we meet our deductible, it should be $4 for 90 again. I’ll just keep doing 30 days at a time until we meet our deductible. Concerta is exempt from the rule that requires a 90 fill on a “maintenance med” with our policy. Thankfully the PA that writes his prescription has known us long enough that she won’t freak out when I tell her that they fill my 90 for 30 days and I need a new scrip.
-D
Kudos, Deborah. You are dealing with all the angles.
This is one reason that I, for years but not now, dealt with getting my husband’s prescriptions filled.
He deals with complexity in his work every day — cancer genomics! — but the complexity and potential quagmires of getting Rx filled was just too much for him. 🙂
g
Doh! I finally found a pharmacy (one Walgreens in the neighboring town) that regularly special-orders my son’s prescription – which specifies “Patriot only” in writing. I dropped off his latest prescription last night, and SURPRISE, they would be happy to fill the prescription, but they no longer take my INSURANCE! Apparently Anthem BCBS couldn’t come to a contract agreement with Walgreens, and so now the ONE pharmacy that reliably fills this prescription is no longer available to me. AAAAAAACK!
When my son began taking this medication 5 years ago, I was able to find the authorized generic (whatever its name was back then… Watson, I think?) with limited trouble – usually the 3rd or 4th pharmacy I called had it. It has gotten harder every year, and now it is basically impossible. Some cycles (every 90 days), I’ve had to call 20+ pharmacies before I have found one that would provide Patriot/Watson/Actavis/whatever. This usually involves pharmacists running the gamut from friendly and apologetic, to dismissive to rude. I remember the one time we tried another manufacturer – I had his prescription filled at a CVS we had used the previous month, and I didn’t bother looking at the pills until I got home… they switched to Trigen, I believe it was, and of course didn’t bother notifying me of the change. My son said the new pill left him feeling foggy and unfocused, and he just didn’t “feel” right. I wasn’t about to mess with a drug that was going to unpredictably affect my teenager’s mood – that’s like playing with fire.
I am now on hold (interminably) trying to see if my insurance will allow me to do mail-order… though my pediatrician’s office doesn’t do electronic prescribing for controlled substances, so I’d have to pick up a paper scrip and MAIL it to my insurance, and then wait for it to be processed and mailed back to me – the whole turn-around could take 2 weeks. EVERY TIME. With my son preparing to go away to college, and having to shoe-horn in doctor appointments during school breaks, this could be totally untenable. I feel like I’m having to work so hard for something so basic, and I just don’t understand why it has to be this complicated…
Hi Rebecca,
Darn.
The reason that getting the authorized-generic is harder now? A flood of Concerta generics allowed approval by the previous White House administration’s FDA chief.
The truth is, though, we’ve been lucky to get the authorized-generic for as long as we have. The only thing that staved off generics years ago is Janssen cutting a deal with Actavis: Actavis postponed introducing its Concerta generic and Janssen allowed Actavis to distribute the brand as a generic (that is, an authorized generic).
This is just the nature of patents. But really unfortunate for many Concerta users.
Do you quality for Janssen’s discount program? https://Concerta.net
It might be a good idea to try one of the newer stimulant options, the ones for which there is yet no generic. (Unless your insurance policy requires generics and charges a big premium for brands.)
QUESTION: Why do you have to mail the script to your insurance?
When I started getting my husband’s medication via home-delivery, I would send an SASE to his prescriber, who would use it to send me the script. I would send it to the home-delivery pharmacy. Never left my house.
QUESTION: Why do you have to wait “interminably” to see if your insurance allows you to do mail-order? You can’t look it up online and contact the pharmacy rep directly? Maybe you’d tried this.
At any rate, good luck!
g
Gina –
Thanks for the swift response, and thank you SO much for this website… it is the ONLY resource I have ever found online that explains all this adequately. I was on hold for a long time because, to make my day even MORE fun, the prescription dept. at my insurance is having technical issues, and their system is down. (They kept me on hold for 21 minutes just to inform me of that fact!) I want to see if they will fill the prescription with Patriot… otherwise there’s no point doing mail-order, and tacking extra time onto the filling of the prescription each time. I think at this point, I’m going to price out Concerta, using the card you’ve linked to here – I called several pharmacies and they all say I have to come in person to see what kind of benefit I’d get from the card. Of course, it’s a fun thought, during a pandemic, walking into multiple pharmacies to get pricing, since none of them will do it over the phone.
Again, I SO appreciate your advocacy and effort and insight on this issue – I sure wish it wasn’t needed!
Hi Rebecca,
I’m happy my work has been helpful to you. Thanks for letting me know.
On hold for 21 minutes. Sheez. Reminds me of the nightmare that was CVS Caremark (I gave them the motto: “Where if you think we care, you’re a mark!” haha)
They would never give me a straight answer on the Patriot authorized-generic. “Send it in and we’ll see,” they said. The reason? They’d have to order it as they didn’t stock it. Maybe they’d get it. Maybe not.
My husband got yet another insurance change with a new job. This time with Blue Cross-Blue Shield Illinois — and we live in the Bay Area. I anticipated red tape and problems. But the pharmacy contact was SO NICE. I kept saying, “Thank you. Thank you. You don’t know what your kindness and patience means. Thank you!”
She probably thought I was nuts. lol
In the interim, I worked with our local Walgreen’s store, and they were SO helpful. But they said they cannot check the price without an actual prescription being in the system — because it requires that in order to communicate with the insurer.
Sorry it’s so hard! I would definitely see what might happen with the brand savings program — as long as you’re not in CA or MA.
g
Hello Rebecca.
My insurance is through AARP United Healthcare. Pre-authorization approval for Authorized Generic Concerta is even harder than finding a pharmacy to fill my prescription.
Walgreens will fill my prescription; it took quite some time and maddening frustration (experienced by so many of us) to get my doctor and pharmacist on the same page. I was fortunate to identify GoodRX and use it to reduce the cost.
Although GoodRX also lists a number of pharmacies with lower prices than Walgreens I have been able to find another pharmacy that will consistently make the Patriot NDC available to me.
Perhaps GoodRX is an alternative affordable option for you. I hope so.
Be safe and well, David
Hi David,
Thanks for responding to Rebecca.
I’m wondering if you really have to get pre-authorization for the Concerta Authorized-generic.
It is, after all, a generic.
g
So sorry: I have been UNable to find a consistent lower cost alternative to Walgreens.
David
Hi Gina. Sadly for me it was pre-authorization hell to get the Specific Authorized Generic Concerta NDC and I had to get pre-authorization any time my dose changed and I had to get the pre-authorization all over again every year. There are other (less expensive) Concerta “generics” that United Healthcare would rather pay for. Same deal as the pharmacies. Both assert that one generic Concerta is equivalent to another, which of course isn’t true.
I have said this before but I want to say to you again how valuable you have been as an advocate and resource for us.
Thank you, David.
I was just checking! Because some people automatically assume they need pre-authorization—when really they only need to have the prescriber specify Patriot generic.
Why go asking for trouble, is my thinking.
But yes, I understand your situation….that’s the very nasty problem with these junk generics. They are CHEAP and have flooded the market.
take care,
g
My son was recently prescribed methylphenidate HCL ER and it was filled by our local pharmacy (Giant) with brand Concerta at generic prices. I have CVS/Caremark for mail order prescription and when I used their website to price the generic it comes up as “unauthorized,” while brand Concerta is available at generic prices ($20/90 days). I was surprised because even their preferred name-brand medications have a $500/90 day cost (under my insurance). I’m hoping this low cost for Concerta via Caremark actually pans out because I’d like to send him off to college without having to worry about potential problems with new generics.
Hi Wendy,
Lucky you! So much depends on one specific insurance policy.
But, as I wrote in the updates to this blog post, it’s a rapidly changing landscape.
The release of this clown car of generics might have caught Janssen flat-footed. But they seem to have jumped into the fray swinging. Who knows what the situation will be next month—or next week. Unlike in previous years, companies don’t issue press releases regarding these deals. It’s the Wild West.
You don’t mention when you son goes to college but forewarned is forearmed. 🙂
good luck,
g
I have followed this post for a few years. I am on Concerta and was getting the Patriot brand as the other generic medication gave me GI issues. Recently I received my prescription from Walgreens and noticed it was Janssen. Are they now making the authorized generic? I am a bit confused.
Hi Tonya,
I know it’s a lot to wade through—and hard to be much more concise.
Maybe sometime, you’ll sit down with a cup of tea and take it paragraph by paragraph.
In the meantime, yes, Janssen is the manufacturer of Concerta. Patriot is their subsidiary that markets Concerta as an authorized-generic.
So, as long as you didn’t pay a vastly higher price, you lucked out!
Gina
I go to Pepperell Family Pharmacy in Pepperell MA. They are able to get it for me but each month I have to call and have them order it if they don’t have it in stock. They stock very little. Their supplier is able to get it for them. Every month I cross my fingers however.
Kathy
Thanks, Kathy.
Do my knowledge, no pharmacy stocks the Patriot authorized-generic. It’s ordered.
Moreover, most pharmacies tend not to stock much of the stimulants in general.
g
All – Just a quick kudos to Gina. Without her and her invaluable information, I too would have found myself stuck in this generic shell game hellhole. Her advice and direction have been a godsend for me and my son for the past 2 years.
Please listen to her advice:
1) mail order instead of local pharmacy if your insurance allows. (Your chances to get the authorized generic increases drastically)
2) 90 day supply instead of 30 days in your insurance allows (Chances are, your insurance will cover 90 days at cost of 2 copays saving you a month of copay)
3) Rx should specify “Methylphenidate HCl Extended-release tablets, xx mg, NDC xxxxxxxxxxx ONLY, 1x day, DAW1” (The key here is the NDC number + DAW1 which does NOT allow the pharmacy to substitute. It must be dispensed as written using the NDC number and the NDC number is specific to the Authorized Generic.)
Again Gina – *YOU ARE A GODSEND* – THANK YOU!!!!
Aw, thank you for noticing my work, Kim.
Unlike many ADHD-related blogs and websites, I do not accept pharma funding (nothing wrong with that for researchers and speakers, imho, but as a trained journalist, I realize it can introduce conflicts of interest).
So, knowing that my work is important to readers means everything.
Thank you for bringing up the home-delivery angle. People tell me all the time….”but you can’t legally get stimulants delivered to your home!”
BUT YOU CAN. 🙂
Here’s a blog post with the details: https://adhdrollercoaster.org/tools-and-strategies/home-delivery-stimulant-medications/
Gina
Emily,
Is there a way you can connect with me via Gina? She should have my email.
Kathy
Kathy — thanks for responding. Can you respond to Emily here? Maybe it will be useful to others. tx
I would appreciate any advice for getting the Patriot version of Concerta in the greater Boston area. I originally got it 4 years ago at Rite Aid without any special ordering needed. Then it turned into Walgreens and no luck. I switched to another Rite Aid, then it also turned into Walgreens, but the pharmacist there still ordered the Patriot version (he said it was the only one he trusted). Then that pharmacist left but I suddenly was able to get it at a closer Walgreens, although it required special order. In December it started to become more difficult to get. The pharmacist said he ordered it but it was not sent to him. Told me it was back ordered. I spoke to someone at Patriot who assured me it was not on back order, plenty of stock. She reached out to some people at Walgreens corporate but I’m not sure how that panned out. Eventually in January I called Walgreens and low and behold, it was sitting on the shelf but no one had contacted me because the prescription had expired in the meantime.
Now we’ve started this same process again. Walgreens ordered it at the beginning of last week and now it’s Thursday. They still haven’t received it. They told me to keep calling to check. My mom and I both take this drug so I have to go through this process twice a month. My doctor can send it the prescription about a week or two before it’s due to be filled, but I have to call to “activate” the prescription on exactly the day it can be refilled, which is only 2 days before I run out. Walgreens will not order it until this time. They tell me there’s no “exception process” to do here because they are able to order it but the distributor just isn’t sending it. I even called the distributor (found some evidence online that it recently changed from Walgreens Boot Alliance to AmerisourceBergen – maybe this is the source of the newest problems???). AmerisourceBergen told me they couldn’t talk to me because I didn’t have an account with their company.
I was thrilled to read about the $4 per month program by Jansenn. Then found out it’s not available in Massachusetts. When I am able to get the Patriot version, I pay about $140 for 30 pills. My mom has Medicare and pays between $5 and $20 per month. What????
Hi Emily,
Sorry you’re having so much trouble.
$140 for 30 pills seems like an awful lot. Do you have a home-delivery pharmacy, with a 90-day prescription?
The hard truth is that we have been lucky to get this authorized-generic at all, for as long as we’ve had it.
It might have continued, had the Trump FDA chief not decided to run roughshod over FDA scientists.
Now it’s a free-for-all.
g
Printed the “Authorized Distributors” list off the Patriot Pharmaceuticals website. Also printed the “Product Portfolio” page from their website showing the NDC codes for each of the Concerta generics. Took them over to my local Fry’s Marketplace (Kroger family of stores, which is a listed distributor). Kindly asked/explained that I wanted to see if they could get this because other generics are not the same delivery system and not as effective.
They were awesome and said they can order any of them. Helped me set up my daughter’s profile with specifications about “Patriot Pharmaceuticals” generic only (no other generic) and noted the NDC codes for the 2 dosages she may need. They told me to have my dr. specify ONLY this brand and NDC when he transmits the prescription. Told me it would take 2-3 days to get it in.
Fingers crossed! This could solve some major headaches. Kroger/Smith’s/Fry’s are a LOT of places!
Good for you.
That’s the advice I gave in the post, including the NDC codes. 🙂
Except: The list of “authorized distributors” is not necessarily accurate, as I wrote. It might make a good starting point, though.
g
We are in Massachusetts and have been lucky in that we found an independent pharmacy (somewhat out of our way) that could get the authorized generic for my daughter. But each month it is stressful. I always breathe a sigh of relief when I get it. It shouldn’t be this way. Now that my daughter is almost 19 and in college she will be assuming the responsibility of her Rx. She thinks she will switch to Adderal hoping it’s easier to obtain. Has anyone had experience switching to Adderal after being on Concerta?
Kathy
Hi Katherine,
Adderall and Adderall XR also have generics. So, I’m not sure what your daughter’s rationale is there.
Moreover, stimulant classes are not automatically substitutable. Given her genetics, it might be that she does much better on methylphenidate than amphetamine — or vice-versa.
For some, Adderall is more problematic than other stimulants:
https://adhdrollercoaster.org/adhd-news-and-research/the-tragic-truth-of-prescription-adderal-or-madderall/
So, it doesn’t really matter what others’ experiences might be. The only thing that matters is what is right for your daughter.
You and she might want to read my book’s chapters on medication: https://amzn.to/36pR4gm
good luck,
Gina
Would you be willing to share the independent pharmacy name and location with me? I am in Waltham and have been having a lot of significant problems getting it at Walgreens after 3 years of moderate problems off and on.
Thanks,
Emily
I take Metadate CD and it works fine for me.
I was on Concerta before there were any generics and the cost was too high for the drug allowance at my HMO, so they switched me. I have used several different kinds over the years and they usually settle in after a bit.
My husband and our housemate have been prescribed both Concerta brand or generic. Until this month, any generics they have gotten have been ok.
The generic they got this month was radically different in both looks and action. Very destabilizing, including our housemate stopping at urgent care because she was so out of whack. They administered an antagonist and we had to go pick her up because they didn’t want her to drive.
Follow-up pharmacist interactions have been mixed, one said they could swap them out if they took them back to the pharmacy. But when our housemate went, the pharmacist onsite said they couldn’t and it shouldn’t matter because they are identical to the Concerta brand…Additionally, they won’t be getting the others any more. There was a general lack of caring in their attitude.
Your site has been a wealth of information!!
Hi Nancy,
Thanks for validating that it was worth me spending so much time on this! 🙂
Gina
Thank you so much for this information! I spent hours last night researching what to do now that our BCBS won’t cover brand name Concerta, and the generics our pharmacy is offering are causing my son to feel depressed. The worst was the one made by Alvogen – he felt suicidal, so he stopped taking it immediately. The next month they gave us Lannett (which I thought was one of the ones that was downgraded?). We even tried to fill a prescription for another brand name (Aptensio XR), but none of the pharmacies around here have it or can get it. It took a week for my pharmacist to tell me that. I was super excited when I read about the Costco Authorized Generics program. I called our local Costo pharmacist to confirm they have the Patriot one. She said they only carry Northstar brand and had no idea what I was talking about with the Authorized Generics program. She tried to convince me that the Northstar generic they have is approved to be the same. That was getting me nowhere, so I am grateful for the Concerta Savings Program Card for now. I am thinking that if all goes well with filling it at the Walmart near me and using the Savings Program, I can hopefully get it for $150 the next few months (after $4 the first month, which would be awesome). That will give me time to try to track down someone who carries the Patriot version. But this has been a nightmare. It was so validating to come to your website and see that we are not alone in the struggle. Thank you!
Hi Steph,
Glad you found the ADHD Roller Coaster!
Sad but true, it seems most pharmacists have been brainwashed into believing that generics are “exactly the same” as brand. Sometimes, it doesn’t matter — and generics present a significant savings. But sometimes ….. many times…especially with psychiatric medications and other uses where dosing is precise…it matters a LOT.
I’m glad you’ve got a plan now. good luck!
g
Hi.
Ugh.! I have had the patriot pharmaceuticals special ordered for me at Walgreens for months.
Now they want to give me cambers, I have not accepted it yet. I put a call into Patriot to get some help. I am waiting for a call back. It takes 24-48 business hours. I am in Southern CA so I cant use the Concerta Card. My two options going forward are the Costco program or getting the doctor to do a prior authorization for the brand. Blue Shield told me that they would only hassle me about once a year to renew it. I will update once a get a call back from Patriot. Thank you for this website.
Good luck, Tina.
I imagine this flood of generics has wholly destabilized the market. The Big Generic companies are probably competing fiercely for market share.
Sure wish that patents lasted longer on some medications.
As it is, we’ve been lucky to get the authorized-generic Concerta for as long as we have.
g
Don’t give up. I had been getting the Patriot Pharmaceuticals special ordered for us at a Walgreens near us that we use on a regular basis. They now say their supplier no longer carries it. I pressed them several times but they stuck to their position that the supplier doesn’t carry it. So I called a different Walgreens (also close by) and the pharmacist said they can order it. So, we just switched the prescription to another Walgreens willing to place the special order. I suggest you call other Walgreens in your area to find one willing to place the order.
P.S. I also called a CVS pharmacist near us. While they said their supplier did not carry the Patriot Pharmaceuticals generic, they suggested calling other CVS pharmacies in the area because each CVS store used different suppliers. Not sure if this is the same structure for Walgreens but I’d just call around until you find a pharmacy willing to place the order.
Hi Vincent,
I’m glad persistence paid off.
The thing is, Walgreen’s MUST be losing $$$ on this.
We do all our drugstore shopping there, as a thank you. 🙂
g
I moved to Florida five months ago. I called around and Walmart Pharmacy was the only place that said they could order Patriot brand for me. I had my doctor write the NDC on the order. It took about two days to get the order. They charged around $125 and I used my GoodRx card and they adjusted the price to $68. They kept the coupon associated with it and every month I go to get that price without it having to get adjusted and every month it’s the right thing with Alza on it. I don’t know if all Walmart Pharmacies run so smoothly, but I’ve been very happy.
Good for you, Susan!
I hope your good fortune holds.
g
Same here. My luck ran out at Walgreens.
Gina, thank you SO MUCH for your continued help and information. I’ve been following this for years, and your contributions are invaluable.
Thank you, Kelly.
g
Hi Gina (and others on this list),
FYI. It appears that Walgreens is no longer an authorized distributor of Patriot Pharmaceuticals authorized generic Concerta according to the Patriot website. Not sure if their contract is being renegotiated or if this is a permanent change.
https://www.patriotpharmaceuticals.com/authorized.html
We have been getting the authorized generic from Walgreens for months. This month (January 2021) they called to inform us the Patriot generic is no longer available and their system does not indicate when (or if) it will be in stock.
For anyone using Walgreens, they can check the authorized distributor list to find an alternate pharmacy. Looks like we can switch to CVS as an alternate pharmacy. We are in CA so we can not use the Jansen discount card.
V
Hi Vincent,
Thanks for joining the collective here. 🙂
Some points:
1.
I think I’ve cautioned elsewhere (in the post or among these comments) to disregard patriot’s published list. It might not be accurate. In fact, I’m not sure that Walgreen’s was ever on that list.
It might be helpful as a starting point, but it’s not reliable.
2.
This authorized generic is never “in stock” — and precise wording matters. Instead, ask that an “exception process” be ordered for you.
3.
Call Patriot when you encounter these problems. Pharmacy business relationships are constantly shifting, so it’s best to go to the source.
I am in California and successfully received my husband’s Concerta AG order last week.
It might be that you encountered a pharmacy clerk who does not know the ropes — or that the MD did not correctly specify or you didn’t ask for an “exception process.” Many possibilities.
I’d try again. Or, try a Rite-Aid if that’s convenient.
good luck!
g
Hi Vincent, From what I’ve read on Gina’s site and what I’ve experienced personally at our Walgreen’s in Virginia, they do not “stock” Patriot’s version of Concerta, but mine has ordered it for me/my daughter, every month for the past 12 months. As Gina has mentioned, you have to make sure your provider uses the specific NDC code for Patriot. And, I’ve learned recently, also include Patriot name on the script. The NDC code should be enough on it’s own, but the Patriot name should ensure that’s the only way they fill it. I would recommend dropping off the script in person so you can speak to someone in the pharmacy department acknowledging the special order/request for Patriot. Good luck to you!
Thanks, Paula.
I’d also recommend asking the pharmacy clerk to flag your account. That way, it comes up when the script comes in….to know “Patriot” only.
Some will do that. Some won’t.
g
Thanks for all the advice. To reiterate, our medical professional does place the order specifying only Patriot Pharmaceuticals generic is to be used to fill the prescription. And, Walgreens has special ordered the Patriot Pharmaceuticals generic for us in the past. What they are saying now is they cannot special order it. We’ll press them again with this month’s prescription. If they continue to say it cannot be ordered, we’ll go somewhere else.
Thanks for clarifying, Vincent. Wasn’t sure if you had all those niggling details. 🙂
Sometimes it really does boil down to the particular clerk.
It’s a mystery how these things work — that our Bay Area Walgreen’s can order it but your SoCal Walgreen’s can’t.
You could try calling Patriot. Sometimes the person answers and is responsive. Sometimes now. Maybe COVID….
g
Hi.
AmeriSourcebergen is the wholesaler for walgreens. They are on the list. I am also having trouble getting patriot from walgreens. Never had trouble before as they special ordered it for me. I live in Southern california and cant use the drug card. I put a call into patriot. Waiting for a response right now. My two options are to use costco in the meantime and get my sons doctor to do a prior authorization for brand, supposedly Blue Shield will only hassle me once a year to have it renewed. Will update when I get a response
Gina, please know what a true service you are providing to so many people!
The blogs and other information on your site are so helpful and so appreciated! Thank you!!
I wanted to share what happened at Walgreens today when I was picking up my daughter’s prescription. After discovering your site last year, we’ve been able to get Walgreens to special order the Patriot brand of methylphenidate ER every month for the last 10 months. At pick up today, when I asked to confirm the brand was Patriot, the pharmacy tech replied, “we don’t carry Patriot. This is from Camber.”
After conferring with a pharmacist, I was told they only had half of the number of pills needed my daughters prescription in the Patriot brand. She told me they were not allowed to order anymore as they had already met their maximum allowable order amount (overall as a pharmacy) because it is a controlled substance. I live in Virginia. Not sure if this is a Virginia state policy or federal policy. My husband experienced the same type of situation with his Adderall prescription, at another nearby pharmacy, Kroger.
It seems ridiculous to put an ordering cap on pharmacies who serve a varying number of people and type of prescriptions every month. The tech offered to check nearby Walgreens to see if they may have any of the Patriot generic in stock. She said when she typed in the specific NDC number on the prescription it came up as Camber, which may explain why they would fill a prescription with a specific NDC code with a different manufacturer.
Is it possible that Walgreens has it entered that way in their system? Aren’t the NDC codes specific to the manufacturer? It seems wrong for Walgreens to make that kind of replacement in the inventory search part of their system without some type of note.
She ended up calling the stores and asking for Patriot verbally. None had it, as I expected. The main thing I want to share is that if indeed, Walgreens has a different drug manufacturer showing up in their system when a pharmacist enters the NDC code for Patriot, in addition to the NDC code we may have to insist doctors also write Patriot brand on the script.
Hi Paula,
thank you for letting me know my work has been helpful to you!
That sounds a little dodgy….that the store had met its quota AND that they allegedly enter the Patriot NDC and it comes up Camber. Hmmmmmm.
Another strange thing: Why would they have Patriot in stock if they don’t carry it? Because Walgreen’s doesn’t carry it; it’s available only when ordered as an “exception process.” Those are the magic words.
If that pharmacy tech called other stores to see if they had Patriot generic in stock, it might be that person doesn’t understand much on this topic.
I definitely would advise the prescriber specifying “Patriot” and the NDC number if there’s room. Even just “Patriot” should be enough.
And remember…..Concerta is offering a savings card. Might be worth checking out. https://Concerta.net
I don’t work for Janssen! Never taken a cent from any pharma company. Just offering this as a readers service.
good luck!
g
Gina, I cannot thank you enough for this post and the difference it has made in my medication for my late-to-learn ADHD.
I used Walgreens for nearly a year before I discovered GoodRX. The savings are substantial. It took some work to find out which pharmacies could/would get the specific NDCs in stock under GoodRX’s participating pharmacies. And I now have to go to two different pharmacies since neither can provide both of the different doses I require (in my case 45 mg: 27 + 18 daily).
I have had to remind two different psycho-pharmacologists with every prescription they write and double check the prescriptions filled each time for the correct NDCs when I pick them up at a pharmacy. An additional benefit: I don’t have to go through the impossible pre-approval process with my insurer to get the medication I require. All of this just part of my learning curve with medication, doctors, pharmacists, and insurers.
I doubt if I could have figured this all out and persisted in my self-advocacy without authorized-generic Concerta and your help.
Best regards, David
Dear David,
Thanks so much for taking the time to write your comment. I deeply appreciate it.
I won’t lie: This is hard and uncompensated work.
The only reason I can motivate myself to invest the effort is knowing that it truly makes a difference in readers’ lives.
It’s crazy, that we have to know more than the prescribers and the pharmacists! But it’s a reality.
Also, FYI: Perhaps to compete with the clown-car of generics, Janssen has started a savings program for brand Concerta. Maybe if push comes to shove again, you might use it.
It’s pretty easy. Just fill in name/contact and download the PDF.
https://Concerta.net
Continued good luck!
g
Hi Gina. Thank you so much for this information. My husband and son both take concerta and our lives have definitely been a roller coaster and a game of cat and mouse with this medication. Once we figure out the rules, they change.
Here’s our newest change: filled my son’s prescription. asked for patriot manufacturer – what our Kinney Drugs pharmacy prefers to get the correct medication. they issued 3 pills, alza,as they were “out” and needed to order (which happens every single time we fill this script). went today to pick up the balance of the prescription, got home and the pills looked off. checked, and the manufacturer is Northstar RX. There is a number on the pill, 215, which resembles a generic you talk about above called camber.
I am so disappointed and tired of this game. the doc said patriot, the first 3 of a 90 day fill were patriot “alza”, and now i have a bottle of 87 pills by northstar. does not appear to be the patented delivery system. can you comment on northstar? have you heard about any new changes on this? thanks for your help
Hi Heidi,
Sorry you didn’t catch my warnings earlier — to always check before paying for the Rx.
I believe that pharmacy pulled one over on you.
Depending on how exactly your doc specified Patriot (by the way, it’s the distributor, not the manufacturer….that’s an important point), you might be able to go back and say, “you gave me the wrong rx.”
It’s very tricky, given that this is a Schedule II substance. I’m not sure what your legal recourse would be, and it probably varies by state.
None of the generics use the Alza technology, so none act exactly like Concerta.
But you might want to try it, if you have no other options, and see how it goes. But be prepared. 🙂
In future, you could ask the pharmacy to specify in your “file” that you want only the authorized-generic distributed by Patriot. They should flag this so that they can be ready to order when your next scrip comes in.
good luck!
g
First, I want to give you a huge thank you for all of the research and advice you have been giving people on this topic.
Second,
I have BCBS, and both my kids have been through the generic rollercoaster finding the right medication, until last fall, when we found Concerta.
My insurance paid for it, with my standard deductible.
In February, we tried to refill both scrips and were told our copay was now over $400, per kid. Lucky us, January was their mistake, and we should have paid $400 then.
Went through the appeals process, and were approved, which brought our copay down to $125, per kid. That’s when I stumbled across this website.
Thank goodness.
A long uphill struggle with Walgreens to get them to consistently get the Patriot generic in, still struggling, and we are back down to our standard copay.
Last month, we received another letter from BCBS stating that they will no longer cover Concerta brand, at all. No appeals process, nothing. Don’t even ask.
It just baffles me that some BCBS branches will only pay for brand Concerta, where mine won’t pay a penny towards it.
So, we are doubly glad to have found your website.
Thank you, so much.
Hi B,
I’m glad you found my blog. It will save you a lot of money and consternation, I bet.
As to your question: “some BCBS branches will only pay for brand Concerta, where mine won’t pay a penny towards it.”
It’s not a question of branches. It’s a question of your policy’s terms.
Even within BCBS of California, there are MANY options for employers to choose from and offer as choices to their employees — and then there are the individual policies.
It all depends on how much you/the employer are willing to pay for your policy, the deductible options you choose, and even how policies will differ in terms of pharmacy coverage. Some have their own deductibles. The price for brand/formulary and generics are set.
It’s up to the consumer and/or the employer.
g
Thank you SO MUCH for compiling all this in such a clear and detailed manner!
Quick update, we were using RiteAid to fill these prescriptions and last month they switched it on us to the TriGen lab version and still call it ‘authorized generic’. We’ve now gone a month without it and will have it filled next time at a local pharmacy that we located who carries the true version.
Hi Dana,
I’m glad you found my blog — and you’re welcome!
That’s a huge bummer.
The pharmacy is WRONG. But they aren’t the only ones. I’ve spoken with high-level pharmacists at, for example, the big home-delivery pharmacies — and they don’t even know what is an authorized generic.
Some have also told me that the Concerta generics that have an osmostic release system are the same as Concerta. No, Concert’a OROS patented technology is a cut above.
But to be clear: You’re unlikely to find a pharmacy who CARRIES the authorized generic. You’re better off with Rite-Aid and Walgreen’s (which do have an agreement with Patriot) and asking them to order it. (You might have to use the term “order as an exception”.)
You might want to re-read the first few paragraphs of the post. It lays it out.
Good luck!
g
I experienced the same thing at my local Rite Aid. I switched to Rite Aid from Walgreens in March after Walgreens was unable to order the authorized generic. A call to Patriot Pharmaceuticals directed me to Rite Aid who we’re stocking the Patriot authorized generic. As of December 2020 the pharmacist told me they could no longer order specific manufacturers and were only stocking Trigen. I don’t know if this is a local/regional change or chain wide. Can anyone confirm?
HI Lauren,
My attempts to confirm have been unsuccessful. Getting answers from national chains on such a specific detail is nigh impossible.
I will try Patriot again. Did you ask Patriot why the change with Walgreen’s?
g
Walgreens was willing to order it, but there was a delay in getting it back in March as my state went into lockdown. At that time, Patriot confirmed that the local Rite Aid was actually stocking their product, not just special ordering it, so I filled there instead of Walgreens. I’m waiting for a return call from Patriot and will try to get more information. Rite Aid is still listed as a distributor on Patriot’s website, but when I spoke to the pharmacist she said they had recently received the Trigen for the first time and wouldn’t be able to special order any other stimulants. I don’t know if this is accurate but I’ll report back if I learn more.
Hi Lauren,
Yes, definitely, COVID has added a huge wrench to the works.
But also, it’s important for folks to remember…..it’s been remarkable for us to have enjoyed the authorized-generic for this many years. And still now.
It’s a cut-throat world out there in pharmacy land. ADHD is a big “market” and the Concerta “market” is prized. Hence by last count 10 generic makers have rushed in to exploit the “market” (aka, human individuals).
As I mentioned in the updated post, Janssen is also offering a savings program now for Concerta. So it might be worth looking into that, for the brand.
g
Hi Gina, a few updates – I spoke with a rep from Patriot who confirmed the exception process is still in place for Rite Aid & Walgreens as of 12/31/20. She promised to call the Rite Aid district manager to request “retraining” of local Rite Aid staff re. exception process. I asked my doctor to send the new prescription to Walgreens instead of Rite Aid due to numerous errors at Rite Aid. I’m still waiting on 1/12/21 to get the scrip filled that my Dr. submitted electronically to Walgreens on 12/31/20. Some of this is holiday delays, but there were a few days back & forth for Walgreens to confirm my report that I couldn’t use the Trigen filled at Rite Aid, then with BCBS to approve an override for a new fill [they have been wonderful and so helpful – called Walgreens directly and spoke to pharmacist while I waited]. Finally with all confirmations & approvals in place the Walgreens pharmacist tried to order Patriot and the order was rejected. She then had to learn about the exception process (said she had never heard of it) and has now sent a request to Walgreens district manager to approve an exception. I will call Patriot again to request they follow up with Walgreens. I report this to encourage others to stick with it, ask a lot of questions, be vigilant and prepare to advocate for yourself every step.
In other news, Costco just announced a “new” version of its member pharmacy program with featured agreements on authorized generics. I called Costco pharmacy several weeks ago to ask if they could/would order Patriot. The said “it is not our preferred” manufacturer/brand – No we can’t order it. But they just launched a new marketing campaign on authorized generics, including Patriot Methylphenidate ER 18, 27, 36 & 54 mg. Prices for a 30 day fill of various strength are listed on the Costco website as available to Costco members ranging from $95 to $117 for a 30 day supply. This is retail with no insurance reimbursement. I’m very curious if this new agreement has any effect on availability of product and willingness/ability of Rite Aid & Walgreens to order it. I have no evidence to this effect, just curious. I’m also curious as to whether Costco would now fill a scrip with my BCBS coverage or refuse unless I paid their retail price, or whether BCBS would offer reimbursement if I paid retail at Costco and submitted a claim. Costco participates with my plan (or did) so I’m not sure if they can refuse a fill because I have coverage. I’ll update if I learn more that might be useful to other readers. Thank you again SO much for all you do, your work is so important and very appreciated!
Dear Lauren,
Thanks so very much for sharing your report with us!
This is definitely a fast-moving target. This clown car of crappy generics has “disrupted” the “Concerta market” enormously. Janssen even launched a savings program for Concerta — the first that I know of (except maybe 20 years ago).
I’m sure the deals will continue to change and evolve. So it’s good to stay on top of things, as you have.
good luck!
g
@Bob, thank you for your post. So insightful and rich with info! You, sir, are doing the lord’s work!
Hi!
I found this article and sent it to my prescriber, who modified my prescription to specify Patriot. Walgreens did fill the scrip, but they had to order it and don’t normally stock it. However, the pharmacist insists that the other generics are also “osmotic release” and is trying to pressure me into using their stock generics because she basically doesn’t want to order something just for me in case my dose changes or I stop going to that pharmacy and she has product left over. She said that all the Concerta generics in her stock were osmotic release and were separate from the “extended release” type. I received Actavis brand before discovering this post and talking to my prescriber.
Is “osmotic release” different from “OSOR”?
Can you point me to any resources that describe specifically how the true generic functions differently? I feel like I may have to “prove” my case at some point.
Thank you for your work. I was recently diagnosed and this is my first foray into the world of prescriptions and it’s been a bit overwhelming.
Caitlin
Hi Caitlin,
First, I removed your last name and deleted that message.
Second, congratulations! Only recently diagnosed and you’ve found my post and thus known to be aware. Many go years….or never… so, good for you.
Yes, I explain that issue in the blog post—that the pharmacy typically has to order the Patriot authorized-generic and it typically must be ordered as an “exception.” (It’s often important to use that word.)
I know of no pharmacy that has it in stock. Most pharmacies keep little stimulant in stock, anyway. Fears of theft, I hear. They order stimulant medications——but from their regular supplier. Patriot might not be part of their regular supply chain.
Some pharmacies are more willing than others to order the authorized-generic as an “exception”. My last conversation with Patriot indicates those would be Walgreen’s and Rite-Aid.
In future, if you have trouble, I would recommend also using the NDC numbers in the blog post. “Patriot” might not be enough for most pharmacists. Both would be best, but there’s only a tiny bit of room there on the prescription. If Patriot worked for you, though, probably best to stick with that.
To your question about “osmotic release,”—in short, that pharmacist is wrong. And she’s not the only pharmacist that doesn’t understand the difference between Alza’s patented OROS osmotic technology and regular old osmotic release. I always thought pharmacists were smarter, more educated than that. Guess I was wrong! Especially the chain-store pharmacies. But I had a “chief pharmacist” at CVS Caremark try to tell me the same thing. I’m sure he thought I was crazy. lol
Here’s what I wrote in this post:
In the past, the prescriber could specify on the prescription: “authorized generic Concerta/Watson, etc.”—or simply OROS.
OROS is Concerta’s patented extended-release technology, owned by a company called Alza and used by Janssen in making Concerta. (The osmotic-controlled release oral delivery system, OROS, takes the form of a rigid tablet with a semi-permeable outer membrane and one or more small laser-drilled holes in it.)
Since then, for a variety of reasons, it’s gotten more challenging. Pharmacies are consolidating and are less “consumer-oriented.” Some of the new generics use other osmotic technology. As a result, some pharmacists mistake “osmotic technology” for the proprietary OROS from Alza.
That pharmacist you spoke with is also wrong in that all the Concerta generics use regular old osmotic release. To my knowledge, only Trigen’s generic does. Camber’s generic cynically replicates the “look” of the Concerta pill but any similarity ends there.
As for other resources to offer you, I can’t think of any. I have pretty much been the exclusive investigator/reporter on this topic since 2014—and I’ve offered more details than any other outlet (most of which, if they do write about this, lift from my work) because I know how important it is.
But maybe this will be helpful: the FDA notice when it downgraded the first two Concerta generics. I wrote about it at this post: Consumer Q&A on Generic Concerta.
None of the generic Concerta products since then is any better. They are all cynically exploiting loopholes for generic drugs.
Here’s the relevant excerpt:
Q 3. What exactly did the FDA say, in downgrading the two true generics from Mallinckrodt and Kudco?
To summarize, the FDA said the true generics might deliver the medication at a slower rate than the brand Concerta. Therefore, this can affect the effectiveness of the medication.
Specifically, the FDA said, in part:
“An analysis of adverse event reports, an internal FDA re-examination of previously submitted data, and FDA laboratory tests of products manufactured by Mallinckrodt and Kudco have raised concerns that the products may not produce the same therapeutic benefits for some patients as the brand-name product, Concerta, manufactured by Janssen Pharmaceuticals, Inc.
“Methylphenidate hydrochloride extended-release products approved as generics for Concerta are intended to release the drug in the body over a period of 10 to 12 hours. This should allow for a single-dose product that is consistent with the effect of a three times per day dose of immediate-release methylphenidate hydrochloride.
“In some individuals, the Mallinckrodt and Kudco products may deliver drug in the body at a slower rate during the 7- to 12-hour range. The diminished release rate may result in patients not having the desired effect.
“As a result, the FDA has changed the therapeutic equivalence (TE) rating for the Mallinckrodt and Kudco products from AB to BX. This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta.”
You can download and print the FDA safety report here
The snag is this: The companies had 6 months to show that their generic Concerta products worked as well as Concerta. They didn’t. They couldn’t. Because they don’t.
Instead, one of them dragged out the situation with lawsuits, trying to sue the FDA. Grandstanding all over social media—and I responded with the facts!. 🙂
But they WERE downgraded, meaning that they could not be automatically substituted for Concerta as a generic if the doctor or insurance company specified generic.
THEN…..we got a new White House administration that appointed a new FDA chief. That chief overrode FDA scientist concerns about generics of these “novel delivery systems” — such as Concerta’s OROS technology. He pushed through dozens of generics, including about TEN Concerta generics, before going back to the rightwing Heritage Foundation.
The damage has been done now. I cannot imagine the FDA going back now to those 10 companies and saying, “Nope, you have to withdraw it.” That would take enormous political will and public support. And most of the public fails to understand that even though many generics are fine — and cheaper — others might truly be risking their lives.
It took an enormous effort for me to report on this issue, open the FDA MedWatch complaint, and follow up with encouraging readers to register their complaints. A Kansas City pediatrician named Kristen Stuppy also worked on this effort.
In the meantime, just try to get that authorized generic from Patriot (a subsidiary of Janssen, Concerta’s manufacturer). I’ve also seen that Janssen is making some moves to compete with the clown car of Concerta generics, making exclusive deals with some pharmacies.
This is a lot to throw at you, but you seem a person who wants and appreciates the details. So there ya go!
Good luck!
Gina
P.S. In this recent Facebook post, I explained the basic difference between the FDA approval process for brand drugs and for generics.
https://www.facebook.com/GinaPeraAuthor/posts/3530451943700310
Tacking onto Gina’s reply here, I have a theory about why the pharmacist was so opposed to ordering Patriot specifically.
My pharmacist told me they would actually *lose money* on the authorized generic. They would’ve done it for me because I’m a loyal customer and they like me (it’s an indie, I’ve never met a chain with that kind of attitude). I chose not to pursue it because I felt guilty doing something that would lose them around $100, IIRC, on every Rx they filled for me.
I could make that choice because I have insurance that will, after a great deal of haggling, cover the brand Concerta. I pay $45 for a month of brand Concerta, vs. $10 if I got the generic. It’s annoying but not a dealbreaker for our current situation.
TL;DR, you might (ironically) have an *easier* time getting the pharmacy to order brand for you. And that ease-of-ordering is worth something too, even if it means a slightly higher copay. The authorized generic doesn’t help if you can’t get it, and these chain pharmacies seem to have no limit to their excuses about why the order will take prohibitively long to come in, blah blah blah.
My doc just writes “brand necessary” on my script.
Word to the wise on that though, the insurance company can still refuse to pay. Every year now I have to go through a prior authorization process, where my doctor has to call and fight with the insurance company and tell them to let me have the brand name. This year it caught me off guard and I ended up paying cash price ($400) for my Rx for two months in a row before it got sorted. It’s reimbursable after the prior auth goes through but still. Ugh.
But! After all the red tape I am able to get the brand, and insurance does cover it, and the pharmacy seems much happier to order brand than the Patriot authorized generic.
ADHD meds: the LEAST ADHD-friendly process I’ve ever encountered.
Hi Jaclyn,
Yes, it’s not just a theory. It’s a reality.
Pharmacies DEFINITELY make more money on the cheap generics. And they can LOSE money on the more expensive ones.
You’ll find I’ve mentioned that many times in this sea of words on this issue. (So many details! All of them important!).
And yes, that can be a good strategy — at least checking on the brand price.
Things are always in flux. I’m seeing signs that Janssen is getting more competitive. Some BCBS plans are actually requiring that customers accept brand Concerta.
Depends on the plan. Depends on the day. 🙂
Thanks for weighing in with that important tip!
g
My child’s BCBS WAS only paying for brand Concerta but now that has changed as the company has deemed there are available generic equivalents. We will need to make new choices in January.
We also had an issue with Walgreens filling her prescription recently (October) when it suddenly was filled with a generic – no notification to us when we picked it up that it was now generic and we stopped checking at pick up because it was always brand. I IMMEDIATELY complained to the pharmacist and was told it was equivalent because the FDA said so. My child’s doctor was sympathetic and called pharmacy but they “couldn’t take it back.” I complained to Walgreens corporate and used the term “compromising patient care” by changing the brand with a generic without telling the customer. THAT got a response and after fingerpointing by the pharmacy to the doctors, we got a real refill two weeks into the month (and noticeable difference in behavior in my child that soon). (As an aside, in my state, pharmacists cannot swap out brand/generics for epilepsy but can for anything else.)
Me to Pharmacist: Yes a brand CAN cost more, but you NEEDED to tell me and give me the choice whether I wanted to pay. (Like a prior writer, I would pay $45 even $100 for a brand prescription).
The WEEK after that struggle ended, we got the notification that BCBS has deemed the generics are equivalent, so be careful if you have BCBS. Ours allows brand at a $10 co pay but January all will change. Apparently, there is a generic equivalent that is the same (said with dripping sarcasm). My child lasted two weeks and it was horrid.
Hi Monica,
What a mess this is. So many details to track and hoops to jump through.
Could it be that you were getting not the “brand” but the authorized-generic until now? (That is the brand sold as a generic.)
That might explain the switch to another generic.
I also wonder if your prescriber failed to specify “brand only” or the NDC number for the authorized generic.
At any rate, pharmacies don’t have to tell you when they switch generic manufacturers. They switch all the time. They don’t have to tell you. Actually, that would be pretty much impossible.
Now there are TEN generics for Concerta — and that means you could get any one of them. It’s not up to the insurer to decide what generic is bioequivalent or not; that is done by the FDA.
But if the prescriber wrote “brand only” or the NDC # for the authorized generic, the pharmacist is obliged to do that. You might have to ask, though, for an “exception.”
good luck,
g
In which case, the pharmacy will automatically substitute any Concerta generic.
Additional signals to keep an ear out for… When I first had to make the change from brand to generic (due to insurance changes) and went to pick up the prescription, when the Pharmacist or tech started to tell me that the pills will look a little different, I stopped them right there and refused it and asked to have it re-filled. When the pharmacy gave me the run-around about getting the Authorized generic, I called Patriot and they helped me find another pharmacy. There were a few hiccups, but now, when they ask if I have any questions, I have them verify that the pills are printed with Alza and the dose. I had the pharmacy put a note in their system to only fill with the Patriot Authorized Generic. It took about 3 re-fills for them to finally start reading that note and this last fill, they called me after the received the prescription and verified that we would be ok waiting a day for them to get the right meds in stock. I have learned to keep about a week’s cushion available between refills in case they don’t have it in stock. Best of luck to everyone!
Thanks, Kathy. That’s exactly what I recommend. I’m glad you are taking that step to save so much frustration!
g
Hi Gina,
First, thanks for all the great info! You are one of the few educated and reliable sources on the web for Concerta generics. I truly appreciate your efforts.
Gina wrote:
“That pharmacist you spoke with is also wrong in that all the Concerta generics use regular old osmotic release. To my knowledge, only Trigen’s generic does. Camber’s generic cynically replicates the “look” of the Concerta pill but any similarity ends there.”
I have been researching Camber and found this in the Camber package insert (it’s on their website). Sorry it’s lengthy:
“11.1 System Components and Performance
Methylphenidate hydrochloride extended-release tablets uses osmotic pressure to deliver methylphenidate HCl at a controlled rate. The system, which resembles a conventional tablet in appearance, comprises an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat. The trilayer core is composed of two drug layers containing the drug and excipients, and a push layer containing osmotically active components. There is a precision-laser drilled orifice on the drug-layer end of the tablet. In an aqueous environment, such as the gastrointestinal tract, the drug overcoat dissolves within one hour, providing an initial dose of methylphenidate. Water permeates through the membrane into the tablet core. As the osmotically active polymer excipients expand, methylphenidate is released through the orifice. The membrane controls the rate at which water enters the tablet core, which in turn controls drug delivery. Furthermore, the drug release rate from the system increases with time over a period of 6 to 7 hours due to the drug-concentration gradient incorporated into the two drug layers of methylphenidate hydrochloride extended-release tablets. The biologically inert components of the tablet remain intact during gastrointestinal transit and are eliminated in the stool as a tablet shell along with insoluble core components. It is possible that methylphenidate hydrochloride extended-release tablets may be visible on abdominal x-rays under certain circumstances, especially when digital enhancing techniques are utilized.”
It appears that Camber (and I assume Northstar because they both come from Ascent) has an osmotic method of delivery as well as Trigen. Of course, it’s not OROS! But it might be worth a shot.
I have tried several classes of ADHD meds and I seem to do best on methylphenidate ER. I tested 10 days of Concerta 36 … smooth as silk. All go, no side effects. I’m presently trying Trigen 36 … doesn’t suck but it isn’t as smooth as Concerta. The plan is to try the Camber product and then try Concerta again … and then decide. If it’s Concerta, I’ll go for the Patriot.
I live in the central Rockies near Glenwood Springs, CO. Only independent pharmacies will order the Patriot product. I have to buy the whole bottle of 100 and it’s $1000.00. That’s the motivation for trying the promising generics with some form of osmotic release.
Ironically, I worked on the marketing for Concerta back in the day. Worked on the Alza merger with J&J. Janssen, Patriot and Alza are all Johnson & Johnson companies. Hence the bottleneck on the OROS delivery system. As near as I can figure, the OROS patent, originally filed around 2003, is “abandoned”, according to Google Patents. Hopefully, someone will come close to mimicking its unique “ascending” delivery of the Methylphenidate ER. Camber/Ascent may be the closest because it is also the newest. It was released about a year ago.
YMMV. Thanks Gina!
Bob
Hi Bob,
Thanks for chasing down the info on Camber. I’m focusing intensively on my online training (people need it now more than ever!) and don’t have time to follow in excruciating detail the continuing saga.
From what I understand, Alza’s OROS is technically superior — or at least it’s been for a while. And I wonder about generic companies being willing to achieve something close to Concerta’s release profile with a cheaper osmotic-release system.
FYI — Disadvantages
A highly effective novel drug delivery system will exhibit some negative aspects as well, of which the leading difficulties include the increased cost of such systems and the need for the meticulous design of the coating film to avoid any defects which would lead to the escape of the drug in uncontrolled doses. Also, some types require precise hole size in the membrane to achieve the desired effect and the drug release may be somewhat affected by food in the gut.
https://www.news-medical.net/health/Osmotic-Pressure-Controlled-Drug-Delivery-Systems.aspx
My instincts are to avoid any company that tries to fool consumers with such a visually similar tablet—aka, Camber. It just feels sneaky, and I don’t like sneaky. 🙂
Still, I’ll be interested to learn how it works for you.
But $1,000!!!! Have you checked Janssen’s new Concerta savings program? https://concerta.net/
Here are the basic guidelines:
Program description:
Eligible patients using commercial or private insurance can save on out-of-pocket costs for CONCERTA®. Eligible patients pay an initial $4 per fill at participating retail pharmacies and receive up to $150 off their out-of-pocket prescription costs, with a maximum program benefit of $1,800 or 12 fills per calendar year, whichever comes first. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. Offer not valid in CA and MA. There is no income requirement. See program requirements below.
Program Requirements:
You may be eligible for the CONCERTA® Savings Program if you are age 6 to 65 and currently use private or commercial health insurance for CONCERTA®.
Thanks for your comment!
g
Gina,
“Thanks for chasing down the info on Camber. I’m focusing intensively on my online training (people need it now more than ever!)”
… and thanks for keeping up the good fight!
“My instincts are to avoid any company that tries to fool consumers with such a visually similar tablet—aka, Camber. It just feels sneaky, and I don’t like sneaky. ”
Or … because OROS may be off-patent … they may have copied their design.
“Still, I’ll be interested to learn how it works for you.”
Me too! I’ll report back.
“Have you checked Janssen’s new Concerta savings program?”
I am on Medicare with a PDP from Humana and I’m 67yo. I’m not eligible. Bummer.
But Thanks!
Bob
Darn! Let’s keep our fingers crossed for the Camber.
g
For once a good news post… It was finally time to fill my son’s Concerta (we are able to do 90 days). We have a BCBS plan that requires us to us the Branded product (as of this year), so I was excited to try that savings program on the next refill. The Tech at CVS that took the prescription persisted when trying to enter the information and it worked!! I haven’t picked it up yet, but he indicated that my 90 day refill will be… wait for it … $4! Hurrah! I feel like I’m getting something back for all the money I’ve spent over time. Know crossing my fingers that in the new year when the insurance turns over and I have to meet my deductible again, it’ll cover it then as well. Wouldn’t that be something? 🙂
Deborah!!! It’s like you won the lottery! 🙂
That’s so interesting….that your plan requires you to use the BRANDED product.
And you can get refills at your CVS stores — not CVS-Caremark? Wow.
Congratulations!!
g
Yes, when our insurance year rolled over in 2020 our plan switched to *requiring* the Branded product for Concerta. That’s the only thing we use where that is the case. Have no insight as to why. It just is. My son has been on Concerta for at least 6 years (ever since he learned to swallow a pill vs using liquid Methylphenidate which was a huge PITA to find, but that’s another story).
Yes. The way our insurance is written, the best price is obtained by going to CVS *or* using the CVS Caremark mail in service. We *must* do 90 day refills on maintenance meds (cost wise, it’s 90 for 60 as far as price). My PCP refuses to include refills on meds to force me to go in every three months, so I just pick them up in person. Plus, nothing is in sync, so there is something to pick up constantly (two adults, two kids and everyone has something). No idea how you’d get things to be in sync when insurance wouldn’t pay for short supply to make that happen. I just ignore the million calls and texts I get from CVS until I have multiple things to pick up at once. Plus, it’s literally about a mile and a half from the house and it’s a 24 hr location.
And so days it comes with bonuses… today I got 2 bags of M&Ms with my meds for $0 ($5 in Extra Care Bucks and the candy was on 2/$5 promo). I never say no to “free” 🙂
Wow, Deborah. It’s your lucky year! No, wait…… lol
I love to hear how easy it is for you now.
We also have BCBS (California), but plans are all so different. We could not get the Concerta brand or authorized-generic via home-delivery. Or storefront. We now get monthly at Walgreen’s for $10.
At least the doc now has electronic prescribing. For 20 years, I’ve had to send him an SASE with the requests and wait for it in the mail. The refill times never coincided with the visit times.
Shew.
g
Most medications used to treat ADHD, including the various types of methylphenidate (such as Ritalin and Concerta) and amphetamine (such as Adderall), are considered controlled substances (stimulants). Concerta is a Schedule II controlled substance and can be habit-forming, as users may develop a tolerance to the drug over time.
There are many regulations on controlled substances both federal and state. My doctor told me I must be seen in the office within every 90 days. I asked for three thirty-day scripts when moving and was denied. I had to wait for the doctor’s office to electronically send the Rx and then the pharmacy had to wait for a call back because the Rx was out-of-state. (The only 90-day supply I could get is crappy Trigen because that’s all CVS Caremark allows on my plan.) So I’m stuck asking every 30 days and waiting for the slow office manager to send in the Rx and return the pharmacy’s phone check . It’s very frustrating.
I’m planning on writing to local and federal legislators to express my opinion that it shouldn’t be this difficult to get my ADHD medication.
Hi Susan,
Yes, it’s so onerous jumping through all these hoops.
I wonder if it would work better with your doctor’s office to send an SASE. That’s what I’ve always done. As a reminder and means of expediting.
You could just address several envelopes at once and have them at the ready. To cut down on writing, I use address labels as the “to” on the SASE.
g
Thank-you for your suggestion but the assistant at my doctor’s office says the pharmacy does not like scripts for controlled substances, especially those from out-of-state. That’s what I’m saying – what works for one person doesn’t work for another. It doesn’t seem fair.
Sorry, Susan, I misunderstood.
I thought you had office visits every 90 days but had to pick up a 30-day each month in between.
Prescribers should have systems in place. Some do.
g
Hi,
Just wanted to leave a note for posterity that, at least as of mid-2020, Giant Eagle in Western PA provides the authorized generic Concerta from Patriot! I overpaid for *months* from CVS for the name brand, not knowing that Giant Eagle right down the block had the authorized generic.
Dear Jay,
Thanks for the “note for posterity.” Haha.
Better late than never!
G
Just wanted to provide info as this website end this loop has been tremendously helpful!! Our local Rite- Aid was using Patriot but just recently switched to Trigen. I had them put thru an Exception Process and it went through/ got approved. I am unsure if others are having an issue with Rite- Aid on this but ours did go through!
Congratulations, Sarah.
That’s what I am recommending to anyone having trouble with Rite-Aid, Walgreen’s, and perhaps some other pharmacies.
I’m glad it worked for you!
g
Well a few positives and negatives. Husband’s new psychiatrist is fantastic and agreed that he needs the reliability of the brand name. Did the PA and they denied it basically saying “can’t you just use the generic”. I hate insurance companies, why do I pay you people anything lol
In the positives we called a Walgreens about an hour away and they carry Patriot Concerta. Negatives it’s an hour away and still $80 since my insurance, again, sucks. So far we’ve had better luck with Walgreens that have resurrected from the remains of Rite Aid locations. The Walgreens near us was beyond unhelpful.
Hi Beka,
Did you look into Concerta’s savings program? https://Concerta.net
And just remember, it’s not a question of a pharmacy carrying the authorized-generic. It’s a question of the pharmacy being willing to order it as an exception.
I know…dealing with insurance issues can be frustrating. So much depends on the quality of the plan — and the employees selections among the options (if there are options).
But, trust me, it’s much worse in other countries. At least you can get the diagnosis here and have many choices of stimulants to choose from, savings programs, etc..
good luck,
g
So for past few months I was able to purchase the Patriot brand authorized generic 27mg from Rite-Aid, which works great and lasts long enough. Currently living in Concord, CA.
Today the pharmacist told me this would be the last refill they can give me for this specific “Patriot” brand generic, and that next month they would be moving onto “Trigen” as their supplier.
I’ve tried Trigen before at Walgreens (they would not order the patriot brand for me, so I moved to rite aid). Trigen should be illegal to sell, it does not work and actually does the opposite! It makes me even more tired. I’m sad that more and more pharmacies are moving to cheaper ineffective generics.
So now, at least for my area, Walgreens and now Rite-Aid is not an option anymore. Anyone else here know any other pharmacies that are willing to order the Patriot AG in California?
Hi Paolo,
Please call the number I offered in the post:
Update 3/9/20: Walgreen’s and Possibly Other Stores
Walgreen’s corporate headquarters confirmed with Patriot that all Walgreen’s stores should be able to order the Concerta authorized generic for you. If you encounter resistance, ask that an Exception Process be ordered for you. Still trouble? Call Patriot at 215-325-7676
Allegedly, Rite-Aid also has an Exception Process as well but I have not yet been able to confirm that with the corporate headquarters.
Other drugstores might be implementing such a policy. But no announcements have been made.
—
Good luck!
g
Everyone who has taken a generic drug that does perform as the brand name drug should file a complaint with the FDA. I did and they called me back to discuss it. With more people doing that, we can get Trigen removed and they can’t foist that crap on us anymore. https://www.fda.gov/consumers/consumer-updates/how-report-product-problems-and-complaints-fda
Hi Susan,
Yes, as I have encouraged for several years, anyone having a bad result from a generic drug should file a MedWatch complaint.
It is important, as you suggest, to be clear that you did well on the brand but not the generic of that brand.
Otherwise, it will be a wasted act. Nothing will be found “wrong” with the generic.
I did succeed in leading the effort to have the first two Concerta generics downgraded. But that was under a different White House administration and FDA Chief.
This is a complex issue, and it’s important to understand what’s happening.
It will be very difficult for the FDA, under a new administration and FDA chief, to turn around and tell those generic manufacturers….oops, no, we shouldn’t have let those generics through. I’m not sure it can happen legally. Which is probably what was in mind.
But still, it’s always good to collect data, and I have found the FDA scientists and other staff diligent in their duty to the public.
thanks,
g
In August, I had the authorized generic from Patriot filled at Express Scripts, the cost was $269 for 90 days supply, the time before that, it was $239. I have BCBS. I just checked pricing at Express Scripts for brand name Concerta, and it was ~$968.80 at Express Scripts. The Patriot version, NDC 10147 0685 01, priced out at $188.61. Interesting how volatile pricing is.
Express Scripts responds well to NDC number, my child’s pediatrician follows the recommendation to prescribe using the NDC number, and I have been able to obtain the authorized generic without any issue. Express Scripts does not participate in prescription savings programs. It might be worthwhile to try to get an initial fill for $4 at a retail pharmacy such as Walgreens, but long term, getting the Patriot product from Express Scripts seems to be the better option.
Hi M,
Thanks for your report.
It really does depend on one’s insurance coverage, as to what’s available at what price — even at the home-delivery pharmacies.
Not just the insurance carrier (in this case BCBS) but the details of the plan — of which there are a dizzying number.
We also have BCBS but with CVS Caremark as the home-delivery pharmacy. Concerta brand is available to us for $100 for 90-day supply. But the AG is not available.
We can get the month-by-month AG at the local Walgreen’s, though, at the generic price of $10/month. In the past I would not have wanted that headache 12 times a year. But now our prescriber has electronic prescriptions and has agreed to just put it on his calendar every month.
All over the map!
g
Reading all this and it’s so sad that I’m willing to pay these prices, but they won’t even let me purchase it through my insurance at all. My husband’s psychiatrist refuses to do an authorization so we’re stuck looking at new doctors now too. It’s just so frsutrating.
Will be checking back to hear anyone’s experience with the discount program. I’m nervous about trying it since I’ve never done anything like this before. Good luck everyone!!
Hi Beka,
I encourage you to read the post in full. It might be that authorization is not the way to go at all.
Rather, if your husband’s MD can specify the NDC # for the authorization, that might work.
You don’t need to be nervous about trying something. You don’t have to commit to it. Just call your pharmacy and/or pharmacy benefit to see what might be possible.
Then just ask the MD to do it.
good luck,
g
Gina – Have you heard from anyone about the discount program? I actually have to purchase name brand concerta through our BCBS coverage and I’m hopeful this will pick up Ane of my cost share. That’s the way it reads as far as intent. It would be amazing if it did. We’ll be up for refill in a couple weeks and I guess I’ll find out.
Hi Deborah,
I just discovered the new program last week. I’ve not had any first-hand reports.
Note that it does not apply in CA and MA.
The coverage seems fairly straightforward:
Eligible patients pay an initial $4 per fill at participating retail pharmacies and receive up to $150 off their out-of-pocket prescription costs, with a maximum program benefit of $1,800 or 12 fills per calendar year, whichever comes first. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. Offer not valid in CA and MA. There is no income requirement.
I hope it works for you! It might be worth asking ahead of time, to see if there are any hoops you need to jump through first.
g
This article is so informative and am glad I found it! It is SO ANNOYING how the generic medicine is not made well and I wish they did more research.
I was diagnosed with ADHD in 5th grade and started taking concerta 8th grade and have been taking it since then.
I am 21 now and still take it. Concerta is the only medicine I have found that works for me and it works perfectly for me. The only thing is that it is so so so expensive.
I have tried the general concerta once in high-school and then again I retried it again this month to see if anything has changed and it has zero effects on me. I still get the brand concerta because it helps me so much with college but it is definitely sucks that it is a lot of money. I wish the general prescription worked on me.
Hi Heather.
I know. It does suck!
This isn’t a matter of not doing enough research, though.
All brand drugs have patents that expire. Concerta’s expired a long time ago. The authorized generic was available only due to a marketing deal between the Concerta manufacturer and a generic manufacturer who wanted to enter the market.
You can still get the authorized generic (that is, the brand sold as a generic), but it can take some hoop-jumping.
Meanwhile, I notice that Concerta now offers a savings program (not available to California or Massachusetts residents, though)
https://Concerta.net
good luck!
g
Walmart in Florida has filled my Rx with the Patriot NDC on it the past two months. It was around $150 but I used GoodRx and it brought it down to $66 – so I’m praying this continues. Previously in Maryland (where I just moved from) I got the same deal at Giant grocery store’s pharmacy. Good luck to all.
Hi Susan, you might want to check out Concerta’s new savings program.
https://Concerta.net
g
There is a limit of $150 and my insurance charges me $368.76 for a 30 day supply so $218 > $66. I don’t understand why the cost is so high!
Hi Susan,
Are you sure you are being charged the generic price?
It might reflect your insurance policy — some people who don’t take medications save money by choosing a policy with lower pharmacy benefits. Is that possible?
Maybe you also have to meet a deductible?
So many possibilities. You might want to call your insurance company and ask. Maybe you could save some money!
g
Looking for advice. My husband is currently prescribed Concerta. He got miscellaneous generics at first and did better than nothing but still not good. He managed to randomly get the Patriot branded Concerta from Kroger once then they claimed they don’t sell it after that. On the Patriot generic he was so attentive and happy, I just feel so sad that he has to go through this and I want to help him.
We have BCBS of Arkansas with medication coverage which would make brand name Concerta possible (probably still like $140/month but I would rather my husband be happy and able to work). We’re trying to get an exception because they don’t normally cover it. If that doesn’t work where do we go from here? Does anyone have experience with Concerta’s savings program and if it works?
Hi Beka,
You are absolutely right. If your husband did well on brand/authorized-generic Concerta, he deserves to get it again.
Your best bet is to talk with your pharmacy representative and ask if you can get the authorized-generic (Patriot).
There seems to be a disruption currently, but no one knows why — or when it will resolve.
You can also call the Patriot number in the post.
Barring that, if you have to get brand, see if it would be cheaper from the home-delivery/mail-order pharmacy. If you have that benefit.
And yes, I see that Concerta has a new savings program; that might be worth checking as it’s not dependent on income level (you can download the card at the site): https://www.concerta.net/
I hope this helps,
g
Thanks, but the coupon is for name brand Concerta and others should know it’s limited. I used my online drug pricing tool provided my insurance. My husband’s employer only offers integrated (drug & medical combined) plans – since ACA there is very limited choice in plans. My integrated deductible is $6000 so we pretty much pay for all of our health care and prescriptions along with the astronomical premiums. We lost our plan that had $0 deductible with $0 generics.
Yes, I know the coupon is for name-brand Concerta. That’s how I presented it. And yes, any assistance/savings program will be limited.
The authorized generic IS the brand; it’s simply sold as a generic.
If it’s possible to get the discounted brand, that solves the problem of trying to find the authorized generic. I know this is not a solution for everyone, but for some it might be helpful.
Many people have plans that sound better than what you describe through their state’s ACA Health Insurance Marketplace. I’m sorry yours doesn’t seem to be one of them.
g
Hi folks — UPDATE 10/28/20
A kind reader has e-mailed the following message:
Just now heard back from Patriot. They are pretty miffed at Rite Aid and are telling the rep to go straighten things out. She also told me that Stop-n-Shop carries Patriot exclusively.
Thank you, LJ!
Gina
I have been able to get the Patriot authorized generic from Rite Aid in Los Angeles for many months, but the pharmacist just called me to say that they can no longer get the Patriot methylphenidate HCI and wants to substitute with the Trigen generic.
I’ll check with Walgreens and Ralph’s (Kroger) to see if they can order it. Thanks for all of your work on this!! It has been very instructive.
Steve
You’re welcome, Steve. Thanks for your comment.
A reader e-mailed me yesterday to say she’d gotten through to Patriot’s rep (phone number in the article). She too had been getting the AG from Rite-Aid.
The reader reports that the rep said she’d call Rite-Aid and take care of it (hopefully).
I don’t know for sure but I suspect that these pharmacies make a LOT of money on these cheap generics — and lose money on the authorized-generic.
Hence, the difficulty getting it.
Concerta just put out a savings program but it’s not available in CA and MA, darn it.
good luck!
g
My doctor was able to send an electronic rx to my usual Publix pharmacy with the NDC (thanks for that info in your post!). Even though they gave me the Patriot Alza generic a month ago just by dumb luck, they told me they aren’t able to get it any longer. The Walgreens pharmacist told me that NDC did show up in his system and that he could try ordering it, but no guarantees.
Unfortunately I have to wait on a new rx to be sent to Walgreen’s. As if this mess with generics wasn’t enough, I’m also having to deal with pharmacists’ outdated information about Schedule II prescriptions. When those prescriptions were paper only, it was the case that they couldn’t be transferred between pharmacies. With EPCS however, DEA has explicitly said multiple times that unfilled EPCS prescriptions for schedule II-V may be transferred to another pharmacy.
Dear Jordan,
Thanks for sharing your experience with us.
It’s just all too much, like some farcical theater, demanding that people with ADHD—who are taking medication to help with organization, initiation, follow through, etc.—jump through so many hoops to get that medication!
I haven’t been able to uncover what is happening. My guess is that Janssen/Patriot just cannot financially compete with the slew of very cheap Concerta generics.
The OROS system works so well for many people. But it might be that, if one cannot afford the brand Concerta, it’s time to try other choices in the methylphenidate (MPH) class of stimulants.
Many of the newer offerings also have savings programs. Here’s the list of all MPH Rx, the newer ones in bold-face.
Adhansia XR®
Aptensio XR®
Concerta®
Cotempla® XR-ODT
Jornay PM®
Metadate® CD
Metadate® ER
Methylin®
Methylin® ER
Quillichew® ER
Quillivant® XR
Ritalin®
Ritalin® LA
Ritalin® SR
Good luck,
g
We were getting the Patriot version at our Rite Aid (Concord, NH) until two days ago (10/24/20). I spoke with them and they said they are not allowed to request a different generic.
Called Walgreens and they told me they can’t get the Patriot generic from their supplier.
We have CIGNA / Express Scripts Home Delivery and they seem to be able to dispense the Patriot generic. We will see if this is what they do !
Good luck with that, Wes!
Sometimes an Express Scripts or other home-delivery pharmacy will have access to the authorized generic but an individual’s insurance policy does not cover it. The generics are so much cheaper.
g
Just an update – Took a few days (electronic rx with NDC sent over Saturday, prescription filled this morning), but Walgreen’s did order and fill with the Patriot generic as requested. Insurance covered it like any other generic.
My daughter just started meds- on 18mg on generic Concerta. She’s not noticing much of a difference. I’m not sure if she needs to try a higher dose or if the issue is she needs to try the brand /authorized generic. (Insurance is CVS Caremark.) Any suggestions what to ask Dr. for first?
Hi CL,
There are probably many ways to go, some harder to pull off than others.
In my opinion, I believe it’s best to start with the brand, identify an optimal dose (if that brand works well), and then, if budget dictates, try 1-2 of the generics.
If they don’t work, you’ll know that the problem was not Concerta or methylphenidate but the generic dosage and delivery.
g
Hi, my son has concerts xr 36mg. When we started it in November 2019 it was a circular white pill. Refill in early September 2020 was white oblong with m 36 on it. Refill today was white oblong like your pictures that has alza 36 on it. The Sept ones don’t seem to be working as well as the original circular ones (we have extra pills due to not using alot during covid). Are they just less potent? Or release wrong?
Hi Melissa,
1. Your son started on one manufacturer’s generic (perhaps Trigen)
2. Then received a refill in September is from yet another manufacturer (Mallinckrodt)
Generics are allowed a large margin of bioavailability — so they can work very different one to the next.
That’s why your son reacts differently to the two generics.
You don’t mention how he is doing on the Alza (brand).
g
I write about the difference between authorized generics and “true” generics in this post and also more detail in this post:
https://adhdrollercoaster.org/adhd-news-and-research/consumer-qa-on-concerta-and-generics/
We haven’t started the alza since we just got it today. I hate to waste a whole bottle of the M one, but if it won’t work as good then I may have to.
Hi Melissa, welcome to the struggle and so happy you found this site. As an ADD-mom with ADD-kids, I can only tell you to follow Gina’s advice to the letter.
After years on Concerta (Alza stamp) I spent just one month on Trigen due to insurance issues. I was SICK – nausea, diarrhea, sweats, dizzy, unable to work, mixing up my words, and in a terrible mood. (I think my post is still here somewhere from July last year).
Please don’t decide that medication won’t work for your son, until you’ve been on the brand name or authorized generic for 2-3 months. It takes time to find the right dosage and for the body to adjust. Of course, medication is only one part of the solution – incl. diet, exercise etc. But with the wrong generic, no matter what else you try… well, I can only speak from my own experience.
It was so hard to make the choice to start medication, but honestly, our daughter is thriving, she has her confidence back, her anxiety is so much better and she is doing great at school.
Anyway, just wanted to wish you all the best and let you know that what you read here is trusted advice.
Vx
Thanks so much, Vicky, for your testimonial.
These stories sometimes are so “fantastical” that some people might think we’re making things up — or that people with ADHD are “hopped up on speed.”
But your story…..a generic makes you SICK….nausea, diarrhea, etc. And that absolutely can happen, and not solely due to contamination. But because these medications affect physiology!
So glad you and your girl are doing well.
g
Hi,
This is a question for anyone with the CVS Mail in service through their insurance.
Are you required to have your concerta filled at CVS (per your insurance) or can you still choose to fill it at other pharmacies?
I currently have Express scrips and fill my prescription at Costco (they are the only ones with the Northstar generic) but my insurance is switching to the CVS mail in service 2021. I just want to be prepared for any *surprises* that might arise.
Thanks all 🙂
Hi Sara,
It would be best for you to ask about that directly.
Policies differ, even with the same home-delivery medication service. Moreover, having CVS Mail Service doesn’t necessarily mean your policy is exclusively CVS local pharmacies.
In MY experience with CVS Mail and Blue Shield of California, it stinks. We can only get an inferior generic (Teva, I think, though it might have changed). So we pay $100 for 3 months Concerta. (Still a good deal compared to some policies.)
We could also get the brand at the local CVS store but only a 30-day supply. Even with a 90-day supply, if it were available at a local pharmacy, the co-pay is $30/month.
When we used to have ExpressScripts, I found it so much better. But that was 5 years ago.
When CVS merged with Aetna, I think all bets were off. It seems to be the 800-pound gorilla.
If you want to know for sure (and hope it doesn’t change soon afterward; pharmacies change generics constantly), you should call the insurance company rep. They set the policies, not CVS.
good luck!
g
Hey Sara,
It would have to depend on your insurance. Through my insurance, Cigna, Express scripts runs expensive, and so I fill it through the CVS pharmacy. It does really depend on your insurance. Originally I was paying 100 for 30 supply of the brand and now its 124 and I am fighting them :/. So really you’ll have to call and ask sadly.
Shannon
Sara, to answer your question, yes I did receive the authorized generic stamped ALZA through the mail from Caremark/CVS…this happened one time in August 2020 and then my insurance changed so I couldn’t celebrate for long but it did happen! Previously during the 18 months I was on CVS/Caremark insurance plan I was able to get BRAND medication from local CVS pharmacy for $20/month copay but never considered the possibility I could get it through the mail.
Now after the change in my insurance I am on Express Scripts as of September 2020 and back to square one and am now only able to get the TRIGEN generic from CVS locally…it does not work nearly as well for me which I noticed day one after the switch. Reduced effectiveness, shorter duration, uneven results throughout the day.
Hello everyone! I’m not sure how to post my own question here so please forgive me for piggybacking on someone else’s…
Does anyone in Los Angeles have any pharmacies that will fill the Patriot authorized generic? This spring, Noreen at Patriot helped me and said that Rite Aid had a deal with Patriot that they must honor it if the Patriot NDC is requested. She called Rite Aid Corporate, sorted it out and since then, we’ve had 8 blissful months with no problems. Then, a couple of days ago when I tried to get my refill, my local Rite Aid said Corporate was telling them to give me another generic substitute (which they shouldn’t be doing). I’ve tried to reach Patriot and left messages but to no avail. They are not answering their phones.
My children also take Methylphenidate. Their prescriptions run out next week. The other generics we’ve tried were disasters. With schools not yet open, we are all stuck in the house doing remote learning. Without this medication, our house is soon going to be BEDLAM.
I have Motion Picture insurance. I’m sure there are PLENTY of people in the film business in Los Angeles with ADHD! Any suggestions? I’m getting very worried.
Thank you,
Katherine
Hi again, Katherine.
Have you checked the cost of brand through your home-delivery pharmacy? It might not be prohibitive.
g
I am sort of confused. On March 13 2020, I realized that I had ADD, I was then Prescribed, Actavis Pharma version of their concerta and it worked wonderfully everything that was ever a problem for me was fixed. Then Covid- 19 hit and there was no school so we didn’t get the prescription refilled until august. The ones they gave me in august were then called teva and they did not seem to work as well. I doubt that I’ll get a response because of how old this post was made but basically I am trying to get the same prescription as the first one that I was given or something that will be similar. Idk who will see this but if I can get a email or something to see what would be the best route to take that would be nice.
Thankyou
Hi Cameron,
I always respond to all comments — and have since 2007. No matter how old the post. 🙂
Here’s what likely happened to you (the short version of my post):
1. You did well on brand Concerta (which for a while Actavis was selling as an “authorized” generic, via a marketing deal with the Concerta manufacturer)
2. You did less well on generic Concerta. (Yours was from Teva but there are a bunch others, and none uses Concerta’s proprietary delivery system, OROS; that’s the problem.)
What to do: Try to get the brand Concerta, either sold as a brand or as the authorized generic. All the details are in the article — summarized in the info graphic.
good luck!
g
Hi Cameron,
In my area, Nashville, Costco pharmacy is the only location that carries the Authorized Generic Concerta that is produced by Patriot Pharmaceuticals. Teva (the original) and Trigen did not work for my son because their extended release technology is inferior/junk to the OROS technology first used in Concerta. OROS is still used by Patriot as an Authorized Generic (AG). You will pay more for an AG but it may be worth it to you. Teva has since released their own generic with a new release technology but we have not tried it.
Recently my son tried the generic sold by Camber Pharmaceuticals and Northstar Rx, both use what looks to be a new release technology, but still not OROS. Both of these may use the same technology because they are both made by Ascent Pharmaceuticals for Camber and Northstar. However my son says this release technology is close enough to work. We are still testing it.
Thanks for sharing that info, Mike.
Yes, Camber’s design seems deceptively close to Concerta’s. But, as you say, not OROS and really nothing like the sophistication of OROS.
g
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.”
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
Do you know who makes the authorized generic of Ritalin immediate release?
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
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.
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
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.
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
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.
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
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.
Hi Susan,
Great job!
I hope you have luck in your new state.
g
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.
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
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!
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
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!
Hi Tina,
I’m glad you discovered the likely culprit. Good luck to you!
g
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
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
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
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
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.
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
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.
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
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).
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
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.
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
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
Ah yes, good possibility.
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
Let’s hear it for the ADHD Roller Coaster Hive Mind!
Thanks, Deborah.
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.
Hi Katherine,
Maybe you just hit the point during the year where your insurance deductible was met? With my policy, once the deductible has been met, insurance pays more (therefore I pay less) for the cost of prescription meds. Just a thought.
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.
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
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!
I’m glad it worked for you, Sandy.
thanks for taking the time to let me know.
g
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.
Glad to hear that, Peter. I imagine it very much depends on the store’s demographics and pharmacy personalities.
g
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!
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
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.
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
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
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
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!!
HI John,
I’m so happy to be of help. thanks for writing!
g
Gina,
I asked you this question almost a year ago. Thanks so much for your response. I realize I never responded.
Since last July, my psychiatrist at Kaiser has been writing the prescription for brand-name Concerta or the Patriot brand. The pharmacy has ordered the brand-name drug, which takes a few days, but I have been able to get it. I pay the copayment for a covered brand-name drug, which is $55 for a one-month supply. I really appreciate that he writes that prescription and that they are able to get it for me. I notice a huge difference over the inferior generics I had been taking.
Thanks again,
Will
Hi Will,
I think I need to re-jigger something. I answer all questions, but I wonder how many people see them! 🙂
At least someone else does. Sometimes.
That sounds like a very reasonable setup you have. That seems better than most I know who use kaiser.
Thank your pharmacist! 🙂
take care,
g
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.
Oh good grief. That sounds ridiculous.
I don’t know if this is helpful, Susan, but there’s a phone number.
https://www.medstarfamilychoice.com/maryland-healthchoice/for-maryland-healthchoice-physicians/claims/claims/national-drug-code-ndc/
good luck
g
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!)
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
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.
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
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.
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
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.
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
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.
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
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.
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
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.
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? 🙁
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
Ask the doctor to put the NDC number on the Rx.
Yes, the NDC number is important. But that is not enough. The post has more details.
g
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.
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
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
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.
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.
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
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.
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
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!
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
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.
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
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!
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
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
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
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.
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
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?
Hi Lori,
please read the updated post….the first few paragraphs might offer a direction.
https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update-6-1-19/
Good luck!
g
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!!
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
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.
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 this issue.
good luck,
Gina
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.
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
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.
Hi Brenda,
ARGH!
I hope you can get the brand/authorized-generic. good luck!
g
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.
Hi Yaolin,
I’m glad you made contact. That is the information I provided at the beginning of the post. 🙂
g
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.
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
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.
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
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.
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
I got as far as calling Patriot.. If this doesn’t work with Kroger – then next month that’s my next step.
Definitely, if you have a local Walgreen’s, that’s the best bet.
g
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!
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
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!
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
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.
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 ?
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.
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
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
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!!!
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
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!
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.
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
I’m in Fort Worth, TX. I called Walgreens yesterday, and they said they couldn’t get it.
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.
Dear Laura,
I’m so sorry that you’ve found yourself in the crosshairs of this shameless hustle by Big Generic and this administration’s FDA.
Please give your prescriber this information. You’ll need the NDC number. Because now there are MANY “methylphenidate ER” generics for Concerta.
https://ndclist.com/ndc/10147-0686/package/10147-0686-1
Best of luck to you.
g
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.
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
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.
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
Hi Gina, it has been a while since I posted. Something is very wrong and I am hoping you can provide me with guidance.
After returning to school after having been back in my home state over the summer, I went to the pharmacy I use while I am away at college. It is the only pharmacy in the tri-county area that carries the patriot authorized generic of Concerta. This is the same pharmacy that had been filling it prior to me leaving for the summer (I had my prescription filled at a chain pharmacy back home during break).
I had called the pharmacy on the 27th and the Pharmacist said she didn’t have enough to fill my prescription and their system said that it was unavailable to order but she would try to place an order anyway. She offered to do a partial refill if she could not get it in stock. She called me the next day saying the order she put through worked and it should arrive “tomorrow.” I thought it was strange how it was unavailable but then the order went through, but that is beside the point. I picked up my prescription on 9/29.
I had been doing so well and excelling in school and everything had been normal. Had been normal being the key phrase….
Since the beginning of October, I have had a lot of trouble sleeping and waking up, trouble focusing, trouble getting through a long day, trouble paying attention to friends, and just an overall irritability and a need to randomly get up and clean the evening before an exam or when something else is due. It almost feels like last year when the pharmacy had filled an un-authorized generic.
I really thought it was just the stress of my professional program as I am on the authorized generic and had no problems in August or September, and this semester is notorious for being hard let alone during a global pandemic, but last week during an exam I could not tune out my neighbors music, I had ear plugs, and it was unbearable, I failed my exam and I have never, ever failed an exam. Something happened last night and I just can’t shake the feeling that it may be related to the exact timeline of when I picked up my prescription, and when all the problems started happening.
I went to fill my weekly pill case last night and when I poured some of the pills in my hand, from the bottle to transfer them, I noticed on three of the pills (they were all next to each other), the word alza was very bold, the text being almost double in width compared to the others in my hand.
I decided to pour the rest of the bottle out to look at all of them because I have never in almost 2 decades of taking Concerta seen that. I found other pills where the normally crisp margins of the letters, instead looked fuzzy almost like they hadn’t dried is the best way to describe them. This made me look even closer at the remaining pills. Some of the pills looked normal with normal text.
I decided to separate them out. I looked at the ones with normal “alza” and the red brown color was uniform smooth, but the ones with the weird bold or fuzzy alza were a faded red brown color almost looked mottled with white; it was extremely subtle. The texture looks like a sponge dabbing on paint if that makes sense.
The last thing I noticed is on some of the pills with fuzzy/non crisp margins, and the mottled faded color, the ends of the pills looked like they were melted or an extra coating was put on them. I guess the best way to describe it is how if you paint your nails and you bump into something before they are dry, they smudge/ripple. The pills that have the normal alza and uniform non-mottled red brown color do not have this on the ends or near the “drill hole/divet.”
That was when I remembered something that happened a few weeks ago when I was setting up my weekly pill case after picking up my prescription. The first pill I picked up was chipped around the “drill hole/divet” I thought that was odd but the bottle was very full and difficult to open so I attributed that to damage from the lid. I thought nothing of it but kept it in the back of my mind.
I know me, I know my body and I just don’t know what to do about this or who to call or ask or what any of it means? After looking at every single pill last night something is wrong, This seems like an issue with the pharmacy or the pills, and my doctor is not available this weekend so I am just looking for guidance because I don’t even know if he can help me with this…
Is it possible there was an error at the facility that manufactures them? Such as a bad/contaminated lot/(batch??)? Could these be tampered with, is that even a thing? Have you ever heard of this happening before? Has Patriot changed anything recently? I really appreciate any and all advice that you may have or anyone on this post may have….
Dear Sam,
That’s awful! I have no idea.
The FDA has very strict guidelines for brand medication productions. So, if the pills are as you describe, it seems unlikely they are Concerta brand/authorized-generic.
Though it might be that Janssen could provide some answers as to what it might be. Perhaps from an online pharmacy selling counterfeits.
Do you still have the bottle? What does it say as the supplier?
You could call the pharmacy but that will probably be unsatisfying.
Here is the contact info for Janssen:
For any questions regarding treatment with CONCERTA®, please call
1-800-JANSSEN (1-800-526-7736)
Monday through Friday from 9:00 AM to 8:00 PM ET
Saturday/Sunday from 9:00 AM to 5:00 PM ET.
Can you send a photo to me?
g
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.
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
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.
You’re welcome, Suzanne. Best of luck to you.
I’ll try to track updates….though companies don’t provide information these days.
g
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.
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
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.
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 🙂
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!!
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!
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
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.
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
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.
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
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.
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
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.
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
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!
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
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!
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
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
Yay!
g
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.
Hi Suzanne,
Wow. Glad to hear it.
Thanks for letting me know.
g
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.
Hi Shawn,
Wow, lucky you! I wish we were so lucky with Caremark CVS!
Thanks for reporting in from the front lines.
g
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.
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
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”.
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
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.
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…
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
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.
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
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!
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
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.
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
My daughter is taking Alza, but she has stomach aches and headaches with it. Any suggestions?
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
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
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
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
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
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. 🙁
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
Yay! My old meds came today! I am so glad I had this info to help me advocate for myself!! Thanks so much!!!
Yay! That’s what I like to hear!
Thanks for letting us know, Tracy!
take care,
g
I think their patent for Concerta with OROS May be expiring today. Check out these links:
1) some random court case summary from awhile back that lists the patent numbers for Concerta: https://www.cov.com/files/Uploads/Documents/JJ_Wins_Battle_Over_Concerta_Patent_Ownership.pdf
2) patent 1 (expires 12/26/19): https://patents.google.com/patent/US6930129B2/en
3) patent 2 (expires 10/29/20): https://patents.google.com/patent/US8163798B2/en
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
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.
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
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.
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
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.
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
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?
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. 🙂
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
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
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.
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
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.
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
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?
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
Hi Beth, Have you tried Costco? They carry it in Nashville, TN. Holly
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.
Should have added that Walgreen’s cannot either.
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
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.
Good for you, Beth. Mind telling us which pharmacy? By “local” do you mean independent?
tx
g
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.
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
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.
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
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. 🙁
Hi Kristin,
I’m confused! Why do you want the AB generic?
Did you ask about availability for the authorized generic?
g
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!
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
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?
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
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.
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
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.
GIna , I say “irony” because the letter states the Brand Concerta will be given at the generic cost.
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
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
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
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.
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.
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.
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
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.
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.
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. 🙁
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
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!
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
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!
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
I’m not sure what to make of this. But here is what British Columbia PharmaCare Formulary covers for Concerta.
https://pharmacareformularysearch.gov.bc.ca/faces/Search.xhtml
Thank you Karen for sharing your process with GoodRx.
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.
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.
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.
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/
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.
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
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
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
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.
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
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?
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
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.
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
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.
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
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.
Thanks, Holly. These chains are huge and I imagine decisions are made on a regional basis as well.
g
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….
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
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.
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
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.
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
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!!!
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
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.
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
AV Kare is another company I have found giving the generic without the OROS delivery system.
https://www.avkare.com/
This is being stocked by the pharmacies in the military treatment facilities under the Defense Health Agency.
Which is funny in itself since this company filed a lawsuit against the VA that was later thrown out.
https://www.courtlistener.com/opinion/3181665/avkare-inc-v-united-states/
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
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
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
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?
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
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!
Thanks, Kathryn!
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.
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
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. :’(
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
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.
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
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
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
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.
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
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.
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
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
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
.
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!!
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
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
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
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”.
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
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).
Well done, Michelle!
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.
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
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
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
Thank you Gina for all thu. I will keep you updated! (From Facebook post today)
Nice to meet you, Diane, West Coast ally! 🙂
g
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.
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
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.
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).
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
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!
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
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!
Great suggestion, Dave. Thanks!
g
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!
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
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!
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. 🙂
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?
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
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.
sorry I meant allow substitutions not all substitutions
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
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.
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
Sorry Gina I sae that section of your post AFTER i wrote the question. Thank you for the late night response.
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
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.
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
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!
Hi Michelle,
Yay! That’s great news! So glad my research paid off for you.
g
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.
Nice work, Susan! Kudos!!
g
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…
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
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!
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
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!
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
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
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.
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
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
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
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
That’s very sweet of you, Audrey. Thank you. <3
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!
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
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.
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
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)
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
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.
My apologies on the Salutation. I meant “Hi Gina”.
🙂 No problem, Javier.
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
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?
Hi Lisa,
Do you have the 90-day home-delivery benefit on your healthcare policy? That’s how we get it.
Here’s how it works, generally: https://adhdrollercoaster.org/tools-and-strategies/stimulant-prescriptions-via-mail-order-pharmacy-maybe/
Note that we are paying for BRAND, not generic.
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!!!
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
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
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
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.
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
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!
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
Thank you thank you thank you!! You are a life and career saver for my son!
Thank you thank you thank you for letting me know! 🙂
g
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.
Well, that was Congress, and it was mostly unanimous, which leads me to believe it’s window dressing. 🙂
https://khn.org/news/no-more-secrets-congress-bans-pharmacist-gag-orders-on-drug-prices/
Pharmacists that work for chains typically know nothing about the “real” medication costs. Especially since most of them are “funny numbers” that no one pays. 🙂
g
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.
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
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.
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
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
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
I thought you might find this interesting. I was looking for info on the patent and found Teva’s. https://patents.google.com/patent/US7195778B2/en which let me to Alza’s original patent https://patents.google.com/patent/US3995631A/en which led me to the microporus one they hold that I believe is the one used in Concerta. https://patents.google.com/patent/US3977404A/en.
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
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.
Ha. Yes, exactly.
tx
g
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.
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
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
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.
Happy to help, Laura! Good luck!
g
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.
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
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.
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
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!
Hi Andra,
I’m glad you found my blog.
What exactly do you need to do? That’s going to depend on a few factors, including your insurance coverage, the pharmacy you want to use, etc.
Basically, please re-read the post: https://adhdrollercoaster.org/medication/authorized-generic-concerta-update-6-1-19/
And focus specifically on the part with the heading: How to Specify the Authorized Generic Concerta
good luck,
g
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.
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
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.
Hi Annabel,
I’m sorry your available pharmacies failed you.
good luck,
g
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.
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.
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.
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 be the best idea. Instead, use the NDC code.
tx
g
Hi Gina,
To answer your question, I asked for the brand name to be written because, like I said, my insurer suggested it and that they would over-ride their normal rejection of the Rx and allow the brand name to be dispensed. We both thought it would be easier than dealing with codes.
Walgreens said they could not order anything else because of their contract with their distributor, which required the useless Amneal. I am not sure if going in person with all the stuff I’ve printed out would make any difference if they are blocked in by corporate stuff. Sure wish I’d have some meds to help me right now…..Grrrr.
New confusing issues…this morning I was told by my insurer that my doctor called in a new Rx for the 27 mg she thinks I should take. It’s written for Actavis. (???) Maybe she’s trying to get me what her books are calling the “true” generic, not aware of the changes? I will stop at Walgreens and inspect the meds. If they are a different generic, then I wonder why they could get them. I doubt I’ll see ALZA!
Very confused, been trying to just get my meds since july 17th.
Sorry if I missed the previous details, Lori Jo. There are many stories to keep up with here!
I’m afraid your doctor might be operating under OLD information. The previous distributor for the authorized generic was Actavis.
Actavis was purchased by Teva, which continued the authorized generic for a while but NOW has its own Concerta generic.
I wonder why YOUR Walgreen’s allegedly has no access to the authorized-generic, in contrast to other reader’s Walgreen’s. It might be a problem with just that store.
good luck!
g
Gina – I cannot thank you enough!!!! I had so much difficulty when the generic originally went from Watson to Actavis to Teva regarding my son… The other generics were so inferior – it was AWFUL. (And I will file a MedWatch report) Because of your research and your willingness to share with othersa a few years ago, I had been able to have his prescription filled as a generic without issue – up until now. Thankfully, I had advised our mail order pharmacy that my son had adverse/allergic reactions to the other generic brands. So when this new recent change took place, they tried to talk me into the new Teva brand generic. But once again, you were on top of this like white on rice! NDC numbers and all. I gave them what they needed to have to see if they could fill under Patriot. I am now waiting to hear back, but knowledge is power and that is what you have given me regarding my son’s health. Again, thank you so very much – You are amazing 🙂
Haha, Kim! Are you from the South, too? I’ve been known to say, “Like white on rice” a few times in my life. 🙂
I am so happy to be of service. Good luck!!
g
Hi Gina,
Well, my family physician threw me “under the bus.” She will not write for the brand, instead sending in a 27mg Rx to Walgreens (who refused to order the ALZA generic) and said I should take that for a month and see if that works any better. I sent a message back to her via the customer service rep (very sympathetic, eager to learn) that I would not be taking any more of the Amneal generic. If the 18 mg put me to sleep in front of my computer at work, how would the 27 mg be an improvement?
I am very disheartened today.
HI Lori Jo,
How disappointing.
But why did you ask your physician to prescribe the brand?
Perhaps your doc is in an HMO, which might have restrictions on how prescriptions are written?
Perhaps she refuses to listen to reason? Can you give her a copy of this blog post?
She could have written it for the authorized generic. With the NDC code in the article (varies by strength).
Is it possible that Walgreen’s “refused” to order the authorized generic because they didn’t know how?
Do you think you could try again, this time giving them the NDC code — and not using the words “alza” or “brand” or anything else? Just the NDCC code.
good luck!
g
Gina, you have given me hope and prompted me to pursue this generic issue. I have filed an FDA report about Amneal 18 mg generic, dispensed by Walgreens. Absolutely worthless. What’s worse, it actually makes me sleepy! I suspect it’s the coating dose (which I never felt) causing a crash. (???)
I called my Rx insurance today. Victory!!! They will put in an override for the brand Concerta and advised me on how my physician must write the prescription, using “D.A.W” or “dispense as written.”
Kudos to OptumRX!!! Kudos to you!!!
HI Lori Jo –
Thanks for writing!
I am so happy that my blog has helped you to figure out what was happening — instead of thinking that “Concerta just stopped working!”
Kudos!
g
Don’t waste your time at CVS retail . Just tried to get them to do a special order in which they did indeed try to get it from Patriot Pharm but were ultimately unsuccessful bc it is a distribution issue according to them .Kroger seems to be the clear winner here as I have contacted one that uses Patriot for generic Concerta.
Good luck with Kroger, Joshua
I’ll repeat what I wrote earlier today: It’s probably not a great idea to call pharmacies and ask if they have access to Patriot products
Just give the name and NDC number; that should be enough
Otherwise, they might be confused and you’ll get the wrong answer
g
Oh, I didn’t know that! I was wondering why CVS was listed, yet they couldn’t get it for us. That makes sense now. Thanks for the clarification!
Yep! I went down that path at first, too!
g
Over the past 4 weeks I’ve tried countless pharmacies and none of them could order from Patriot distributor. I know some of us here have had success, but I tried all the same pharmacies with no lock.
Question: has anyone contacted Patriot directly to ask them what we can do to help Pharmacies order from them? Maybe they have an info sheet or contact details we can take with us to the pharmacy; because three of the pharmacists I went to were genuinely helpful and I watched them making calls and try to figure it out without success. So I’m hoping maybe there’s a way Patriot can help us? Obviously there is a benefit for Patriot and they might just be unaware; I don’t know that’s why I’m asking 😀
Yesterday, I paid $705 out of pocket for the brand name (that’s after all discounts) because our insurance doesn’t cover the brand name effective this year and the Prior Authorization didn’t get done. $705 a month – that should give you an idea of how desperate I was to avoid another 4 weeks of hell on the Teva generic – I was having facial twitching; panic attacks; my blood pressure was sky high; my words were slurring; I was irritable beyond control and my performance at work was abysmal …
For sure now that I can actually think clearly again today – the difference on brand name is unbelievable! – I will be filing medwatch on Teva generic, using the details Gina mentioned here.
Thank you again for this post Gina; it’s been a safe space with so much helpful information over the last month and I’m forever thankful for you!
Hi Vicky,
Sorry that you are having trouble
$705 wow UNACCEPTABLE!!! 🙁
As for an info sheet from Patriot, maybe in your unmedicated and panicked state, you quite understandably missed that part in the post
As I wrote, when I called Patriot, I had to tell THEM the situation; all the advice here I had to research and gather quite independently
Some thoughts, now that you can think clearly again (talk about a Catch-22!):
1 Don’t ask if the pharmacy can order from Patriot
That’s the wrong question that could lead to the wrong answer from people who don’t understand this situation
Instead, give the pharmacist the NDCC code for the dosage you seek (it’s in the post) and ask for that
Print this post and take it if they need more information
2 Ask your prescriber to specify that NDCC code and write “medically necessary”
3 Patriot was slow to get started with its supply chain; maybe it’s worth trying again at a few pharmacies
4 Check with your pharmacy benefit manager to see if you can get a 90-day prescription at a storefront; it’s not available to everyone and for every medication but it might be worth asking about
5 Think about home-delivery; Making the leap to home delivery can take some prep work but once it’s in place, it can save a lot of money and hassles; think four times a year dealing with this instead of 4
(sorry that the period key just broke on my keyboard!)
good luck!
g
This is just awful.
I’ve had to do the prior auth runaround before too. It took a couple weeks for me to get things sorted, and only then after my doc had a very irritated phone call with my insurance company. They were gearing up to deny me again when I switched to a different insurer. (This was Cigna, who I quite frankly have heard only negative things about.)
I actually wrote a long rant about it here: https://adhdhomestead.net/prescription-prior-auth/
But TL;DR Cigna’s system for managing this red tape was ABYSMAL, and that’s me being generous. My advice if yours hasn’t gone through yet: follow up every day. At least. Because I wasted days sending faxes into a black hole. Unfortunately for them, I ran out of my meds before I was finished having to make phone calls to their support line.
That is just a frightening situation: to run out of meds when you are jumping through hoops to get your meds
Nightmare!
Vicki, I googled Patriot Pharmaceuticals and on their website there is a link for their retailers. There are several pharmacies listed on there but I think it depends on your location also. CVS is listed as a partner pharmacy, yet none of the CVS’s where I live will order from Patriot for us. It may be worth looking at though and see if there are any pharmacies listed on there you haven’t tried yet that may be in your area. Best of luck!
Thanks for trying to help Vicky, Kristin
I did include the link to Patriot Pharmaceuticals in the post
The website does not list the company’s retailers or pharmacies; it lists the authorized distributors
That is a very different thing and it’s why I did not include that in the post; because, as you point out, CVS pharmacies are rarely coming through for customers
g
Thanks Gina and yes I did miss that, my apologies.
Doctor did put the NDC code on the Rx this time and that got me the Brand name, which isn’t covered by our insurance. BUT if the supply chain was slow on the uptake, that makes a lot more sense now. I will definitely try again next month and keep you posted.
Vicky — how did the NDC code for the authorized-generic bring you the brand? That doesn’t make sense
If indeed your doc wrote the correct NDC, then the pharmacy screwed up
Probably it’s too late to get your money back but you might want to double-check before next time that the prescription is written correctly
If the doc wrote, for example, “Concerta [plus the NDC code],” the pharmacy will fill with brand Concerta and ignore the NDC code
good luck!
g
Yes, I called Patriot two weeks ago and they couldn’t tell me which pharmacies carry their authorized generic. I persisted but she said they really have no idea. I called a couple of smaller local pharmacies with one telling me they could order. I went to Walgreens to get my paper script back because they initially said they couldn’t get it. The pharm rep offered to look into it further with the NDC # and said they “could” get it afterall. I don’t know if they changed their tune because I was going to purchase elsewhere or if I was lucky enough to speak with a more helpful pharmacy employee st that visit.
Hi Suzanne,|
I doubt the pharmacy cares if you go elsewhere; it’s probably not a money maker (might even be a loss)
It seems the difference was that the next time you offered the NDC number?
I will re-emphasize in the post the importance of that; also, there might be “middle men” between Patriot and pharmacy’s distributor, so they might not think they can access it
thanks!
g
Ah! You know, you might be right that she wrote Concerta instead of methylphenidate ER along with the NDC code. Good catch! Sorry I’m so slow on the uptake! 🙂
No, Vicky, you are not slow
This is incredibly complex and precise stuff!
A PITA!
g
Just spoke to a pharmacist today 8/23/19. She said the NDC code on Patriot version changed. But what they got is still cylinder shaped and seems to be the same. Mom w/ 3 kids that demand cylinder shape said it worked correctly. Just FYI Gina in case you are able to update this post with new NDC codes to help all of us. Thanks for all you do! You are honestly a life saver!
Hi Aaron,
You are most welcome
I am happy to help (and I cannot use periods today because that key is broken!)
I just checked the US National Library of Medicine Daily Med listing; it hasn’t been updated and the NDCC numbers changed so I’m not sure where else to reliably get those numbers
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dad446b7-b26c-44f2-9e30-4cbd10d8b23c&audience=consumer
Same with the National Drug Codes List: https://ndclist.com/ndc/10147-0685/package/10147-0685-1
remember it needs to say ALZA
good luck!
g
No I don’t care for monthly either. I like the 90 day supply, but I like getting it local.
Just my preference. Thanks for listening.
Oh, I agree, Craig. Getting the 90-day supply locally would be my preference, too.
The problem is that so few pharmacies seem to have the Concerta authorized generic to fill even a 30-day supply, much less a 90.
And really, it’s not limited to the Concerta authorized generic. It’s many stimulants. They don’t like keeping them in the store, apparently. For security reasons? That’s what I’ve been told. Don’t know if it’s true.
g
I can always take my script back from the person standing in front of me and go somewhere else. If I send it away I’m at their mercy.
It’s then all down trusting them to do the right thing. A back and forth with them over the phone or through emails is worse than the face to face frustration I’m dealing with now.
Plus waiting for it show up on my door step, tracking or not, is not how I want to deal with this.
I’m not saying it isn’t a viable alternative, but I want more control over the process than that. Which is why this is so frustrating.
I am not recommending that you do it, Craig.
I am explaining how it works, that there are other options. Many people don’t realize that stimulant prescriptions can be delivered at home.
This is how I’ve procured my husband’s medication for 15 years. Four times annually.
I would never go back to monthly at the storefront. I found much less control that way.
But that’s just what works for us.
good luck!
g
Clarification please- when you say home delivery, do you mean mail order like Express Scripts?
I do send away for another medication using them but I wouldn’t risk any mix up or delay associated with mail order and my necessary daily meds.
Hi Craig,
You mean you don’t want to risk exactly what you are dealing with now with the local pharmacy? 🙂
There are ways to manage it, with a little planning.
For example, to send in the Rx 2 weeks before the fill date and call the pharmacy to make sure there will not be holdups.
Often, you can speak ONCE to a supervisor and asked that your account be flagged, so you don’t have to do it each time.
If you do NOT receive it in time, there are typically provisions for providing stop-gap supply at the local pharmacy.
I wrote this blog post a while back:
https://adhdrollercoaster.org/tools-and-strategies/stimulant-prescriptions-via-mail-order-pharmacy-maybe/
g
My odyssey began last Thursday. I dropped off the prescription and was off across the state for most of the day. I returned that evening to pick up the script and saw the wrong pills in the bottle.
I told the young lady that I wasn’t accepting that medication. I asked if that was what the chain (Meijer, Inc.) had switched to and she said yes. I told her that I would then like to have the name brand and that I would pay the difference to make sure I had the proper type. She then told me that she would need to order it since they didn’t have it in stock. Also, since it was late Thursday they wouldn’t be able to put in the order until Sunday evening.
I at least was able to block the sale ahead of time since I had run into a problem last year while on vacation visiting my mother. I got stuck with a different generic by CVS when I tried to fill my script at that time. I had filled it multiple other times when out there but the last time had been two years prior. I wasn’t able to refuse it at the time since I didn’t look at it before buying. I was only after getting to the car and checking it that the switch was revealed. No recourse at that point.
I returned home and discussed the issue with my doctor and was able to get another script to rectify the situation. I also was able to get her to do a 90 day script since I was able to do that at my pharmacy. It wasn’t an available option when I first started taking it years ago and I hadn’t thought to ask again until this issue cropped up. I was doing it for two reasons- the first being that it was easier to take a trip and not be caught out taking care of the script on the road. The second was new regulations that were being placed upon my doctor that would require an appointment each time I needed the script written. Just because lawmakers want to look like they are doing something about the opioid epidemic, we get caught up in the unintended consequences.
Returning to the story at hand. I was told that the meds would be in by Tuesday evening. Yesterday I got a text pushing back to today. Then I receive a call today telling me that the reason it kept getting delayed was that they could only get 100 pills of the asked for 180. I tell them fine, I will take whatever I can get just to get by and figure out what to do later. I then show up to pick up the script and they only have it dispensed for 34 days worth (68 pills). My insurance will only cover that amount. I say fine I will pay the rest myself. They tell me it will be $930!!!!! For the other 32 pills?!?!?!?!
This is just disgusting. The whole system is f*cked up.
In the middle of this I did try to stop by my local Kroger but that pharmacist went in to full corprate mode of “I can’t order through Patriot. I can only get what our distribution network send me.”.
I can’t see any of these large pharmacies/companies doing anything to fix this since it doesn’t make financial sense to them. And I can’t see the small guy going out of his way to order the authorized generic since he will be doing it at a loss. And if no one is buying it from the manufacturer, then why would they continue to produce it?
I will fill out one of the FDA forms but that doesn’t help me right now. I can only fight this mess when I have the proper meds. But if I can’t get the proper meds, then things get tough.
I have been quite patient through out the process but it’s difficult. The young man dealing with me today was just one in a long line of “drones” that are just doing their jobs, but you just listened to me talk about the problems associated with this whole process. Don’t then tell me to “Have a nice day!” Really genius? A little awareness of what just happened would be appropriate. While I don’t want your less than sincere “I’m sorry.” , it still would have been better.
Dear Craig,
I feel your pain. And yes, I fully recognize the Catch-22 here. It’s why I continue to write about this.
What’s strange is that Kroger’s and Walgreen’s, for example, are not monolithic in their ability to fulfill the authorized-generic prescription. It seems to depend on location within either chain.
Unfortunately, I’ve found the storefront method the most problematic. They have limited supply — and perhaps limited suppliers.
The home-delivery pharmacies seem better equipped to fill the 90-day prescriptions. Even then, in my experience, some try to wear you down. You have to know what you are talking about and escalate the issue until you get a positive response.
good luck,
g
Craig,
I missed an important tidbit in your comment. I found it when I was revisiting.
From what you wrote, you specifically asked the pharmacy to order through Patriot. That might be the problem.
I know there are many details to wade through here (not my fault!) and they are particularly hard to parse when one is not on the correct medication!
So, let me make this clear here: Don’t ask the pharmacy to order through Patriot!
Pharmacies vary in how they get supplies. It might be that their main supplier distributes FOR Patriot — but the pharmacy doesn’t deal with Patriot directly.
That’s why I encourage following the instructions in the post: Get your prescriber to specify the NDC number only.
Look for this section in the post: How to Specify the Authorized Generic Concerta
good luck!
g
Feel like I could cry a little here. It started last night when I went to refill my son’s 54mg and my other son’s 72 (2×36) mg of Concerta at Walgreen’s.
(I’ve had experiences with the Trigen about a year ago that were nightmarish — both of my boys were hostile, aggressive, and having the worst few weeks of school ever (one in 8th, one in 6th). One night before going to bed it dawned on me that their ADHD pills looked different that month when I got them from CVS. I noticed the new manufacturer and read this blog. )
Well, since I’ve been informed thanks to this blog I have been making sure they’ve gotten to right manufactured version of Concerta. I have very fortunately been able to get the Patriot brand for the past few months until yesterday when they were out.
I literally spent the entire night calling around to different Walgreen’s until one pharmacy said they carried the correct brand. When I got there I noticed they had filled it with TEVA — the pharmacist said it was osmotic release and not to worry.
I told her I need to go with the Patriot brand. She restocked the medication and gave me my script back which had all sorts of writing all over it. “Where can I go with this script?” I asked. She said I could try another Walgreen’s and have them call her — she said that “I might be successful this way.”
Are you kidding me? “I might be successful?” I took a deep breath and told her that my son has anxiety along with ADHD and that it was very important that he got the OROS type of ADHD medication. She repeated to me that the TEVA was osmotic, and that it would be fine. I ended up trusting her words, having that medication restocked for my son, bought it for almost $70, only to return home and read the comments on this blog.
I feel like crying. Here goes a month of hell. The questions I am now asking: “Do I take him off for the month?” “Do I try the TEVA and hope his anxiety (with the new school year upon us) doesn’t completely overwhelm him?” “Do I try and made an appointment with his developmental pediatrician who prescribes his meds in an attempt to have him rewrite a script and search feverishly for the Patriot?”
Thanks for letting me vent. It’s not enough that this disorder affects so many areas of our lives for my two sons and I…. Now it comes down to the incredible frustration that treating their ADHD is yet another struggle.
Dear Laura,
I’m so sorry you’re coming up against pharmacists who lie and misrepresent. You’re not the only one, unfortunately.
An “osmotic” delivery system is not the same as the complex and proprietary OROS, made by Alza.
It seems that today’s pharmacists — at least those working for chains — are little more than salespeople, more mindful of profit centers than patient welfare.
This isn’t right. I hate to get “political” but elections do have all kinds of consequences. And these generics seem to be one of them.
This administration appointed a venture capitalist and Heritage Foundation fellow as FDA Chief — traditionally, a position filled by high-level physicians and life scientists. He pushed through hundreds of generics and scoffed at FDA staff concerns that these generics were not truly equivalent to the brands.
Under the previous administration, we were able to get the first two inferior generics downgraded. Now we are up against so many, it’s dizzying.
Readers have been filing FDA MedWatch complaints. We should do it when we can. But with this administration, I am not optimistic.
g
Not necessarily *helpful* info, but food for thought: I was talking to my doctor this morning about Rx coverage. For the second time in two years, I’d had to switch steroid inhalers because insurance said “nope, not that one, get this other one.”
I had let the situation go for two months, using my albuterol inhaler more often instead, because thanks to aforementioned Concerta/other ADHD med hoop-jumping I didn’t have it in me to slog through more Rx bureaucracy. Not great, I know. My doctor told me this. She also told me if I ended up in the hospital because whatever they recommended didn’t work as well as what I was originally prescribed, I had no recourse with the insurance provider. They are protected by saying “we made a financial decision, not a medical decision.” In other words, we always have the option to pay out of pocket for whatever medication we think is best for us!
This is especially frustrating in the case of Concerta, which some of us rely on to maintain an everyday baseline level of functioning. These medications aren’t performance-enhancing drugs, they aren’t a luxury. They literally make us less likely to get into auto accidents. Less likely to take any number of other dangerous risks. Less likely to make unhealthy choices with food, alcohol, drugs.
All things that should feel like a financial liability to the insurers. But if anything happens, well, it’s not doctors pressuring patients to use ineffective generics. It’s all a financial decision, not a medical one, and no one’s forcing us to buy these meds with our insurance benefits.
Looking at all the work people on this thread are putting in to get their prescriptions filled, thinking about all the others who will give up before they get that far, makes me so angry. It seems like such a waste of potential, not to mention good health, all for — as you call it — “Big Generic.”
Yes, Jaclyn, and the insurance companies are provided cover by FDA generic guidelines—which were on their way to being updated for Concerta, under the last administration.
The FDA was very responsive several years ago, in heeding those complaints and acknowledging that the two Concerta generics did not work as well, significantly not as well, as the brand. And the FDA downgraded them. That meant insurance companies and pharmacies (we cannot overlook chain-pharmacy business models) could no longer force policyholders to accept the generics.
But when the FDA chief appointed in 2017 scoffs at the need for better guidelines in creating generics of medications using sophisticated delivery systems. When the FDA chief pushes through tons of generics (and claims it is serving the public, as cost-saving, and many in the public are too naive to know better), well, this is what happens.
Consumers better get smarter.
g
God bless you all. I stayed up for 24 hours to get my life back in order, and if it had not been for yall, I would be done for. We all know the generics do not work, so before you turn over your script, please please please have your MD authorize per order the exact Alza OROS delivery system only, and profile it. Then it is the pharmacist job to follow protocol. Set a 10 day reminder, call your pharmacist that day so that they can get a head start in insuring a med order will nor occur on their watch, per MD order. Licensed Professionals get paid to do so.
ADHD is a medicated symptom, why are we doing the heavy lifting? There’s protocols in place to make sure the correct vasodilator are prescribed as ordered per lab results, what’s the difference? A lab report? No! So therefore, tell your Doctor to insure a medication error doesn’t occur due to his negligence, from ensuring his patient has not recieved the correct treatment as written.
Nobody chases down blood pressure medicine manufacturers, the MD writes prescriptions ensuring properly functioning medication is dosed as prescribed. The pharmacist insures protocol is adhered to.
The advocacy of this blog is amazing. God bless you all.
I hope you can get some sleep now, Amber! 🙂
You know, the FDA chief appointed in 2017 pushed through a trainload of generics. I would not be surprised if many of them are causing problems for people with other conditions—and they will never know. They (and maybe their physician) will think it’s something else.
Scary.
g
I’m wondering if you have any information on the new Teva generic that has a weird logo and the numbers 726 on it. This seems to be what Walgreens is pushing now instead of the authorized generic.
From what I’ve researched, it seems this new Teva generic was approved as recently as two months ago and has an “AB” equivalency rating. But it looks very similar to the Mallinckrodt generic that was downgraded by the FDA, and definitely does not seem to have an osmotic system (I’m going by appearance here—absence of laser drilled hole) like the authorized generic and Trigen Lab’s generic.
Sorry for all of this information, but I guess my question is this: because this Teva generic was AB approved by the FDA very recently, does this mean it had to fulfill more stringent standards that came into place in the wake of the FDA downgrading the Mallinckrodt and Kremers generics? Does this mean the Teva one could be more similar to the authorized generic than other non-authorized genetics in regards to delivery profile?
Frustrated because I switched from CVS to Walgreens hoping to be given the authorized generic. Was given the Teva instead, unfortunately.
Hi Will,
The Teva generic is just one in the clown car of Concerta generics churned out in the past 2-3 years. None of these generics use the Alza OROS technology — the delivery system that makes methylphenidate Concerta.
Sorry, I can’t help you insofar as knowing if the FDA standards being more/less stringent now.
My guess is the standards have not changed (meaning, improved). “Big Generic” will continue to exploit the lack of updated guidelines on these drugs with proprietary delivery systems. And the FDA guidelines will not be updated until the “climate” in Washington changes and consumers are held in higher regard.
The FDA chief appointed in 2017 openly scoffed at the FDA ” holding up good generic medications” due to wanting more rigorous guidelines. He pushed through hundreds of generics. Now he’s gone back from whence he came: venture capital.
This is my 12/2017 post on the first in the “new” batch of generics:
Trigen Laboratories
Mylan
Impax Laboratories
Amneal
https://adhdrollercoaster.org/medication/7977/
The best you can do is try the generic you have and see if it works for you.
As for switching from CVS to Walgreen’s, you might have better odds of getting the authorized generic from Walgreen’s but you must ask for it in advance and have your physician specify, as I detailed in the post.
Good luck!
g
I’m curious as well. From what I understood Teva bought out Actavis who Walgreens was getting the authorized generic from, and they have since then replicated their own generic version of the drug. Teva did not work for my son. I found Kroger gets the authorized generic and we are now going with them. CVS carried it through Trigen Labs, which did have the predrilled holes but it still didn’t work the same for my son.
Hi Kristin,
I cover all of that in the post. It’s dense, so maybe you missed it the first time.
Teva purchased Actavis a couple of years ago. Actavis brought its previous deal with Janssen, to distribute the brand as an authorized generic.
That deal ran out. Then Teva introduced its own generic.
The Trigen generic is NOT the authorized generic for Concerta. It is a regular generic, like all the others. It uses a type of osmotic delivery system but not the Alza OROS osmotic system. Very different things.
g
My Walgreens was pushing that one too. I found the right one at Kroger. I hope this helps you.
I suspect it’s the sales line from the company to pharmacists: “It’s osmotic!”
We know better.
I’m glad you found help at Kroger. It seems this might be a regional issue within the chains, too.
g
Thank you SO MUCH! My son had an adverse reaction to one of the concerta generics they eventually pulled a few years ago. He’s now having problems with the new Teva generic. Your clearly written information saved me tons of time!
Thank you for letting me know, Kelly!
g
Josh,
I’m not sure. I can only get a 30 day supply at a time for my son so I didn’t think to ask. I hope they do and it works out for you with no troubles!
Kristin
Kristin,
Prescription is on its way back to me . Does Kroger fill the prescription for 90 days?
Josh
Josh — it used to be that you could get a 90-day supply only via mail-order.
Now you can get the 90-day supply at some storefront pharmacies.
It just depends on the chain and if there is a location near you.
Here’s a bit on Walgreen’s program. But I think CVS has it, too. Probably others.
You should check with your local Kroger’s.
https://www.drugtopics.com/chains-business/walgreens-expands-90-day-pharmacy-program-offering
g
Gina,
One last thing my prescription plan is CVS/Caremark.
Josh
Josh, I had this same exact problem with CVS yesterday and have the same exact RX plan. I finally found Kroger carries Patriot!!!!! Try your local Kroger!
Kristin
Gina,
The pharmacist looked them up and everything and say the only thing for CVS Caremark prescription service they carry is Trigen. I told them to send the prescription back and try retail. I did exactly what you have been instructing people to do told them the distributor and everything including the NDC number.
Oh Joshua, I’m sure you did everything right. Sorry to be unclear.
I just am very familiar with CVS-Caremark and their “wear ’em down” tactics.
g
Attention people using CVS Caremark Mail delivery service : Patriot Pharmaceuticals distributors will not distribute to CVS Caremark for mail delivery. So anybody that has to use the CVS Caremark mail delivery service you cannot get the authorized generic of Concerta. Just got off the phone with CVS Caremark asking them to return my prescription to me. I am very sorry to report this news.
Hi Joshua,
Are you sure about that? Sometimes, a pharmacy’s rules depend on the insurance policy — and those can be all over the map, from cheap to “Cadillac.”
In my experience, CVS Caremark representatives (including pharmacists) have not been well informed.
To other readers, I’d like to warn, “Your mileage may vary.”
I’ll try to get an answer on that on Monday. Too late to call now.
g
We were recently switched to Teva from Actavis and it does NOT work! Right now I am having trouble finding a pharmacy that will order from Patriot. We may have no choice but to go with the brand name for now. These other generics do not work the same in any way! I’ve filed a complaint with the FDA and hope others will too as I’ve read many complaints similar to mine on various forums.
UPDATE!!!! KROGER PHARMACY CARRIES PATRIOT PHARMACEUTICALS!!
Thanks for the report from the field, Kristin. 🙂
g
Thank you so much for this! My insurance recently forced me to get my meds from CVS, and only in 90 day mailed supplies. I was forced to use the TriGen generic, as it came by mail, I had no way of asking about the manufacturer before it came, it SHOWED the correct pill online, and I obviously couldn’t reorder it once it came. It took me a MONTH to get used to it, and it actually works pretty well now. But I can’t take off of work 4 days a year to wait for the delivery, so I finally got them to agree to pay for the 30 day supplies from Walgreens. Well, Walgreens can’t get the TriGen ones, they couldn’t get Actavis (now I know why), but he said he could probably get the Patriot ones. Reluctantly said yes, because he said they looked identical to Actavis. Now I’m glad to know they’re the new authorized generic! I’m praying the switch back doesn’t screw me up like the other switch did. (To be honest, I actually prefer the TriGen! Much more energy and a better mood. But, I still can’t take off work. If only they let me do the 30 day!! Already spoke to my employer about it, hopefully they add the exception clause for next year so I can do that. I was *livid*.)
My Walgreens was more than willing to work with me and he’s trying his best to get the pills by tomorrow. Patriot is VERY limited supply unfortunately he said. Now I know why! At least if these don’t work right, it’s only a 30 day and I can go back to the TriGen one…fingers crossed it all works out.
Hi Caitlin,
Yes, being home to receive the delivery can be a hassle.
Are you signed up for e-mail notifications? There might be an option for receiving an e-mail with tracking info when it ships.
And yes, the TriGen generic might in fact work better for you than the Concerta brand/authorized-generic.
There is nothing wrong with these generics, per se. It’s that they don’t perform similarly to Concerta (the release profile, etc.).
good luck!
g
Thanks Leslie! The nearest one is about 30 minutes away, but that is definitely next on my list to try. Appreciate it!
Vicky if you have a Kroger local, try there. I had success with my sons 54mg.
Quick update: Walgreens can get the 18mg authorized generic for my daugher’s Rx without issue (thank you, God). However, they cannot get the authorized generic 36mg for my Rx – the pharmacist literally just said no. I called her back and told her people are able to get at Walgreens, that I have the NDC number and if she can please help me. She gave me the most patronizing smile I’ve ever seen and walked off. I wanted to cry; I cannot believe I’m facing the same same SAME situation again! (Yes, I’m overly emotional; I have ADD! Lol)
Phoned CVS inside Target where I know the pharmacist and she is unable to order that NDC number, however, she advised that I phone a CVS that’s not inside Target since they have different suppliers. So I did and the standalone CVS pharmacist said if my doctor puts the NDC number on the Rx she will try to order it for me.
It’s day 20 of the Teva generic and my doctor reckons I’m having allergic-type reactions to it. Diarrhea, headache, exhaustion, sweats, shaking …. and that’s not even talking about how it doesn’t help for my ADD! 🙁
What about people who are new to ADD diagnosis and don’t know about authorized generics? What about kids being put on the generics and being miserable, saying the medication doesn’t help and getting wrongly diagnosed as not having ADD?! I know I’m preaching to the choir, but where else can I vent to a sympathetic audience 🙂
The FDA guideline should not only be that a generic should have the same ingredients. It absolutely has to look at the delivery mechanism, especially for medication where the delivery is pivotal to effective treatment.
Does anyone know a lawyer that works with stuff like this? I’m at the point where I want to go study law just so I can take action!
That’s cruel and inhuman punishment, Vicky! 🙁
You wrote: What about people who are new to ADD diagnosis and don’t know about authorized generics? What about kids being put on the generics and being miserable, saying the medication doesn’t help and getting wrongly diagnosed as not having ADD?!
Exactly. That’s why I have covered this issue for years. (Not to mention all the other “prescribing gone wrong” issues.)
The FDA was grappling with this very issue: How to create guidelines for generics of drugs with these complex/proprietary delivery systems. When I first called the FDA about this years ago, I found the person to be very helpful. I opened a MedWatch complaint, readers followed through on specifying their specific problems with the medication, and the FDA downgraded those generics.
Then, 2016 happened, and a venture capitalist was appointed as FDA Chief. His “platform” was pushing through as many generics as possible.
Hence this clown car of Concerta generics—and many other medications.
Now he’s gone back to venture capital, but the damage remains and will continue until voters start connecting cause with effect.
A lawsuit would find no grounds, I suspect. Because these manufacturers are following FDA guidelines.
Perhaps instead of law school, you could volunteer right now to register voters and support candidates who want the FDA to do its job instead of being a lackey for “Big Generic.” Just a thought. 🙂
g
I’m sorry you are having trouble getting the authorized 36 mg. What a rude pharmacist! Can you try a different Walgreens store pharmacy? The one closest to our house wasn’t helpful but another Walgreens location a little farther away (one more mile away) was able to order it. You could also call a small independent pharmacy in your area. One near our house said they could order it so I know at least I have a backup if Walgreens ever falls through. I think they want the business. I’m in Jacksonville, Fl.
FYI – Walgreens was able to “order” the authorized generic methylphenidate ER from Patriot Pharmaceuticals for me.
Initially, they filled the prescription with Teva generic “equivalent” and said they no longer had the Alza inscribed pills that were previously made by Watson/Actavis (and they didn’t have any info on where I could find them).
I found this blog and other online articles and saw that the authorized generic is now made by Patriot.
I called Janssen/J&J/Patriot and they couldn’t tell me which pharmacies are prescribing their medication. I called some small, independent pharmacies and one said they could order.
I went back to Walgreens and asked for the written script back so I could buy the Patriot generic from the other pharmacy.
The pharmacy assistant did some checking in her system when I gave her the info and the NDC 10147-0686-1 for the 36 mg. She said she could order it! Just picked it up. I’m happy! Note – not all Walgreens have offered to do this for me but I found one a little farther away that works with me.
Hi Suzanne,
You persevered. Good for you! 🙂
I’m glad my work saved you some legwork.
I’m not sure where else you read that Patriot is the distributor now. I was the first, as far as I know.
Other people’s work gets copied so freely online.
Anyway, in future, it might help to be clear on one thing: Actavis, Patriot, etc. do not make Concerta (or it’s authorized generic, which IS the brand marketed as a generic). These companies are merely distributors. And this can change at any time, though I doubt that will be the case with Patriot, which is a division of Janssen, the manufacturer.
I’m glad you had success.
g
Thank you , Gina. Your information is so helpful so I thank you for sharing this with everyone,
I think I read about Patriot in comments posted in an additudemag online article but yes, your site has so much more detailed information. Thanks for correcting me about Patriot. So, Janssen is the actual manufacturer of the authorized generic now (according to the FDA)? Even though my insurance has a mail order pharmacy, I’m unable to do that. Not sure if it’s a state regulation for controlled substances in Florida? I have to present a paper script from our Dr to the local pharmacy.
Yes, Additude has a long history of stealing my work. 🙂
But it sounds like a reader shared it there. Too bad they didn’t share the link.
Most people don’t think about how many hours it takes to research this ongoing story.
To your question: Janssen has ALWAYS been the manufacturer.
Janssen manufacturers the brand. The “authorized/branded generic” IS THE BRAND. It is only marketed as a generic.
This is a confusing concept for many people. I use all caps to try to clarify. 🙂
re: home delivery: Are you absolutely sure of that? Did you try?
In most cases, you send in the paper script. Some physicians have electronic prescription capability.
g
tx
Thanks a lot Dr Gina!!!
We were facing the wrong fight (1) Pushing for brand and (2) running failed two-step therapy tests without knowledge of the huge differences between generics.
Surprisingly, every stakeholder expressed their ignorance on this topic: .
-Doctor said: “I heard something but I am not really aware of any details”
-Insurance: “we don’t mandate any particular Mnfg. We have no idea.”
-Express-Scripts: “we don’t have such information. File the prescription first”
-Walgreens mail delivery said: “you need to register, file your prescription and we will let you know between 5-7 days if we can deliver”..????
Every one in their own profit silo, patient is thrown under the bus.
Thanks for your advocacy!
Ed, an ADHD -parent of an ADHD-boy.
Hi Ed,
I’m so glad you found my blog.
You are so right about the “stakeholders.”
g
So happy to report that Kroger has the Patriot in stock and I was able to get my sons prescription filled with the AUTHORIZED generic yesterday.
Woohoo, Leslie! Thanks for reporting in.
g
My son has been on Concerta 18mg and then 27mg since around July of 2018. We initially started with some knock off generic, so we requested the Azla and he responded much better to it. Unfortunately, we also experienced the sudden bait and switch at CVS where they gave us the new imitation generic. After about 2 weeks on that medication, my son developed an eye tic and they darted left to right and rolled around. We stopped that medication and moved to Vyvanse. The tic occurred again. I’m not saying the crappy generic caused the tic, but it does coincide with the timing. My son NEVER had a tic on the authorized Azla generic and even the pediatrician said it’s unusual to develop a tic after being on medication for that amount of time. I’ll be filing a Medwatch complaint.
Good for you, Kat. Mom on the watch!
It’s sort of pitiful that we have to be so vigilant, but that’s where we are now.
The tics might be triggered by too high a dose being “dumped” into the system at once.
The Concerta delivery system (the Alza OROS capsule) is unique– and therefore hard to replicate.
Thanks for filing the Medwatch complaint!
g
Thanks so much for the article that you wrote; I wasn’t really sure where to start.
You are welcome.
It took quite a few days to research all the pieces and put them together.
My journalistic skills came in handy! 🙂
g
Walgreens was able to fill the prescription!!! I took prescription in on Aug 8 in the evening and it was ordered and ready on Aug 13.
I did exactly what Gina said and it worked out.
Thanks again for your help. Hopefully, next months prescription will be stress free too.
SHEW! I’m glad it worked for you, Kim!
Thanks for letting me know.
g
I just dropped off a prescription at a Walgreens yesterday. I spoke with the pharmacists snd he indicated that they could fill the prescription. The prescription was written exactly as the article had instructed. The Walgreens that I went to uses AmerisourceBergen as a distributor. I was told the prescription would be available next week on Tues or Wed but to call ahead to confirm. I approached the situation just like Gina said. I’ll see next week if everything worked out.
Good luck, Kim!
There are many types of distributors — and at different levels.
And there is a lot of variable terminology.
Whatever you want to call it, Patriot Pharmaceuticals calls itself A Sales Agent or Distributor of Authorized Generic Pharmaceutical Products
It is the sole source of the Concerta authorized generic.
Other distributors might buy and supply the product to pharmacies.
But that is the source. And it’s important that we all understand the distinction.
g
Our CVS pharmacist is a rare find – very helpful, diligent, actually cares and follows up on stuff. End of 2018, she sent an appeal to her head office because even though Actavis (at that time the auth. generic) was showing on her list of available medications to order, the order wouldn’t go through on her system. She was phoning me with updates and went back to HQ 2 or 3 times. Eventually HQ told her that yes, they do have an agreement with Actavis, but it’s not a “cost effective generic” for them, so they’ve blocked it from being ordered. That’s why, for Concerta starting this year, I’ve had to go to Walgreens. So frustrating, I know! 🙁
Hi Vicky,
Good for that pharmacist. I hope she didn’t find herself in hot water later.
That is exactly the case: the authorized generic for Concerta is more expensive than any in this clown car of Concerta generics.
Smaller, independent pharmacies might actually lose money in filling a prescription for the authorized generic. A great bit of money.
With their economies of scale, I can’t imagine it’s that bad for the big chains.
The fact that CVS will not fill a legitimate prescription speaks volumes about that company.
But I need to clarify something for you:
Do NOT ask for Actavis. Actavis was only the distributor, not the manufacturer.
The current distributor is Patriot Pharmaceuticals.
If Walgreen’s is coming through for you, great. If not, you might want to re-read the post, to get very clear on the facts.
I know it’s a lot of details. I tried to make it as clear and simple as possible. But it’s not simple! 🙂
Thanks for sharing your experience.
g
Thank you so much for this information. It’s lifesaving! You are my go to when my Concerta looks wrong.
I can confirm that the “Patriot” brand generic is identical to the name brand.
I felt a wave of relief when I picked up my prescription, using your information, and saw those beautiful little barrels. Bonus: Actavis cost me $75 co-pay, Patriot was $15!!!!!
ETA: I filled mine at Walgreens. They had to specifically order it. We have an arrangement where I request they order it about 5 days before I need it so they have time to get it in stock and will hold it for me. I try and pick mine up at the 28 day mark so I can have some back up in case of emergency or FDA/manufacturer screw up.
I’m glad Walgreen’s came through for you.
The store is probably making no money on that prescription — might even be losing something.
So, I consider that real (and rare) customer service.
You might want to think about home delivery. Four times annually instead of 12. 🙂
I mention it in the post and link to another post on how it’s done.
best,
g
Wow, and you saved money, too!
Win!
Thanks for letting me know!
g
I’m right in the middle of this battle for both myself and my daughter, so would be wonderful to have something to take to the pharmacy as a starting point.
To be sure, before I get my hopes up: Did you fill the Patriot distributor at Walgreens? This information is gold, thank you so much for letting us know!
Yes, Vicky, that’s what doublen writes. As do other readers.
Gina
I have been acting as go-between for my doctor and CVS Health for my Patriot 36 ml ER version of Concerta. Both CVS Health and the local retail CVS keeps telling me that CVS Health is unable to obtain the Patriot version, even though it’s on the Patriot website. Do you have any advice on how to proceed?
Thank you!
Hi Adam,
Can you go to a Walgreen’s instead?
CVS has a history of this kind of profit-over-customer behavior.
Otherwise, I would print the post, bring it to the pharmacy manager, and ask why, SPECIFICALLY, can CVS not fill the prescription as it is written by your doctor?
You’ll want a good answer.
This is presuming, of course, that your physician has written the prescription according to the guidelines I suggest.
Good luck!
Gina
Just to say thank you once again. This was an invaluable post so filled with helpful facts and ideas.
Thank you, Vicky.
Thank you Gina. Yes, it is unacceptable, I agree. It’s been so many years of fighting this battle. Our insurance has denied all requests for brand name coverage; and after paying $750+ per month out of pocket we just couldn’t afford it anymore. Which is why I was so happy when I found out about authorized generics. I have to say, my doctor works with me, she wrote “Brand or Teva only” just like I asked. Going forward I will list the NDC code as you mentioned. The problem is that I thought Teva makes an authorized generic; and up until I saw your post, I couldn’t find any indication otherwise. Thank you for the information, the details and the support!
I know. The battle is exhausting. It’s unconscionable. Especially when you don’t have useful medication in your system!
I’m sorry that my blog didn’t show up earlier in your research. Or that your doctor didn’t know not to write “Teva only.”
You know this now but I’ll just repeat for others: It’s never a good idea to write only the name of the distributor. Too much can change, and quickly, in that regard.
This has been such an ongoing, convoluted mess.
Just remember that “authorized generic” means that it is manufactured by the brand company. It is not manufactured by the distributor (e.g. Actavis, Teva, etc.).
good luck!
g
Folks —
If you or your loved one had a poor reaction to one of the new seven generics (not the authorized-generic), please file a MedWatch complaint with the FDA.
This is the ONLY way we can change this.
The political climate today is not what it was in 2016, when we successfully lobbied the FDA to downgrade the previous two inferior generics.
The outgoing FDA chief (who took the position in 2017) made a huge push to approve generics — and even scolded the FDA for wanting to take a little more care in developing guidelines for approving generics of medications with complex delivery systems (e.g. Concerta).
But we will change nothing if we don’t try.
Here is the direct link to the form: https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1
Thanks,
Gina
Hi Gina,
I filed a complaint with the FDA about Mylan’s generic Concerta almost a month ago. Today I received a call from Mylan asking me a few questions about the issue. The woman I spoke with was very polite and willing to talk to be about the issues I experienced while I was taking their product (18 mg. generic (not authorized)). She thanked me for taking the time to file the complaint because she says many people just simply stop taking the medication without actually saying anything about it or filing a formal complaint. I told her about a few forums online that I have been reading (specifically this one) and that many people are experiencing the same issue. She supported me taking the authorized generic, and assured me that the product will be further investigated. It feels really good to make such a difference. The phone conversation literally took only 10 to 15 minutes, and just thinking about the number of people I could be helping in the future if the product is recalled makes me feel amazing. I hope that all of you reading this are inspired to make the same decisions about your specific generic products that are simply not working. I told the lady from Mylan that I believe the delivery system is not up to par with where it should be, and that this should be looked into further. She made a note of this in my complaint. Speak up! Encourage others to do the same. We have to be advocates to lessen the trouble and worry that comes with these awful generic medications. Thank you all for reading. Hope you all can find the relief you deserve, and wishing you all the courage to file the FDA complaints and make a difference one complaint at a time.
Sincerely,
Zachary B.
Hi Zach,
Thanks for your advocacy!
Maybe Mylan will learn something from all this. But I highly doubt it.
This is not a company that acts with patients interest in mind:
https://www.bloomberg.com/graphics/2019-generic-drug-price-fixing/
At least their representative will have spoken with a real human who has real-life adverse consequences from their product.
The main thing is registering the complaint with the FDA.
g
Thank you very much. I’m 39 years old and I type this as I’m sitting here in tears, sweating for no reason, with an upset tummy and heart palpitations. I just yelled at my family for no reason and it was like I’m watching myself do it and couldn’t get control. Credit goes to…. TEVA!
Early 2019, I did a TON of research when my insurance stopped paying for Brand name Concerta. Finally found ‘Teva is the new Actavis’ and when our pharmacy ran out of Actavis last month, I was so happy that they were willing to order Teva.
When I picked up my daughter’s 18mg Rx for Teva brand about 2 weeks ago, the Pharmacist opened it and sure enough, it had Alza and it was the authorized generic. Yay! Then last week, they filled my own 36mg Rx for Teva. My husband went to pick it up and when he got home, I saw it was NOT the Alza it was the actual Teva AB generic.
The pharmacy cannot (understandably) accept the medication back and the doctor cannot write me a new Rx since it’s so controlled. I’m stuck, feeling like this – yet again – for another 23 days. I’m just so thankful my daughter has the authorized generic and it’s only me going through this hell.
So I’m writing this post to suggest – each and every time you pick up a prescription – ask the pharmacist to open it up and check for the details as described in this article.
Hugs to all the ADD people out there. We are not a “disorder”; we are a different kind of brain that the world needs to be whole!
Dear Vicky,
This is unacceptable! 🙁
I’m disappointed that your doctor seems content with leaving you in the lurch. Did you ask?
There are justified reasons for your NOT taking the Teva generic and for getting your proper medication. You tried it and it’s not working.
If you’re up for it, I’d encourage you to call your insurer and explain what happened. Ask what can be done. Explain that you will send it back to them to prove that you are not taking it.
Yes, I always encourage folks to check the bottle BEFORE they pay for it.
Ticks me off royally.
Good luck!
g
Last month our local Walgreens, Target-CVS and also standalone CVS, were all unable to order from Patriot for the authorized generic. However this month, Walgreens were able to order from Patriot and fill my daughter’s Rx! (Note that I haven’t picked it up yet, but over the phone they assured me it was those blessed little barrels).
I lucked out and got a part time, super helpful pharmacist who – per Gina’s instructions – looked up the NDC number. She had to put in “do not substitute” on the Walgreens system, and put a comment ‘patient cannot tolerate Teva generic’. Otherwise apparently the system might switch out and substitute for a different generic, based on a lower price.
As Gina mentioned, Patriot was slow to get their supply line going, so it might be worth trying again if you had no luck last month. I really hope Patriot will stick around as the distributor for a few years!
In the meantime, I’m going to file a medwatch complaint about the Teva generic. Facial twitching, panic attacks, lethargy, diarrhea and absolutely no help for ADD. All of which cleared up the day after I (paid $700 cash and) went back on the Brand name.
Thanks again to Gina for this page and also to everyone who shared! It helped so very much. The war isn’t over but this battle for me is won…. at least for this month! 🙂
Yay Vicky!
We have so many generics to battle now—and vastly different FDA leadership. But try we must!
$700….omg.
You are welcome! So happy to have made a difference for you!
g
Gina, I have to thank you SO much for this post and all the comments!
My son was on the Actavis-distributed authorized generic until Walgreens switched to the new Teva generic a couple of months ago.
He was doing really well on the authorized generic (after the years of trying other ADHD meds), but we decided to give the Teva one a shot. It was out of his system much faster, gave him daily headaches and we could tell it wasn’t controlling the ADHD behaviors nearly as well.
We talked to his doc and I asked if we could give Adderall extended-release a shot since it didn’t look promising at first to get the authorized generic Concerta again. So we switched a week and a half ago and boy is there ever a difference, but definitely not in a good way.
Poor kid crashes hard around 1pm when it wears off because he’s a super-fast metabolizer. We tried an immediate-release Adderall in the afternoon around 1p and that would keep him up all night, which led to fatigue the next day.
So after reading your thread and comments and seeing that Kroger might be an option, giddyup…let’s get things back like they were! I called our Kroger (in Virginia) and asked who their distributor of generic Methylphenidate ER was and BOOM…Patriot Pharmaceuticals. 🙂 I had my doc call in an electronic prescription to them and had him specify the NDC number on the scrip. I picked it up today and we’re back in business with the authorized generic.
I have never felt such relief, I swear! I just need to stay on top of Kroger and call a week prior to needing a fill to make sure they have it in stock. It really shouldn’t be this hard to get the meds we need for ourselves and our families, but Gina, you have made this process so much easier.
I really appreciate all the hard work you’ve done!
Dear Michelle,
That poor boy! You poor mom!
I can’t imagine what it is like to watch the downspiral. Painful!
I am so grateful to be of help here. And thank you for letting me know.
g
Larry In KC,
Would you mind sharing the address of the Walgreens where you got the medication?
Thanks so much to all for the information provided in this string! Very helpful!
I’ll pick up the new prescription today from the md. It will be written as suggested. I can’t get it filled until around Aug 5. I’ll see if they will fill it then.
Hi Kim,
You might want to give the pharmacy a heads up. Just print this post. It has all the information they need.
g
Thanks, Gina, for your excellent article.
We used to get my daughter’s generic Concerta from Walgreens because they were the only chain that had the right one – Activis
Having experienced inferior genetics before (that’s why we eventually had found Walgreens) I told the pharmacist that this wasn’t the right pill and a long conversation started. It was during one of the breaks in the conversation that I found your article. Thank you!
I immediately asked if Walgreens could order from Patriot, but they said that they couldn’t, so I returned the product, got the prescription back, and started calling pharmacies for the next 1/2 hour to see if anyone used or could order from Patriot. I was so upset and felt like giving up, but my daughter had taken her last pill that day and I need to get something for the next day.
God bless her, she was in the car amusing herself on her phone and behaving well while I called like a madman to every pharmacy in the area (thank goodness for Google maps!). I looked at the authorized distributors for Patriot and it looked like rite-aid might carry it, but found out that in our area rite-aid pharmacies are actually owned by Walgreens, so no luck there. Finally, I found out that the pharmacy at the Wegmans grocery chain carried Patriot — I shouted for joy, I’m sure that the pharmacist thought that I was crazy, lol. So now I have a new Pharmacy and the right product for my daughter, thank you so much for giving me the info to do so.
You are a true blessing.
Awww Pat, you are one persevering mom. Your daughter is lucky! 🙂
I’m so glad you found my blog when you did.
I hear Wegmnan’s is an excellent store! Good for them.
thanks so much for writing,
g
Gina, thank you so much for this. I had been getting great results with my mail providers by having my physician use the activis designation as well as authorizied generic, thanks to your prior hard work.
til all of a sudden this month express scripts decided to charge me $150 for the BRAND instead of my normal $20 for the authorized Generic. (Yes, I know how lucky I am to have gold plated health insurance. We pay for it becuase the medication savings alone covers our premiums and annual deductible. ). thank god that a quick web search showed your brilliant journalism again!
I wanted folks to know that when I spoke to a phramacist at express scripts and read all this to him, he made it clear ot me that my physician should write “Please dispense authorized generic OR brand, based on plan preference ”
Back in April, Express Scripts took his Rx for the Activis/Authorized Generic OR Brand, then since they didn’t have the former, they sent me the Brand and charged me $20.
Using EXACTLY THE SAME RX IN JULY, they sent me the brand and charged me $150. The idea that I as a patient hav eto know all this for my doctor and pharmacist to do their damn jobs is frustrating. My dr charges me a lot of oney to do anything related to insurance, and his fee is $280 for the 20 minutes I have to spend with him each quarter to get this prescription. I’ve been stable on this medication for more than 5 years. I’m not a drug seeker. It’s ridiculous that I have to go through this charade.
yes, I know it’s still a bargain. But screw them. I’m disputing the difference with my credit card because they refused to refund the price.
Anyway: tell your audience,Express Scripts DOES carry the Patriot authorized generic (at least for my formulary) and again, use this language: “Please dispense authorized generic OR brand, based on plan preference”
I’ll give an update when I reorder in October. but thank you again, from the bottom of my part.
Hi MB,
So happy these posts have been helpful. And yes, I know. It is beyond frustrating! It is fraudulent!
All I can say is, my husband is lucky that I do all this for him. I suspect he would just give up or say, “Okay, I’ll pay $500/month” or whatever. 🙂
That’s why I suggested covering all the bases. It’s really not worth leaving these things to chance, in my opinion.
I’m afraid I disagree with the language Express Scripts suggests. It didn’t work for you, and I know it won’t work for many others.
Pharmacy benefit plans don’t typically have a “preference” in such case. The pharmacy, given no authorized-generic in stock, can justify sending out the more costly brand, given that wording.
I suspect that you had different results each time because different people handled the order.
Good luck!
g
Gina,
An update as promised. I’m still disputing with Express Scripts. My bank has backed me TWICE with this dispute and they’re still saying my account balance is past due.
Today, they confirmed that the prescription for my next group of pills was written properly and willb be dispensed as a brand name with the generic price. My doctor followed your suggestion with the number and the text you wrote, we also added “whichever is lower cost to patient” to the end just in case.
As an annoying but telling side note, Express Scripts told me today I have the option of accepting the $100 credit now, or filing an additional account review with them to get my full $130 back. I decided to take one for the ADHD team and file the complaint. I was polite, persistent and explained the situation carefully. On the call, the pharmacist did explain that the prescription filled at generic price was exactly the same as prescription filled at brand price. (prior to the new way of writing). So we have them on tape saying that nothing has literally changed by the manufacturer.
So, I’ll report back again once a) I’ve confirmed that the drug has shipped with the right price and b) what Express Scripts rules, either way.
I’m blessed enough that the $130 difference in copay won’t break me, so I’m using this hill to help my fellow sufferers as thanks for all you do for our community.
MB
Way to go, MB—taking one for the team. 🙂
I’m sorry to hear that Express Scripts seems to have gone the way of CVS Caremark — where, if you think they care, you’re a mark. 🙂
We never had a problem with Express Scripts or Prime Mail in the past.
I find it SHOCKING how many pharmacists repeat this Big Lie. It’s an indication, apparently, of how whatever they learned in pharmacy school goes by the wayside when working for a profit-greedy corporation.
Then again, maybe they didn’t learn about generics in school. Also, shocking!
Best of luck to you!
g
Gina,
Your work here has been a true lifesaver!
My awareness of this issue began when one uniquely aware, transparent, and honest pharmacist explained the difference in generics. He went out of his way to make sure I always received the “right” one. When he retired I was on my own; fortunately, I found you just in time!
The information and tools you provide have made it possible for me to successfully hunt down my authorized generic. As the industry continues to play its hunger-games I feel uniquely well-armed – I confess, it feels SO great to stop them in their tracks when I speak their language and they realize I’m not messing around.
I have forwarded your information (including web-links and crediting you) to many people in hopes of empowering them as you have done for me.
I get a bit teared up when I think about how much better my family’s life is because of you. To say thank you is such an understatement. -Amy
Dear Amy Jo,
You are making me cry! 🙂
Thank you so much for taking the time to write.
This is exactly why I do this work.
I am so grateful to have been helpful to your family’s health and happiness—and for your sentiments.
I am chin-deep in developing online training. Flagging a bit today. But you just gave me a boost.
big hugs,
g
Has anyone had any luck at any of the pharmacies in the metropolitan area of Detroit or in other parts of Michigan with getting any pharmacy to order the authorized Concentra generic?
Hi Kim,
It might be faster to call a Walgreen’s and ask.
If that store is not helpful, ask for the regional office and call them.
good luck,
g
Hello,
I wanted to thank you personally for your article. It helped me make an informed decision when switching from Adderall XR to Concerta. I would have otherwise thought all the generics were the same as I think of all the other generics but now I know better and was able to find that RiteAid in California is supplied by Patriot with the Alza pills (at least the one near me). Walgreens said they “may” be able to get it, CVS said Trigen only, Costco only carries Avkare, and Safeway is exclusive to mallinckrodt near me. All of them denied being able to order from another source so I’ve stuck by Riteaid. With GoodRX total comes to $108.70 per 30 tabs at 54/mg. It’s more expensive than $87 at CVS but I believe it’s worth it to get the “original” formula of release.
I will be keeping an eye on your site for changes and news, thank you for doing us a service. It is truly appreciated!
Dear Tony,
Thank you for taking the time to write. I’m glad that you found the info.
You know, just last week, at my local Adult ADHD group, one new attendee, a woman who said she is a scientist, raised a big stink about this issue. She assured everyone that “I am a scientist” and all generics are the same as the brand.
She was not having it, when I tried to explain, no, that’s not always the case.
Shew!
So thanks for believing me (and everyone else!). With a difference of only about $20, I think it behooves you to go for the brand/authorized-generic.
If your situation ever changes, you can always try one of the (inferior) generics. If it works well for you, okay. But until you’ve tried the brand, you won’t have established a baseline by which to judge.
I’m surprised that Safeway is still selling the Mallinckrodt. That was downgraded by the FDA. It doesn’t mean it cannot be sold. It just cannot be substituted for brand.
Good luck!
g
Kroger Pharmacy for the WIN!!!!! (Of course I have to finish out this month with half a supply of the authorized, and half with Teva Pharmacuetical generic. I am trying to rotate them so we don’t have two whole weeks of hell. (And that’s what it’s like). When the medicine is in his system it works fine – but the crash when it’s out of his system is HORRIBLE! He’s WORSE than he was before he started on medicine.
The pharmacist at Kroger seemed to have a bit of knowledge regarding this issue too – which was a MAJOR PLUS!!!
Good luck out there all.
Good news, Leslie!
Question: how does one get more than 1 month’s supply at a time? This whole song and dance every month with paper refill forms that I have to guard with my life in our chaotic house is seriously getting old. Don’t love being treated like a drug dealer every time I am at a pharmacy.
Hi Rimma,
I recommended home-delivery in the post. If you have the option, it’s definitely worth pursuing. It will still take some leg work on the front end.
Here is an excerpt from this post — along with a link to another post where I explain how it works.
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.
Yes, this is legal! Read more here: Tip: Home Delivery of Prescribed Stimulant Medications
For anyone in Seattle area, QFC Pharmacy told me they now carry the correct generic from Patriot. Will switch our prescription from Walgreens to there. Absolutely HATE finding out about this when doing refills with 5 pills left ;( At least Walgreens told us right away they no longer carry the generic we need, the previous pharmacy just quietly switched us to the crappy generic and we were left wondering what the hell was wrong with our child for 2 months, until I stumbled on this site and had a talk with our pediatrician.
THANK YOU SO MUCH FOR DOING ALL THIS WORK ON THIS SITE!!!
You are most welcome, Rimma. Thanks for noticing that this is a lot of work. 🙂
Obviously, I am not paid for this and it takes a lot of time.
But the very idea of lives going off the rails — adults, teens, children! — and not knowing why….I couldn’t sleep at night if I didn’t try to help.
Are you sure that Walgreen’s couldn’t get it? Did you share with the store this blog post? Typically, Walgreen’s has been the better actor throughout this mess.
Turns out Walgreens can order the right brand for us. At least they said so over the phone. They said their supplier does stock the Patriot brand, we just have to let them know at least 3 business days in advance that we’ll need it so they can special order it.
It’s a bit annoying because insurance is very tight with controlled medication’s coverage and doesn’t allow refills too soon, so it’s a small window when we can special order it.
If all else fails, I’ll stick with QFC.
Hi Rimma,
That’s great.
Yes, I know, it’s torturous to do every month. That’s why I encourage trying the 90-day home delivery, if you have that option.
https://adhdrollercoaster.org/tools-and-strategies/stimulant-prescriptions-via-mail-order-pharmacy-maybe/
g
Hi Gina,
In Philly at least, Walgreens either regularly stocks or at least is willing to get the authorized generic from Patriot. So far so good.
Peter
Thanks, Peter. I’m glad that Walgreen’s is maintaining its reputation for putting customers first. Unlike CVS.
The store probably makes no money on these authorized-generic Concerta prescriptions; might even lose money.
g
Maybe I need to move to Philly – my local Walgreens gave me a hard “NO” – “we can’t special order – we just have to use what our warehouse has in stock and sends up”.
Wow, that’s not very helpful.
Did you give them the information? Perhaps it’s not “a special order.”
g
Hi Gina,
Posting a follow up from New England… My local Walgreens pharmacist put in an order for Patriot generic 18 mg and 36 mg on Tuesday. After calling her daily, today she filled my Rx for 60 days of 18 mg OROS, but the 36 mg came in as Teva (though the pharmacist had requested Patriot). So, a small victory and further evidence of broken system. I am encouraging patients and parents to register their concerns with both pharmacies and their insurers, using the reasoning that the insurance companies have a responsibility to my patients, who are their “customers,” and that as the insurance companies are the ones paying the pharmacies, they should be able to demand the authorized generic…
To be continued… I appreciate people’s reports on how the different generics effect them relative to OROS. My impression at this point is that the Teva generic lasts 1-2 hours longer than OROS but has a harsher cut off (ie crash) as the delivery of methylphenidate ends. Does this fit with others’ experience?
Thanks again for your work on this and other topics related to empowering individuals to advocate for themselves and others regarding ADHD.
This is a very frustrating time for those of us who have relied upon OROS…but having this community is encouraging!
Hi CP Mama,
Thanks for your report.
It might not be that the “system is broken.” Rather, it’s in transition.
I doubt that it is enough to ask only for the distributor. In fact, that seems highly risky. You’ll probably need to ask for the other criteria that I specify in the post.
Maybe yo/the pharmacist did and that still happened. It might be that Patriot doesn’t have all the dosages in supply yet.
As for the insurance companies making demands, they really wouldn’t have a leg to stand on.
These are approved FDA medications. Approved as generic and substitutable.
This problem starts with the FDA. Specifically with the Trump-appointed chief who came from venture capital and is now back in venture capital. But in between, he went on a campaign to push through a huge number of generics.
He chastised the FDA for dragging its heels. In truth, the FDA scientists knew that many of these generics were not “equal”. With Concerta, there is a proprietary delivery system. Without it, you just don’t get the same effect. The same release profile.
The FDA knew this and was trying to come up with a means of testing generics for these proprietary delivery-system medications. Then Trump’s Gottlieb stepped in and did immense damage. I’m not sure we will recover.
How we vote matters. For so many things.
g
P.S. CP Mama, on your question about the other generics, it’s really impossible to say. They will affect individuals differently. Even Concerta does, given differences in neurogenetic issues around metabolism, etc.
God Bless You for doing all this research.
It’s heartbreaking enough these kids have to be on medicine but to have this much trouble getting the authorized generic is ridiculous.
When my son started, I was getting his at CVS. Then one day when I picked up his Rx I was given the “we have a new manufacturer but it’s the same drug” spill.
I didn’t know any better so I picked it up and cake home. By the end of the first week, I was thinking “what the heck is wrong with my child”.
It was like this for months until I started doing research and found this page, and seeing I wasn’t the only one.
So I started calling around to different pharmacies to find who now carried the authorized. So we switched to Walmart and had a good run there, until one day I picked his Rx up and got the “New manufacturer” spill.
I had to endure another month until I found that Walgreens was carrying the authorized. We had a good run for about 2 years, until tonight when I got the “new manufacturer” spill and it was NOT the ALZA.
I wanted to cry right then and there. I’m so frustrated. But I don’t want to switch to a different med. Looking at Patriot, the only two places I have near me on that list are CVS and Kroger. I’m going to start calling tomorrow and PRAY that when he gets a refill next month we will have the Authorized again.
Dear Leslie,
Thank you. I’m so glad you’ve found some answers here.
I, too, find it unconscionable, this trying to pass inferior medications on to people who need them for their very functioning.
You might want to not wait. You might want to call your insurance company and complain that your child is experiencing problems (if that is indeed the case) and get a replacement now.
best of luck,
Gina
Thankfully it was a split Rx. 16 pills were the authorized, the other 14 say Teva on the bottle. The shape of it is one we haven’t tried before, so I will risk the 14 days of it just to see, especially with it being summer vacation and not in school.
The round table shaped ones were awful and I feel made his ADHD symptoms WORSE and also made him more prone to anger and tantrums. He was a completely different child.
Ah, good. Well, at least you know.
I am horrified thinking of how many people will start experiencing problems (including children) and not know the cause — will attribute it to something else.
I collected some stories regarding the last time this happened.
https://adhdrollercoaster.org/tools-and-strategies/sound-off-downgraded-generic-concerta-users/
g
So, I called my Walgreens pharmacy today and was basically given a hard NO regarding ordering the AUTHORIZED Patriot Pharm. brand. Was told they just get whatever their warehouse sends and cannot special order. Going to try Kroger and pray that I get a better result. I would prefer that he stay on this medication, as I know it WORKS and seems to have less possible side effects – but I’m almost at the point of wanting to switch to prevent going through this so often. Unfortunately, my child’s pediatrician doesn’t seem to understand the issues I am having with these different generics.
Hi again, Leslie,
I’m sorry that your physician is ignorant. That is not a good sign in a physician prescribing for ADHD.
But I’m afraid it is quite common.
Perhaps you could print and give him/her a copy of these posts:
https://adhdrollercoaster.org/medication/authorized-generic-concerta-update-6-1-19/
https://adhdrollercoaster.org/adhd-news-and-research/consumer-qa-on-concerta-and-generics/
good luck,
g
Gina, you are a true savior! Your suggestions have paid off for us in getting the new Patriot Authorized Generic. BTW, we live in the Kansas City area.
We followed your steps in this sequence:
1. Had our psychiatrist write out the scrip with both Patriot pharmaceuticals AND the NDC #. He also signed on the “dispense as written” line. Yes, you can specify a named generic.
2. Checked the list of “authorized distributors” from the Patriot link listed in one of your earlier posts. The only company from that list in our area was CVS….got 2 different stories from 2 different pharmacists at the SAME LOCATION. One said no problem, the other said absolutely not. Bye Bye CVS.
3..Went to our local Walgreen’s with the remainder of our Teva authorized generic in hand. They had no idea Teva had switched until I asked their pharmacist to open a bottle of the new “true’ generic and placed it side by side with the authorized one I had.
4. Had to explain to them how the OROS system timing worked vs. other delivery systems we had tried, stressing how this was crucial to my child’s success in school and life…again, they had no idea there was a difference.
5, Stayed polite but persistent the whole time.
6. The finally acquiesced and ordered the Patriot version using the NDC # from our Dr.’s scrip.
7. I picked it up yesterday…..Eureka!
Our insurance covered at the same rate as other generics…no problem.
I am convinced they ordered it because our Dr. signed on the “dispense as written” line. This Walgreen’s had never seen that done with a generic before.
Have no idea if this will last, or if someone further up the chain of command will put a stop to it and insist on a cheaper version from their approved wholesaler
Dear Larry,
Thanks so much for taking the time to share that report from the front lines!
I am so impressed with your diligence and perseverance! Way to go, dad!!
I love it when the things I suggest actually work! 🙂
Twenty years ago, I started my advocacy thinking that if I just educate consumers about ADHD so they can get diagnosed — then the rest of the professional world will help them.
But nooo….. I quickly learned that we really must self-educate and self-advocate — for ourselves, our partners, our children, etc. With therapists, with professionals evaluating for ADHD, with prescribers, and even with pharmacists, dagnabbit.
I am developing online training for consumers, covering all these topics. The changes we need will come only from grass-roots education and demand, imho.
I will add your note to the end of the story.
thanks again,
g
Gina,
Thank you so much for doing all of this research and for communicating so lucidly!
I’m a psychiatrist and have taken Concerta since medical school (I was diagnosed after a terrible first year and credit methylphenidate with my having been able to complete my medical training). The chronicity of this issue is unbelievably frustrating as a physician, a patient, and now as the parent of a teenager recently diagnosed with ADHD and started on Concerta. She’s trying out the Mallinckrodt generic now, but my own anxiety has been rising: several years ago, when the first unauthorized generics came out, I had a miserable personal experience with the Kremer generic.
Our local Walgreens (East Coast) just stopped carrying the authorized generic, but I am heartened to hear that some Walgreens have been open to ordering Patriot.
One thing I am surprised by is that Watson never made dexmethylphenidate (Focalin) into an OROS formulation…it seems like such an obvious thing to do to get another patented med, and I think it would be clinically so useful!
I appreciate the work you are doing and hope to do my part by educating my patients, colleagues, and the pharmacists I interact with regarding this problem.
Hi CP Mama,
Thanks for the kind words. I appreciate your taking the time.
Wow, I’m glad you found treatment helpful in completing your medical training.
You could always ask your Walgreen’s store to try.
Did you know that both the Mallinckrodt and Kremers-Urban were downgraded by the FDA? They should be no longer substitutable for Concerta.
What’s what we achieved several years ago, through filing many MedWatch complaints.
Then this clown car of generics came on the scene, spurred (from what I can see) by the venture capitalist who was put into the FDA chief spot in 2017 and was a big proponent of generics. Declares they are exactly the same.
Now he’s through the revolving door at the conservative Heritage Foundation, back into venture capital, and currently named to Pfizer’s board.
We cannot have sociopaths in these critical positions. It is wrong.
Let’s hope we turn this around before everyone forgets what standards are.
g
I am so thankful to have come across this post! Thank you all for sharing your experiences and knowledge with the issue of “true” generics vs. “authorized” generics.
I was diagnosed with adult ADHD (combined type) late last year and have been trying to find a medication that works. I started out with Ritalin (true generic) taken twice daily (10mg). This medication helped, but the dose was too high and it did not last long enough. I also did not want to take medication so frequently, so I talked with my doctor about Concerta. I liked the idea of one pill every day for all day relief.
For about 5 months, I was going to CVS pharmacy and was receiving the Trigen 18mg. true generic. It was definitely smoother than the Ritalin and had way less peaks and valleys, however there were times where I did not feel the medication working at all. For me, this medication had 2 bursts of action…one immediate, and the next about 3-4 hours afterward. I tolerated it thinking that this was normal delivery and the best relief that I could have.
I then realized that I had a university pharmacy that carried generic Concerta, and that my copay would only be $10! I was immediately interested in trying to save money as I was spending $88.00 each month for the generic Trigen Concerta at CVS (yeah I know its expensive, but I was under the impression that CVS was accepting my insurance, but they were not. I was simply getting the discount card price).
I went to the pharmacy and received my first monthly supply of Mylan 18mg true generic Concerta. I swear this pill is like a placebo. I immediately felt all of my ADHD symptoms returning (I have combined type- so combinations of no direction, OCD, restlessness, unable to focus, anxiety, interrupting others, confusion, repeating myself, etc…). This last month has been horrible! So I began doing some research of my own…
This blog post has been a SAVIOR! I am going to the pharmacy tomorrow. I already notified the pharmacy of my current issue with Mylan, and I also filed a complaint with the FDA (through the link in the above post, thanks for that!). The pharmacy was able to order me the brand name Concerta from Janssen. I was not aware of the whole “authorized” generic thing until reading this, and how complex this entire issue is! I am planning to have a discussion with my pharmacist tomorrow when I go to get my prescription. My current insurance allows for me to receive the name brand Concerta with a $85.00 copay. While this is less than ideal and more expensive than I hope for, I will likely pay for it so long as I can finally get my symptoms back under control. This past month has been terrible.
I hope that the conversation with my pharmacist tomorrow goes well. I am going to mention the authorized generic, Patriot Pharmaceuticals, and plan to stay calm and kind. I am really hoping that it can be ordered! I will be sure to provide an update on this page. I do not want to pay $85.00 each month for the brand name Concerta. I have decided that if I am unable to get the authorized generic, I am going to try and switch my medication to Vyvanse (because on my insurance formulary the copay is only $20, and this is much more affordable for me right now and this medication is also designed to last all day).
I am frustrated with the current circumstances surrounding this medication! I feel that many people suffering with ADHD could be getting the relief they need from Concerta if there weren’t so many horrible “true” generics out there circulating right now. So many people must feel so hopeless! It’s awful.
I am so happy to have discovered the information on this post and I cannot say thanks enough! I do not want to switch medications if I do not have to. I plan to provide an update tomorrow with what happens. Thank you all for reading and I wish you all the best on your pursuit of finding the authorized generic medication you need and DESERVE! Don’t be afraid to spread the word to us fellow ADHD-ers about these crazy times with generic meds! Thanks!
Dear Zachary,
I’m so happy that you found my post. Thank you for taking the time to thank me and share your experience.
I definitely think you are wise to fork over the $85 for brand FOR NOW. You want to be operating on all 8 cylinders while you sort out an ongoing strategy.
In the meantime:
1. CVS has been a “bad actor” for years with this issue, including continuing to force FDA-downgraded generics on consumers whose insurance required substituting with a generic if available. They flouted the law in doing this.
2. Walgreen’s has been the more responsible pharmacy. I’ve already heard reports that the Patriot supply is available through some Walgreen’s stores.
3. Check out your pharmacy benefit for a home-delivery option. If you have that, I really recommend it. It can take more leg work on the front end, but if you pull it off, that’s 4 times annually you have this hassle instead of monthly.
4. Definitely consider a trial of Vyvanse. For some people, Concerta and Vyvanse work almost equally well (but with slightly different effects). But for others, genetic variations mean that they will do well strictly on one class of stimulants or the other (methylphenidate or amphetamines).
Good luck and stay posted!
g
Hi all!
Thank you Gina for the quick reply. I appreciate your research and dedication to the newest aspects of this conversation! I wanted to provide and update with what happened at the pharmacy!
So I went into the pharmacy on Monday and asked about the medication. I told the pharmacist that I refuse to purchase anything that is not the name brand or the authorized generic. I was very polite and expressed my issues clearly. I did not want to waste any time or money with medication that simply does not work! The pharmacist told me about the distributor they use, and I then pulled up the Patriot pharm website and showed them that McKesson just so happens to be on Patriot’s list of authorized distributors! This was great news, and the pharmacist politely told me that if I call a few days before I plan to pick up my next month’s supply, that they will try to order me in the authorized generic from Patriot! This is such great news. No need to have a conversation about changing medications.
The pharmacist also told me that being Patriot is now the only authorized generic distributor for this medication that the demand may be high and there may be a chance that they are unable to get the authorized generic (if it is on back order or unavailable). However if this does happen, the pharmacist will order me the name brand Concerta. I only plan to take ALZA from this point forward, and I recommend this to everyone prescribed Concerta! I mean, if you find a generic that works for you congrats! I am happy that your symptoms are under control. I personally would much rather support a company that has medication that works for a wide array of those living with ADHD, and not pharma companies that do not care and make terrible products with unsettling side effects (focus on money instead of efficacy).
That being said, I talked with my doctor as well about the situation and it was nice to feel that she was on my side. Her and the pharmacy have been communicating about the issue and are trying to come to terms with what to do. Wouldn’t it be great if I influence the pharmacy to only carry the authorized generic from this point onward? Oh, I can only hope for the sake of myself and all those who are struggling with their generic Concerta medications.
Overall, discussing these issues with my doctor and the pharmacist was a success. Being open about what works and what is not working has been incredibly successful. I encourage you all to have open conversations about the medication you are using/would like to use with both your doctor and the pharmacist. I know it is not always easy! I am fortunate in that I did not even need to change the wording on my paper prescription to get the medication I need and deserve. Communication was the big success point for me! I realize this method may not always work for everyone depending on the circumstances, the quality of medical coverage, and the relationship between each individual and their pharmacist. My tips are to not be hostile, express your concerns politely and sincerely, if they are resistant simply let them know that you will take your business elsewhere and prefer a pharmacist/doctor that is willing to cater to the needs of the patient, and make sure you have done your research and are prepared to respond to questions and comments that come from the doctor or the pharmacist. Patients should not have to go through all of this, however do not be quick to surrender and shut down! This is for your mental and physical health! Make it a priority and allow that to shine through your conversations. Be open and talk about it! It really helped me at least!
My plan is to stay tuned to this website and hopefully stay up to date with the “generic Concerta” situation. I plan to give updates every once in awhile and let you all know about what has worked for me and what has not in regards to getting the authorized generic medication. Fingers crossed that most of my hurdles have been leaped already- at least for now. Cheers all! I hope you all get the relief you need. Make sure to post questions. Many of us are in a similar boat and we should be more than willing to help one another through tips, advice, and feedback.
Sincerely,
-Zachary B
Dear Zachary,
STELLAR!
Excellent self-advocating! Very thoughtful and helpful account.
Thank you and do please keep us posted!
best,
g
Thank you for this post!
I found it after an afternoon of raging about getting stuck with an inferior generic form of Concerta.
I am not sure how many people know this yet, but Walgreens no longer carries the authorized generic. They lost a customer today
I don’t know if this is just my state, but once I paid for those pills, I am not able to return them. I am also not allowed to get a new prescription right away to correct this error! So, I am stuck with the lesser form of Concerta for a month. If anyone has a remedy that is legal in the state of South Dakota, let me know ASAP!
Hi Alex,
Sorry you found this after the fact. I’ve been covering this topic for several years now. Quite a moving target!
But at least found my blog now.
I’m afraid there’s nothing you can do after you purchase it. I’ll re-emphasize that in this post.
BUT I would take this up with the Walgreen’s manager. They might not have it in stock now but it IS available (through a different supplier, Patriot). Other readers who patronize Walgreen’s have reported success. It’s not widespread, but at least it is not a storewide policy to NOT order it.
You probably want to at least try it, if you have no other option now. That way, if it doesn’t work as well for you, you can go on record with that with the insurance company. Perhaps it will allow a new Rx.
Good luck!!!
g
Just tell them to order the Patriot one. They can get it through their warehouse supplier, Amerisource Bergen.
Thanks for offering help, Melisa.
I am actually recommending against asking for “the Patriot one” and instead to use the NDC #.
I explain why several times in these comments and in the post.
It can be a useful extra bit of information but not alone.
g
Sorry, forgot to mention that even on Goodrx website, the Teva generic tablets with Andrx logo & number on them state that they are made by Activis US. And the alza tablets still state Activis US as the mfr, nothing about Patriot Pharmaceuticals. Which I’m sure is adding to the confusion..Argh!
Hi Jess,
Yes, there is too much that is confusing about this issue. I try very hard to cover all the bases in my posts, but it is a lot to navigate. And then there are details such as the one you report.
So that others might find clarity:
1. There is leftover supply, so some bottles/boxes of the Alza tables still might be marked with Actavis US.
2. But Actavis was NEVER the manufacturer. It was only the distributor. Patriot is now the distributor.
3. The Concerta manufacturer has always been Janssen.
4. Years ago, Janssen made a deal with Watson (later Actavis, which was then purchased by Teva): If Watson/Actavis would delay introducing their own generic, Janssen would allow them to market the brand as a generic (that’s what an authorized-branded generic is), at generic prices.
Thanks,
g
I’m sorry, but the more I think about it, the angrier I become in regards to Teva and their knock off Concerta.
If you do a a search for teva concerta, it will bring you to their website. Scroll down and you will see a picture of the 18mg with Alza printed on tablet and below it says its the authorized generic. Scroll down further and you will see pics of the 27, 36 and 54mg tablets with the andrx logo and a number on them..
To get more info you must click the arrow to the right of each strength to open the dropdown menu, where u will then see that they are the AB rated generics. Since Teva purchased Activis and distributed the Alza for whatever amount of time, one could say maybe they just didn’t update the picture of the 18mg yet on their website…
However, one might see that first alza pic and figure that the other tablets below look different now but are still the authorized generic. It just seems all too convenient that they bought Activis, distributed the alza pills, then come out with their own generic..Its super shady…No wonder people and pharmacists are confused!!
Hey,
Hey, there’s plenty to be angry about!
I’m the last to argue that “Big Generic” isn’t “super shady.” 🙂
But if you read my response to your other comment, it becomes clear.
Watson (later Actavis and then Teva) had a generic in the works for a long time. Concerta manufacturer forestalled it by striking the marketing deal: You delay introducing your (crappy) generic, and we’ll let you sell the brand at a generic price.
As for pharmacists being confused, I find too many pharmacists (at the chain pharmacies anyway) are entirely compromised. They are putting the chainstore’s profits first, patient interest second.
I understand that employees must do a company’s bidding. It is not up to these individual pharmacists to make decisions on which generics they can sell.
But it IS up to these pharmacists to at least be honest about the potential differences between brand and generic.
Unfortunately, the FDA director chosen by this White House Administration in 2017 perpetuated this lie. Unlike previous FDA administrators, he came from the venture capital world. He chastised the FDA for going too slowly in approving new generics.
The FDA had been trying to grapple with how to approve generics of medications using proprietary delivery systems (like Concerta’s Alza OROS capsules). But Gottlieb said (paraphrasing), “Stop being so fussy. Push those suckers through.”
I find it horrifying and shameful. Now he’s gone through the revolving door to the Heritage Institute (“conservative” think tank) but has also returned to venture capital.
I wrote about it on my FB page, Maybe this link will work: https://www.facebook.com/GinaPeraAuthor/posts/2307533312658852
g
Thanks for the info.
I was able to get the authorized generic (patriot) 36’s today at a Walgreens in Raleigh.
Two of my kids noticed their pills had changed last week. I went to Walgreens and the pharmacist basically said they don’t carry the authorized generic and that he heard the Teva generic was the same. Argh.
For my other child I asked the psychiatrist to write brand name – dispense as written. The pharmacy tech called to make sure we were willing to pay 400 instead of 30. When we mentioned the authorized generic issue — she researched it in real time and said she would look into getting the patriot version. Today I picked up the meds and it was the patriot version (w/ alza on pill) and we were only charged the 30 copay. Love her. She said that they were able to get the patriot version and that, as you said, the prescriber should either specify Patriot or use the ndc number.
Not sure if we were lucky this one time or if patriot supply chains working.
Thanks for all the info.
Whewee! Thanks for the report from the field, Tom.
That’s at least two reports now that the Patriot supply line is working.
(Honestly, from my encounters with the company, I was starting to wonder if it was ….I don’t know….existing only on paper for some reason.)
I’m not surprised that Walgreen’s went the extra mile to help you. Walgreen’s was definitely the better actor during the previous generics mess; CVS the worse.
That tech is a jewel!
I’m so glad this worked out for you and your children.
g
That’s great to hear! Where in Raleigh did you find it, Tom? I live in Apex, so I like to try the same store.
Hi Tony —
I wrote to Tom, and responds with this (Thanks, Tom!):
Walgreens – Store #12730
11201 DURANT RD
Raleigh, NC 27614
919-518-0514
FYI. I was just able to order 3 month supply of Patriot authorized generic (Alza36) from Homescript
Fantastic!! Thanks for letting us know, Brian!
g
I got the last quantity 57 Alza 54mg authorized generic pills at my local Walgreens. This was after I rejected the Teva so called true generics (best to open the pill bottle right at the counter!). Bummer. Pharmacist says that he cannot get any more Alza 54mg.
Lucky you, Da Ro!
You don’t need to open the bottle, though. It should say on the label.
I’m hoping that the transition will end soon and the supply lines will be more readily available. Who knows.
In the meantime, buy brand if you can afford it.
good luck!
g
Hi again. Got the balance of Alza pills from Rite Aid. Maybe I was lucky and just got some remaining stock. None the less, Rite Aid is now our pharmacy for Alza Concerta (and my son’s shrink is finally starting to understand the Concerta generic issue).
Hurrah!
You might want to ask the pharmacy to be prepared for next time. 🙂
g
Thank you so much for this information! Sometimes even the pharmacists aren’t sure what is going on, and this will help me communicate more clearly with them. This is the second time you have helped me figure out “why can’t they get it for me” and “what do I need to ask for exactly” in the past few years. The generics cause spikes in my daughter’s anxiety. I will report her issues through Med Watch and the FDA.
Hi Amy,
You are most welcome!
Thanks for reporting the issues. It’s crazy that, with everything else we have to do, we have to rein in “Big (Greedy) Generic” but there ya go.
g
Thank you so much for staying on top of all the spinning gears here. We are a psychiatry office and our psychiatrist is very insistent that people only get the authorized generic. But we have a hard time keeping up with who owns it and how to get the pharmacies to recognize and honor what we’re writing. Even when we switched to writing “Alza/OROS” we learned that some patients have for years been dispensed AB- (and in one recent case BX-) rated products and the pharmacists have ignored what we wrote. Your updates have given us our best chance possible to prevent needless suffering for our patients. From now on we’re giving the manufacturer name, the NDC, and we’re going to write “ONLY” at the front and back of the instruction just for overkill. Given our recent interactions with pharmacies I don’t think you can write too much – if you’re serious about wanting to get the fill in a specific way.
Hi Josh,
Thanks for letting me know my work has been helpful to your office and your patients.
I surely don’t get paid a salary for this! The payment is in knowing there might be a little less unnecessary suffering in the world.
You are right…over-kill on the script!
I had one top-level pharmacist at a home-delivery chain pharmacy tell me that the Trigen generic was OROS.
I asked him who told him that. He said, “Trigen.” !!!!
When a top-level pharmacist doesn’t know the difference between a basic technology (osmotic) and a proprietary technology (OROS), we’d best all stay on our toes!
g
Thank you Gina and Jaclyn for your thoughtful and helpful responses. Will keep following this. Thank you for all of the information. Hope to have some sort of a resolution soon. Even if have to change meds and start from scratch:(
Hi, I received the new Teva generic on 6/21, have taken it for last 3 days and it is definitely nothing like the authorized generic I had been on and bad side effects-headaches, anxiety, teeth clenching and wears off after 4 hours. Called pharmacy and they stated that teva is what they now carry. Will call my Dr tomorrow, but brand Concerta is just not feasible right now…wonder if I’d be better off asking to switch to Ritalin IR TID ? This is ridiculous! Did not get diagnosed til 36 years old, Concerta(authorized generic) was giving me some semblance of a life and the pharmaceutical companies/retailers get to just rip it out from under me. Have filed report with medwatch and urge everyone else that is having a negative reaction to do the same asap, doesn’t take very long and might help. Thanks for listening.
Hi Jessica,
I appreciate your frustration — and share it.
Thanks for filing a Medwatch complaint. It’s horrible that we have to hold these greedy generic manufacturers responsible. But until the FDA can come up with new generic guidelines for medications with novel delivery systems—or government oversight improves on consumers’ behalf—this is what we’re stuck with.
Just so you know…we’ve actually been pretty lucky to have had the authorized/branded-generic for as long as we have. Generic manufacturers were licking their chops almost a decade ago, as the Concerta patent was expiring. Janssen made a deal with that generic manufacturer (Watson, at the time) to postpone that in exchange for a profitable marketing deal.
It might be worth your while to try some of the newer products, some of which have savings programs. They might even suit you better. Who knows.
good luck,
g
For what it’s worth, I had good results for a long time with Ritalin LA/Metadate ER (methylphenidate hydrochloride). The generics are a bit variable as well, but because of the simpler delivery system I was more willing to use them. That being said, the generics definitely didn’t feel as gentle as the brand (Ritalin), if that makes sense. I noticed it more. I’m guessing you appreciate the Concerta for some of the same reasons I do, including the fact that I don’t feel it working at all.
Anyway, if you’re getting bad side effects it may be worth trying the Ritalin generics. Unfortunately they’re only a six-hour dose so I would have to remember (or set an alarm) to take it at 8:00 and 2:00 every day. Definitely not ideal but better than nothing.
I was diagnosed at 24 years old, 2 weeks ago. My psychiatrist started me on Concerta 18mg, and I got my prescription filled at Fred Meyer. It wasn’t until after I bought it that I realized that Fred Meyer was 2x more expensive than CVS, walmart, and Walgreens according to GoodRX coupons. ($90 at CVS, $180 at Freddies) BUT, I received the authorized generic with the Alza label.
I’m titrating and just got a 15 day prescription of the 27mg to try next, and this time I got my prescription filled at CVS (unknowing of this whole generic fiasco at all at this point) and received Trigen TL 707 tablets this time.
I’m too nervous to even try it and instead we’re going to skip 27mg and just try 36mg since I can use the pills I have left from the 18mg.
But if anyone is looking for authorized generic, I got them at Fred Meyer (Kroger), but they were 2x the price than CVS. I’ll be calling around the other pharmacies in town that have the lower prices, but I’m thinking I might be better off just paying the premium for the authorized generic.
I’m a business intelligence analyst by trade and never have had to research into pharma before, only knowing the general disdain everyone has around it. My marketing professor in College worked high up for a pharmaceutical manufacturer for body part replacements (knees, hips, etc) and we spent a lot of time discussing morality regarding that industry specifically and his experience. The scariest statement he made in class after discussing the carbon knee replacements that got recalled and sued for for causing cancer, (the company won the lawsuit though) was: “So when anyone asks me, do these knee replacements cause cancer? Well… we won the lawsuit. They don’t cause cancer. But would I put one in my grandma? No.”
My research has only just begun, but so far I’m already horrified.
Hi Lo,
Good idea, starting with the brand. That way you eliminate a variable.
Medical devices….one thing. Pharmaceuticals…quite another.
Also, if that professor was in marketing, perhaps he was unable to parse the nuances around that case. Just a possibility. I’m much more skeptical of the medical device industry. While other sectors were somewhat brought to heel under the ACA, the medical device makers still operate unencumbered, from what I can see, and very lucratively at that.
Still, there’s no need to be horrified. Don’t let ADHD-related fear centers blow this out of proportion. You have access to a medication that’s been a game-changer for millions of people. So, let’s celebrate that!
Yes, if you have to pay twice as much for the authorized generic/brand, that might be a good investment.
If you have health insurance that includes a pharmacy benefit, you’d undoubtedly save more using that. Check for a mail-order pharmacy benefit, too.
Good luck,
Gina
Dear Gina,
You are performing an extremely valuable service here. Thank you for your careful and resourceful work. We have shared your information with our son’s prescribing physician and hopefully can find a pharmacy willing to source from Patriot or willing to pressure its primary or secondary wholesaler to do so. I wonder if the authorized generic deal between Janssen and Actavis/Teva merely timed out, or whether Teva wanted to launch its own version and therefore Janssen brought the authorized generic in-house to Patriot?
Peter
Thanks for the kind words, Peter.
I know first-hand what a panic this is. I’m offering lemonade from our lemons. 🙂
It’s strange. After the Watson-Actavis deal expired, there was no public mention of the new arrangement with Teva. I called Teva. A cryptic response. (e.g. “We’re selling it. Don’t worry about it.”)
Teva purchased Actavis so maybe there was gray area for a while.
Also, Teva had in the works its own generic.
The authorized generic deal typically comes about when a drug is going off patent. The manufacturer makes the deal with a generic manufacturer to forestall generic release for a time.
Patriot has not impressed me so far. Something “off” about the entire operation, from what I can see. But my husband, who knows scientists who work in pharma, says, “That just sounds like pharma management. Very dysfunctional.” 🙂
We shall see. I opted for the brand this time. Because the situation did not look good for getting the authorized/branded generic.
Good luck!
g
This website was an amazing help! Getting ahold of the ALZA pills can feel impossible but this site answered all my concerns. thank you so much for making this page and being so thorough
I’m glad you found it helpful, Mary. Thanks for letting me know.
The details can be overwhelming but if I don’t include them, more questions!
We’re opting to go for brand now, until the dust settles.
g
My wife found the authorized generic at Kroger.
Also, on the lawsuit idea, after multiple car accidents by a kid, and other issues, it would not be hard to prove that intentionally ineffective medication has caused harm. Proving loss of income or relational issues might be hard, even to value. But if we can prove that car accidents have materially increased, then executives could be worried about personal criminal charges.
Imagine if a cholesterol medication watered down its dosage. If multiple people died, that would be easy to prove criminal intent. That’s what is needed for class action. Very clear and widespread damages that can easily be directly attributed. If you have a major car accident, please save a few pills from that bottle for later testing of strength.
Hi Aaron,
I’m no class-action legal specialist. 🙂 But I imagine it would be easy to pick apart the particulars of car accidents. I mean, those can happen at any time, caused by a ton of variables. Unless there was a massive number of them. And I sure hope that is not the case.
The stories I’ve heard cover a lot of ground — children failing in school, surgeons having trouble performing surgery, less productive at work, etc.
I don’t know. It’s a mess. And someone should be accountable.
g
Thanks so much for this post. I’m now paranoid! Was this a very recent change? My daughter’s bottle incicates it’s produced by Actavis/Teva, and it has the Alza label and barrel shape. It was filled May 22…I assume it’s the correct med because of the Alza label, yes? With the unavailability I’m scared now to see what will happen when we need to refill, since this is the only med that works well for her. I’ll probably need to do some calling around…
Yes, Elizabeth. You’re good! If it says Alza, it’s the brand/authorized-generic.
g
I just want to say thank you for posting this! I filled my daughter’s script the June 1 and got something different from Teva. I called the pharmacy and spent a long time on the phone with them. They insisted that it has the correct osmotic delivery system. I searched online but couldn’t find anything. I’m so glad to have the answers spelled out for me! Thank you so much for this information!!!
Hi Jeanne,
I’m so happy you found me! Yes, several pharmacists I’ve been in touch with have made the same mistake — confusing a generic osmotic system with OROS.
Astounding.
g
So I’ve re-read everything like 5 times…what we were given may have osmotic release like the bottle says, but NOT the OROS because it doesn’t say ALZA on the pill. Correct? It’s the Teva brand and it’s an oblong pill but not barrel shaped. They are so tricky!!!
Tricky is the word for it!
Yes, you have a regular generic, not the authorized/branded-generic for Concerta.
It’s just possible that you might like it better than Concerta. The thing is, though, for people who are accustomed to Concerta and expect a generic to be close to it, many find that is NOT the case.
G
If or when (not really a question about when because when I’m determined I’m, well determined…) I get an answer I’ll post it in the comments!
Great. Thanks.
ADHD Malta lobbied their government to get the branded Concerta back. Seems to be winning though gov’t being non-commital.
https://timesofmalta.com/articles/view/branded-adhd-medicine-back-on-the-cards-though-timeframes-remain-hazy.713194
I got my reply!
Only now not sure how to follow up, because I did not get the answers I hoped for.
The way I interpret the swedish FDA’s answer is that there are no (at least not identifiable) “true generica” in Sweden?
I have written back and asked how I can identify the different drugs available to me in order to make an informed decision on which to ask my dr. for.
The answer below – my quick translation from Swedish, but should be more or less correct I hope.
“Hi!
Thank you for your questions.
In Sweden, the terms “authorized generica” and “true generica” are not used, so we do not make a difference between these. A generic drug is defined according to EU directives as a drug that has the same pharmaceutical dosage form and the same active substance content as an original drug and, where required, has demonstrated bioequivalence with the original drug. To obtain a new drug with a new active substance (so-called original medicine) approved, a comprehensive chemical / pharmaceutical, preclinical (animal studies) and clinical (human studies) documentation is required. For a decade, a research company has the exclusive right to the documentation that has been produced for approval. After the exclusivity period expires, other companies can apply for and later market drugs containing the same active substance, so-called generic drugs.
All drugs listed as interchangeable have been considered medically equivalent by the Medical Products Agency. The basic criteria for drugs to be considered interchangeable is that they should:
be approved as a drug
contain the same active ingredient (s)
contain the same amount of the active ingredients
have the same formulation
have been judged to be bioequivalent / therapeutically equivalent
included in the drug benefit (decided by the Dental and Drug Benefit Agency (TLV)). However, medicines can be included in the Medical Products Agency’s substitutability list before it is included in the drug benefit. No exchange will then take place at a pharmacy.
More information about the generic exchange can be found on the Medical Products Agency’s website:
https://lakemedelsverket.se/malgrupp/Halso—sjukvard/Forskrivning/Utbytbara-lakemedel-/
(I checked and there were no additional information on any distinction between authorized and true generica.)
The Medical Products Agency has also produced information material on the generic exchange together with the Dental and Drug Administration (TLV), which can be found on the TLV’s website:
https://www.tlv.se/apotek/utbyte-av-lakemedel-pa-apotek/informationsmaterial-om-det-generiska-utbytet.html
(Nor did I find any additional info on the site she linked above)
The “NDC” code (the National Drug Code, according to the article) is an American concept that does not exist on drugs in Sweden.
I hope that this answered your questions, you are welcome to come back with any follow-up questions.
Sincerely,
Åsa Tunon
FDA (Läkemedelsverket)
Åsa Tunon
Farmacology. PhD, Pharmaceutical Investigator
Unit for Pharmacy and Biotechnology”
He took the term “generic” and ran with it. Letter of the law, not the spirit. Bloodless functionary.
Thank’s for all the hard work you put in to explaining and exposing information on generica.
I tried to find information on true generica v.s authorized generica at our equivalent of your FDA (Läkemedelsverket) but there is no info (at least not easily) available. So I sent my questions to the registrar and hope to get an answer soon.
I have tried all the generics available in Sweden, and I must say they all gave me more side effects and the effect varied A LOT, therefore I always insist on getting the brand Concerta. In Sweden the pharmacies are required to suggest the cheapest alternatives to all medicines, but the can only force you if your Dr. have not specifically written on the ordination “should not be exchanged for generica”.
Luckily for me living in Sweden I never have to pay more for any and all med’s I need (the subsidy increases in increments of a % of rebate over 12 calendar months) about 150US dollars. After that everything is free for 12 months, and the the cycle repeats.
The generica that swedish FDA provides for Concerta:
Concerta®, Depottablett 36 mg
Janssen Förmån
Methylphenidate Mylan, Depottablett 36 mg
Mylan Förmån
Methylphenidate Sandoz, Depottablett 36 mg
Sandoz AS Förmån
Metylfenidat Actavis, Depottablett 36 mg
Teva Förmån
(“Förmån” means that a medicine is covered by the system of rebate. Not all med’s are, things like viagra are not, but all critical medicines are covered.)
In Sweden the available methylfenidate med’s are: (from http://www.fass.se)
Sökresultat för “metylfenidat”
Läkemedel (32) Substans (1)
Sjukdom (0)
Metylfenidat Actavis
Concerta (Metylfenidat)
Equasym Depot (Metylfenidat)
Medanef (Metylfenidat)
Medikinet (Metylfenidat)
Methylphenidate Alternova (Metylfenidat)
Methylphenidate Mylan (Metylfenidat)
Methylphenidate Sandoz (Metylfenidat)
Ritalin (Metylfenidat)
Parallellimporterade läkemedel (7) (“Parallell-imported”)
Concerta (Metylfenidat)
Equasym Depot (Metylfenidat)
Medikinet (Metylfenidat)
Methylphenidate 2care4 (Metylfenidat)
Methylphenidate Mylan (Metylfenidat)
Methylphenidate Sandoz (Metylfenidat)
Ritalina (Metylfenidat)
Läkemedel som för närvarande ej tillhandahålls (9) “Not presently available”
Metylfenidat Teva
Equasym Depot (Metylfenidat)
Metylfenidat
Medikinet (Metylfenidat)
Methylphenidate 2care4 (Metylfenidat)
Methylphenidate Mylan (Metylfenidat)
Methylphenidate Orifarm (Metylfenidat)
Methylphenidate STADA (Metylfenidat)
Ritalina (Metylfenidat)
Ritalin (Metylfenidat)
Avregistrerade läkemedel (7) “De-registered”
Concerta (Metylfenidat)
Concerta (parallellimporterat), Depottablett 18 mg
Medartuum
Concerta (parallellimporterat), Depottablett 18 mg
Omnia Läkemedel AB
Concerta (parallellimporterat), Depottablett 18 mg
Paranova
Concerta® (parallellimporterat), Depottablett 18 mg
Teva
Concerta (parallellimporterat), Depottablett 27 mg
Medartuum
Concerta (parallellimporterat), Depottablett 36 mg
Medartuum
Concerta (parallellimporterat), Depottablett 36 mg
Paranova
Concerta (parallellimporterat), Depottablett 54 mg
Medartuum
Equasym Depot (Metylfenidat)
Equasym (Metylfenidat)
Medikinet (Metylfenidat)
Plimasin (Metylfenidat)
Ritalina (Metylfenidat)
Ritalin (Metylfenidat)
Dear Peter,
Thanks so much for providing this resource to the ADHD community in Sweden.
This blog is read by a few folks in Sweden. 🙂
cheers,
g
This is by far the BEST article I have read! I’ve been on Concerta for almost 17 years and when I went to pick up my prescription I was given the “generic” and it is awful. I might as well not take medication because the Teva brand does not work. I remember when they had to pull the generic years ago because even though it was similar chemically, it was the outer coating of the name brand which made Concerta different than the rest of the medication out there. I will file a medwatch report with the FDA because they shouldn’t be marketing a generic Concerta if it doesn’t work exactly the same as the name brand
Thank you again for all the information that you’ve provided!
Hi Melissa,
I’m glad you found me. I’m not sure anyone else is covering this. Amazing, as it stands to affect millions of people in the U.S. alone.
Actually, I was a ringleader on getting the first two Concerta generics downgraded by the FDA.
It wasn’t that long before SEVEN new generic manufacturers issued their versions.
Actually, the problem wasn’t the outer coating. The problem was the inner/outer technology. Without that technology (Alza’s OROS delivery system, a laser-drilled osmotic pump), Concerta would just be Ritalin. It’s the same chemical compound: methylphenidate.
The delivery system makes all the difference. And none of the generics have that system. It’s proprietary and it can’t be manufactured in some backwater Big Generic shack in China, India, etc.
“Big Generic” is very cynically exploiting FDA loopholes. FDA has had a hard time coming up with generic guidelines for these novel delivery systems such as OROS.
Good luck!
Gina
Yep. Writing about this ongoing Concerta generic issue led Facebook so prohibit me from advertising.
I’ve appealed. Each time, the algorithm behind the curtain says, “Our decision is final.”
Crazy world this is getting to be.
“I wrote to them the other day, offering help in identifying co-plaintiffs.” Good on you for doing so Gina. Yes I’ll spread the word about medwatch.
Thanks for keeping blogging on this topic.
I want to thank you guys so much for being involved in this “nightmare”. When you figure out an ADHD med that works for you – then you can start to build on that ADHD med to take on life. But, when the big pharma companies keep switching up sub par generic meds for brand in the name of profit. Life comes crashing down and you have to clean up the mess to figure it all out again. I was diagnosed at 19 and now 51. Started off with Ciba Ritalin SR 20 started a family and built a company for the next 25 years. Ciba SR 20 discontinued. Went to Adderall and lost my company, my mind and almost my family. Went to true OROS Actavis Concerta and I’m starting to get it back together. Now AC is discontinued. I’m tired and don’t want to do this anymore.
I feel your pain, Brian. And I am happy to help. But I need to correct some points you make.
1. “Big Pharma” is why you are able to “take on life.”
2. “Big Generic” is what’s messing with you. That and “Big Pharmacy.”
3. It is not the “Actavis Concerta.” Actavis was only the seller (then Teva).
4. It is the AUTHORIZED GENERIC (the brand sold as a generic via marketing deal).
5. It is STILL AVAILABLE. You might have to work harder to get it, though.
Print out my post and highlight the key information. Take it with you to your MD and/or pharmacy.
good luck!
Thanks Gina,
too bad.
I’m doing well, hope you are too.
Thanks for the reminder about the Caddac page on it.
“Only financial harm” Idiot judge.
“When we succeeded in getting the FDA to downgrade the first two inferior generics, the Mallinckrodt CEO refused! And he filed a lawsuit (later dismissed). CVS continued to substitute the downgraded generics, illegally.”
So evil. Wish more ADDers were out of the ADHD closet so they could pressure that company AND the FDA on this. I.e., a #GenericConcertaHarm campaign or something like that
In the judge’s defense, the plaintiff didn’t show damages. The law firm seemed asleep at the wheel on that one, and they seem to have successfully litigated other class-action suits.
I wrote to them the other day, offering help in identifying co-plaintiffs.
It was adults with ADHD and their parents or partners who followed through in filing the MedWatch complaint. It took me a while to get through to someone at the FDA but when I did, she was very nice about helping me open the claim.
You can always share the medwatch link from this post in your blog, Twitter, etc. Spread the word!
I agree with everything you’ve said. The system is a mess and I don’t know what will fix it. It certainly is not set up to help the consumer (or the physician, since we spend so much non-reimbursed time trying to get patients what they need through prior authorizations and excessive paperwork – there was just a NY Times article about all the “free” time physicians are spending doing things if you want to read more about one more thing that increases physician burnout).
As for what conditions the pharmacy must fill a prescription as written, I would think if the person filling the prescription asks for it and that is what they will pay for, they should be able to get the preferred medication brand. If the pharmacist refuses, a patient could try another pharmacy – which might be good for the pharmacy if they lose money on that prescription. The whole issue with the Patriot brand though might be that it is not available. It’s hard to know when pharmacists say they can’t get things what the situation is. Sometimes they really can’t and I can find it on the shortage list published online. Other times I think they just don’t order from that company and “can’t” get it because of that. For the big chains I’m sure the individual pharmacist really can’t change that. It’s a system thing.
I know many who use GoodRx without their insurance to get a preferred medication that isn’t on their formulary. That causes issues with them being considered “non-compliant” since the insurance company doesn’t know about the medication, which then translates to the physician getting fax after fax to discuss the importance of taking medications for XYZ (usually asthma in my pediatric world – I hate to think of the issues for adult physicians who deal with more chronic diseases). The “non-compliance” can also hurt the patient because many insurance companies offer benefits when people go to the doctor as recommended and take medicines as recommended. While that’s good in theory, until they cover the medications they seem to think are beneficial at a price that people can obtain them, patients will either not fill them or use another cheaper way to get them.
Aiyiyi! I’ve always been quite sure of the burden all this places on the physician as well. But the details…
Maybe we need a few good templates.
g
I have a love-hate relationship with coupons for medications. There are many reasons that I try to explain in https://questforhealthkc.com/2018/01/20/affording-medications/ (sorry if you don’t want blogs linked here).
Thanks for sharing the legal issues in Europe with Concerta and generic versions. It’s interesting to see that they have similar issues despite their different healthcare system. Someone always has to pay. One question I have is how much does it really cost to make the medications? Pharmaceutical CEOs make millions each year.
With so many generic versions, it will be extremely difficult to assess when a patient isn’t doing well on a particular dose of medicine. I’ve already had a couple of patients who weren’t doing well and we had to have a long discussion of whether to try a different strength or use a different pharmacy to get the authorized generic, which they previously did well on. When they do return, they’ve all done well again. Unfortunately now the authorized generics are difficult to find, so that’s not always an option. It’s too hard to know if a different generic would work better than the current generic version. These are not cheap, so parents don’t want to fill several scripts trying to find the right one. They already know what works, but insurance formularies that require generics over name brands make it impossible to afford the name brand.
I do worry that it will take even longer than it did in 2013-2016 to show that each of the new generics does not work well (if that’s the case). Since there are so many brands, reports of each individual brand will take longer to collect. And that’s only if people file Medwatch reports. I’m sure many never even know that’s a possibility or they don’t do it for any number of reasons. It’s easy and risk free to file a report, so I highly recommend that people do file one if they notice a problem.
Thank you for continuing to fight this fight and share what you learn.
Thanks for the details, Kristen. No problem with the post-sharing. I’m sure it will be helpful to my readers.
I’m not saying any of these alternatives are ideal. But some people are being forced to try them.
Yes, Kristen, pharmaceutical CEOs make millions each year. But I find it’s easy to scapegoat “Big Pharma” without considering “Big Generic” and “Big Pharmacy Chain” and even “Big Cheap Employers.”
Big Pharma gave us the novel delivery system of Concerta, which was a breakthrough for millions of people with ADHD.
The generic manufacturers knowingly exploit FDA loopholes regarding these novel-delivery system medications. The big pharmacy chains wear down consumers (when they aren’t gaslighting them with assurances that the generics are “exactly the same) by saying they cannot order the authorized generic for Concerta. (When we had Aetna, they’d give me a new excuse every day, including that the physician had gotten some tiny detail wrong. Only when I Twitter-shamed the CEO did I get a response.)
That CEO of Aetna got THREE QUARTERS OF A BILLION DOLLARS for shepherding CVS’s purchase of Aetna. (How that’s not a massive conflict of interest I cannot imagine.)
CVS has definitely been the worst throughout all this, and I’m afraid it is calling the shots for all of them. Walgreen’s was the best. But now with the flood of Concerta generics, I think even Walgreen’s is saying, “we can’t afford to fill these prescriptions.”
An independent pharmacist who left a comment here said that they lose $100 for each authorized generic (Concerta) that they fill. Their reimbursement price is based on the lowest “true” generic price.
We need consumer protections. Especially after years of “public health officials” beating the drum for generics.
I can’t imagine that we’re going to win this battle, not without a legal fight.
One father of a child with ADHD did file a class-action suit, but apparently, he was a bit….impulsive. He failed to establish harm to the child. In other words, that the medication affected the child adversely. Instead, he argued for financial damage — that he’d paid for a generic that didn’t work as well as the brand.
Maybe some enterprising law firm will get on it.
OH, do you know when and under what conditions the pharmacy MUST fill the prescription as written, no matter what the insured’s “formulary” is? I can’t find an answer for that.
g
thanks,
Gina
As a pediatrician who has counseled patient families on this issue over the years, I strongly encourage anyone who has a different response to a generic vs the brand file to a MedWatch report. This allows the FDA to be aware of the problem and hopefully take action. It took a long time with the original non-authorized generics, but it did help.
The problem with changing to a newer MPH is insurance formularies usually restrict to a few medications. I find that few will allow Daytrana, Quillivant/Quillichew, Aptensio, and others due to expense and there are no generics available. If they do allow them, they can still be very expensive or not as effective. Ritalin LA, Metadate CD and Metadate ER simply don’t last as long as Concerta, so that introduces the need for an afternoon dose of ritalin during school, which is not acceptable to or appropriate for middle and high school students, who would miss part of class daily to go to the office or school nurse for medication.
Hi Kristen,
Thanks for weighing in. I typically post a link to the FDA Medwatch with every post. I was trying to streamline this last one. 🙂 But I just added a bullet point at the end.
Readers are finding the entire issue confusing (even to understand the difference between an authorized generic and the other generics).
I offer all the avenues I can to get the “real” Concerta but some people will, unfortunately, be refused. After that, people need options.
With some of the newer Rx, as I’m sure you know, at least there are savings programs. If someone cannot qualify outright for financial assistance from the pharmaceutical manufacturer, they might qualify for the discount program.
I’m not sure how we’re going to fight this flood of inferior generics. Especially at a time when consumers have targets on their backs in most areas.
We need serious lobbying, including from our alleged advocacy organizations.
Check out what’s happening in Malta vis a vis Concerta:
https://www.maltatoday.com.mt/news/court_and_police/95469/mother_files_judicial_protest_over_sons_adhd_treatment_with_alarming_side_effects#.XPxsEtNKh4Y
http://www.independent.com.mt/articles/2019-06-08/local-news/ADHD-patients-to-get-branded-medicine-after-authorities-approval-6736209291?fbclid=IwAR2Y-kwE7fXziBZIWAuDrWOiOYw_PoVwQ88MxhnUTeRUSqw-1tsEmO0q1ZI
cheers,
g
I’d like to know who in the United States has any success ordering this. We live in the Philadelphia metro area and have contacted over a dozen pharmacies so far including all the big names and independent. None will order, not even from the distributor list. They say they will not order from other distributors. This is a nightmare.
Hi Jamie,
I feel your pain.
I think it’s probably too soon to know how this (the authorized generic moving from Teva to Patriot) is all going to shake out.
As I mentioned in the story, it is usually a better idea to try the home-delivery pharmacies. They have more access.
Barring that, it might be time to try one of the newer MPH offerings: Daytrana, Quillivant XR, Aptensio XR, Cotempla XR-ODT, QuilliChew ER, Methylin, Ritalin LA, and Ritalin
Jamie – I have just hopped on board the “Patriot” train and I too live outside of the Philly Metro area in Wilmington, DE. I had to search several chain pharmacies when the answer came in the strangest of places – the Wegmans Pharmacy in Concordville, PA carries the ALZA Patriot manufacturer of Methylphenidate. I have been able to get meds for both of my boys. They did say that “after this we will not have it in the 18 mg strength” which is going to cause issues for me. I have to go back and discuss this with the pharmacist who was unavailable at the time. Try a Wegmans that is closest to you. Best of luck!
Hi Chris,
Great luck! Thanks for reporting in from the front lines 🙂
Another reader had luck with Wegman’s. I hear is a fantastic chain, with award-winning customer service. I wish we had Wegman’s stores in California.
Just FYI — I’ve learned how important terminology can be. Many readers assumed that Actavis was previously the manufacturer of the Concerta authorized generic. With this transition, that has created some big problems.
Janssen is the ONLY manufacturer of Concerta, the brand and the brand that is sold as a generic (the “authorized generic).
What changes is the distributors. The distributor probably won’t change any time soon; Patriot is a subsidiary of Janssen.
Still, it can be risky to tell the pharmacy that Patriot is the distributor. They might not be able to order directly from Patriot but might find it through a larger distributor that works with Patriot.
As I wrote in the piece, the best strategy is to us the NDC numbers.
thanks,
g
Wow. Hope someone does a class action suit against manufacture’s of the generic Concerta’s that are not like the regular Concerta. This has been going on for so many years. I have coached a lot of lawyers with ADHD, maybe some lawyer with ADHD might do a class action suit.
It’s hard enough to get people with ADHD to take meds because of all the stigma, getting a legal version of Concerta that does not work in practice like the real version makes it more likely that some ADDers will try it once and give up on all meds. And they likely won’t even know it’s a generic because pharmacists get kickbacks, oops, incentives to sell generics and some don’t know that it’s generic let alone it’s a version of a generic that does not work like the actual medication.
Do you know the Canadian version of the real authorized Concerta?
HI Pete,
Nice to hear from you. I hope you are well.
Yes, this is a big issue—for the reasons you entail and more—and why I have devoted so much “pro bono” time to it for almost 5 years now.
The major problem, as I understand it, is that FDA generic guidelines were written before the advent of novel delivery systems, such as Alza’s OROS. Another major problem: What I consider very sociopathic “big generic” companies have expertly exploited loopholes. When we succeeded in getting the FDA to downgrade the first two inferior generics, the Mallinckrodt CEO refused! And he filed a lawsuit (later dismissed). CVS continued to substitute the downgraded generics, illegally.
I am not sure what will change vis a vis the FDA but I am not expecting any push to protect consumers during this White House “administration.”
I did hear of a few lawsuits filed by consumers, but I don’t know the outcomes. e.g. https://www.courthousenews.com/dad-says-albertsons-sells-bad-adhd-drugs/
re: Canada. I’m not up on the latest. The last post I wrote is from 2014: https://adhdrollercoaster.org/adhd-news-and-research/generic-concerta-in-canada-parallel-problems/
CADDAC has posted this (which includes where medication users can file a complaint if they have adverse effects from the generic (but did well on the brand): https://caddac.ca/adhd/document/generic-medication-substitution/
Cheers,
Gina
P.S. The judge tossed out Mr. Turetsky’s class-action suit. Apparently, Turetsky did not claim harm was done. Only financial harm. Too bad.
https://cookcountyrecord.com/stories/510715650-judge-tosses-class-action-vs-osco-over-generic-substitutions-for-brand-name-adhd-drug
Can anyone share where they are getting it? Walgreens said today that they cannot order it. (The Patriot authorized generic.)
Hi Jamie,
I included a link to the list of distributors in the blog post. You can print that and take to Walgreen’s, to see if they will order.
As I explained, though, some pharmacies will lose money by filling this prescription. Perhaps that is the case with Walgreen’s.
good luck
Gina
Walgreens doe not have a contract for it at the present time . What pharmacy chains have been carrying it. I have been told cvs only caries Trigen brand or whoever Trigen is now. Trigen is an old form of osmotic release. I am a pediatrician and I write these prescriptions a lot as concerts is my first line medication. I wants had a pharmacy give a patient A.D. pills of the authorized generic and 10 of a different generic
Hi Dori,
Yes, I’ve not heard that Walgreen’s is still carrying the authorized/branded-generic for Concerta. That chain was the most reliable source, from what I heard, during the problems with the first two Concerta generics. Now, from what I understand, with the introduction of so many generics, pharmacies lose money by filling with the authorized/branded generic (reimbursements are based on the lowest price generic).
I’m not sure how you are using the term “A.D.”. But yes, that scenario doesn’t surprise me. I heard of customers given 10 pills and told to come back in a week. As if getting these monthly prescriptions filled weren’t hassle enough.
For now, I am recommending that Concerta users check out the brand cost and consider that until the dust settles. Home-delivery pharmacy is typically cheaper, for a 60- or 90-day supply.
g
None of the NDC’s you list seem to be available. Are these still the right numbers?
Hi Rona,
Absolutely these are the right numbers. Check them yourself.
e.g.
https://ndclist.com/ndc/10147-0685/package/10147-0685-1
As far as your first sentence (“None of the NDCs you list seem to be available”)—the emphasis is on seems.
You might want to read the post in full to understand why you might mis-conclude that.
So is their anyway to tell the difference between the authorities generic vs the brand name?
Hi Randy,
I covered that. The pills should look like this (and the label should say “Patriot”):
Unfortunately, the large PBMs like Caremark, Express Scripts and Optum Rx do not reimburse independent pharmacies for the authorized generic. It’s not uncommon to LOSE over $100 below the cost of the medication because the PBMs base their reimbursement on the cheapest generic available that is not A/B rated. The loss of reimbursement is getting worse as the big Chains and PBMs are trying to run Independents out of business. Unfortunately, we have to make the hard choice between keeping our doors open and serving our customers with the best service they deserve. Very sad.
Thank you, Christina. I had just added a bullet point: If you have a choice of local pharmacies, independently owned stores typically are more service-oriented than the big chains.
I had imagined that what you detail might be the case, and I am sorry to hear it. $100 loss! Unconscionable. Especially since these generics seem to me like a very cynical play.
I was shocked that CVS was allowed to purchase Aetna—and that the CEO got a quarter-BILLION-dollar payout for arranging it! I had to Twitter-shame him in order to get my husband’s Concerta from CVS/Caremark. (His Twitter account was repeatedly touting the practice of “mindfulness.” I had a bit of fun devising retorts on that theme.)
It’s just not right. I hope things improve for you and other independent pharmacies.
g
Whew! Thank you for your journalistic work here. I’ve never tried to get anything but the Janssen brand Concerta but now I may just try for the authorized generic. It’s just that I’m getting tired. Tired of going through a whole process every month. Filling these prescriptions for three people in my household. & Etc.
But for what it’s worth, I got out of the big chain pharmacy game several years ago. All of them had issues keeping even the generic meds in stock — don’t even think about special ordering the brand — and made me feel like they viewed me as a criminal until proven otherwise. Didn’t matter if I’d been a regular customer for years.
I found an independent pharmacy with a much better focus on customer service and I haven’t had an issue since. Because they can. Once a business gets too big, the line employees lose all their autonomy and they can no longer treat each customer/situation as an individual. For someone trying to fill a stimulant prescription month after month, year after year? That just didn’t work for me at all.
Hi Jaclyn,
You are welcome! I hope it helps.
Yes, I do often recommend independent pharmacies. They care more about their customers and will take the extra steps. If you can establish a relationship, they can also help you work through issues as they crop up.
Unfortunately, much insurance these days has very circumscribed pharmacy access. CVS is one of the major offenders, and especially since CVS bought Aetna, it’s the 800-pound gorilla. I don’t even hear about Prime Mail and Express Scipts any more. I wonder if they’ve been pushed out by the likes of CVS.
When it comes to asking an independent pharmacy to order the authorized generic for you, here’s the thing: These pharmacies can actually lose money (one pharmacy owner tells me $100, in another comment), because they are reimbursed only at the rate of the cheapest generic.
At any rate, if you can, I really recommend home delivery — and get those Rx synced. Getting three Rx filled every month? Wow. That gives me palpitations. 🙂
g