Raphael Stevens

It’s been 10 months since the Food and Drug Administration first announced a nationwide shortage of Adderall — and the supply strain could potentially worsen in the months ahead.
Some experts noted they’re concerned about market conditions as children, who are commonly affected by ADHD, head back to school. 
It’s nearly impossible to know when the shortages will end — or what exactly can be done to resolve them — because of the lack of transparency in the pharmaceutical industry. 

Ten milligram tablets of the hyperactivity drug, Adderall, made by Shire Plc.
Jb Reed | Bloomberg | Getty Images

It’s been 10 months since the Food and Drug Administration first announced a nationwide shortage of Adderall — one of the most widely used medications for attention deficit hyperactivity disorder — and the supply strain could potentially worsen in the months ahead.
While some supply issues have improved, many Americans are still struggling to find and fill prescriptions for the drug and other medications for ADHD that they often rely on to stay focused and complete daily tasks.

Drug-shortage experts told CNBC that it’s extremely difficult to forecast how much longer the shortages will last because of the lack of transparency in the pharmaceutical industry — and some are concerned about market conditions as children, who are commonly affected by ADHD, head back to school. 
“Unfortunately, we might see the shortage worsen. We are heading into back-to-school time, so I am worried about it worsening as we go into that season,” Erin Fox, a pharmacist at the University of Utah and leading expert on U.S. drug shortages, told CNBC.
Adderall is one of more than 300 drugs in short supply in the U.S. as of June, according to a list from the American Society of Health-System Pharmacists, which represents pharmacists in a variety of health-care settings. That list also includes Adderall alternatives like methylphenidate, which is commonly known under the brand names Ritalin or Concerta. 
Adderall and alternative ADHD medications apart from other drugs are Schedule 2 controlled substances. 
That means the federal government regulates how those drugs are made, prescribed and dispensed because they’ve been deemed to have a high potential for abuse and could potentially lead to severe psychological or physical dependence. The designation also means that patients need to get new prescriptions for those drugs every one to three months. 

Millions of Americans in the U.S. use the drugs to help them concentrate, control their impulses and manage their schoolwork, employment or relationships with others. ADHD is usually diagnosed in childhood and often lasts into adulthood.
An estimated 6 million children have been diagnosed with ADHD, and 60% were being treated with medication as of 2016, according to the Centers for Disease Control and Prevention. Meanwhile, around 8 million adults have been diagnosed with the condition, but only about a quarter of that number are getting treatment for it.

Back-to-school supply strain 

Many children and young adults with ADHD often take the summer off medication and primarily rely on it during the school year. That could lead to even more demand in the months ahead that may not be met. 
Historically, prescriptions for ADHD medications increase as the school semester starts around the U.S. — and “there is no indication this year will be different,” according to David Margraf, a pharmaceutical research scientist at the University of Minnesota’s Center for Infectious Disease Research and Policy. 
Some drugmakers have said they expect to resupply a few ADHD products in August or September, according to an FDA database on shortages. But Margraf said “we need to be cautiously optimistic” because drugmakers don’t disclose exact numbers of how much stock they’ll have available by then. 

30mg tablets of Shire Plc’s Adderall XR.
Jb Reed | Bloomberg | Getty Images

That reflects a bigger issue with the ongoing shortages. It’s nearly impossible to know when they will end — or what exactly can be done to resolve them — because of the lack of transparency in the pharmaceutical industry. 
“Very little factual information is out there. I think this is one of the biggest issues,” says Ozlem Ergun, a mechanical- and industrial-engineering professor at Northeastern University and an expert in pharmaceutical supply chains. “When you don’t have transparency or information sharing, how can you understand and resolve a problem that is complex?” 
“This really, really hurts the users and the hospitals and the health-care system. They have pretty much no vision of what the future looks like,” Ergun added.  
Teva Pharmaceuticals, Amneal Pharmaceuticals, Novartis’s planned spinoff Sandoz and Purdue Pharma subsidiary Rhodes Pharmaceuticals, which all manufacture drugs targeting ADHD, don’t need to publicly share information about where they manufacture medications, how much of them they make, where ingredients are sourced and their overall production capacities. 
And the Drug Enforcement Administration — the federal agency that regulates controlled substances — shares little information about the production quotas it sets for each manufacturer of Adderall and other ADHD medications.
The DEA specifically limits the amount of raw ingredients, such as amphetamine, a drugmaker can get to manufacture those drugs.
“We don’t have the quota amount that each company is given. And we also don’t have the amount that each company is actually producing and if they’re meeting those quotas,” said Fox of the University of Utah. “There’s no way to understand which company maybe isn’t doing the job and which companies are, so we just don’t know exactly what’s going on.” 

Production limitations

Ending the shortages of Adderall and other ADHD medications is no easy task.
“It’s not as simple as a free market where you just boost up production and meet demand,” said Michael Ganio, the senior director of pharmacy practice at the American Society of Health-System Pharmacists. 
Many manufacturing plants operate at or near capacity and create multiple drug products. That means increasing the production of one drug could potentially require reducing production — and potentially impacting supply — of another drug, according to Ergun. 
“In general, it is difficult to increase the manufacturing capacity for a drug,” she said. “There isn’t much unutilized capacity anywhere.”
It’s even harder to scale up the production of tightly controlled ADHD medications.
Drugmakers can request for the DEA to increase their production quotas if necessary, but it takes “a lot of push” for the agency to actually approve that, according to Margraf. 
And even if the DEA does approve a quote change, it could take months to do so: “It’s not just flipping a switch and boosting your output by 20%,” ASHP’s Ganio said. 

Members of the Drug Enforcement Administration raided two homes side-by-side, in an assumed illegal marijuana operation, on January 31, 2019 in Commerce City, Colorado.
RJ Sangosti | MediaNews Group | The Denver Post via Getty Images

Some drugmakers have suggested that DEA quotas are contributing to the ADHD medication shortages or making it harder to alleviate them. That includes Aytu BioPharma, which makes an ADHD drug that used to be in shortage. 
In a CNBC op-ed in February, Aytu CEO Josh Disbrow said the DEA could potentially cause widespread drug shortages if it underestimates demand and fails to increase quotas in a “timely manner in response to new information.” 
However, the DEA and FDA pointed to a different problem in a joint letter released earlier this month. 
The agencies said an internal analysis found that drugmakers fell 30% short of meeting the full quota for amphetamine medications in 2022, leaving about 1 billion potential drug doses on the table. They added that there’s a “similar trend” occurring this year. 
The DEA and FDA said they called on manufacturers to confirm they are working to increase production to meet their allotted quotas.
“There’s obviously a lot of finger-pointing going on here between the agencies and manufacturers,” Fox said. 

Surging demand for Adderall

The shortages of Adderall and generic versions of the drug kicked off last August, when major manufacturers reported that their medications were on back-order. 
Manufacturers are required to notify the FDA of a shortage, but not the cause of the interruption. However, the FDA pointed to “ongoing intermittent manufacturing delays” at Teva when it first announced the Adderall shortage. 
Teva previously said the manufacturing slowdown was partly tied to a labor shortage, which was quickly resolved. Teva did not immediately respond to CNBC’s request for comment about the state of its Adderall manufacturing. 
A surge in demand for Adderall and other ADHD medications seems to have played a significant role, too. 
U.S. prescriptions for Adderall rocketed to 41.4 million in 2021, a more than 10% increase from 2020, according to IQVIA, a health industry analytics firm. 
One possible factor sending demand up, according to experts, was the increased use of telehealth services during the Covid public health emergency that may have allowed for more relaxed prescribing standards for ADHD medications.
The pandemic also created a perfect storm of distractions — such as the shift to remote work and a thrum of anxiety, stress and grief over the uncertainty of Covid — that may have exacerbated some ADHD patients’ symptoms or convinced more people that they have the condition, prompting them to seek treatment. 
The increased demand for Adderall amid shortages of the drug likely resulted in a domino effect, too, with health-care providers and patients being driven to turn to alternative medications, triggering shortages of those drugs as well. More

SpaceX launched four people to the International Space Station from Florida as Elon Musk’s company begins its 11th human spaceflight mission to date.
Known as Crew-7, the mission for NASA will bring the group up to the space station for a six-month stay in orbit.
The mission brings the number of astronauts SpaceX has launched to 42 since its first crewed launch in May 2020.

SpaceX’s Falcon 9 rocket with the company’s Crew Dragon spacecraft on top is seen after sunset at Launch Complex 39A ahead of the launch of the Crew-7 mission.
Joel Kowsky / NASA

SpaceX launched four people to the International Space Station from Florida as Elon Musk’s company begins its 11th human spaceflight mission to date.
Known as Crew-7, the mission for NASA will bring the group up to the space station for a six-month stay in orbit. The mission is SpaceX’s sixth operational crew launch for NASA to date, and the first of the additional missions the agency awarded SpaceX.

Crew-7 launched in the early hours of Saturday morning from NASA’s Kennedy Space Center, beginning a nearly one day journey to the ISS.

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The mission brings the number of astronauts SpaceX has launched to 42, including both government and private missions, since its first crewed launch in May 2020.
Crew-7 consists of NASA astronaut Jasmin Moghbeli as the commander, European Space Agency astronaut Andreas Mogensen from Denmark as the pilot, and Japan Aerospace Exploration Agency astronaut Satoshi Furukawa and Roscosmos cosmonaut Konstantin Borisov as mission specialists.

(From L) Roscosmos cosmonaut Konstantin Borisov, European Space Agency astronaut Andreas Mogensen, NASA astronaut Jasmin Moghbeli, and Japan Aerospace Exploration Agency astronaut Satoshi Furukawa, wearing SpaceX spacesuits wave as they prepare to board the SpaceX Dragon spacecraft for the Crew-7 mission launch, at NASA’s Kennedy Space Center in Florida, on Aug. 26, 2023.
Gregg Newton | AFP | Getty Images

SpaceX launched the astronauts in its Crew Dragon capsule called Endurance, on top of a Falcon 9 rocket. Both the rocket and capsule are reusable, with the Endurance flying on its third mission to date.
The company is under contract for 14 missions under NASA’s Commercial Crew program.
SpaceX developed its Crew Dragon spacecraft and fine-tuned its Falcon 9 rocket under NASA’s program, competing against Boeing’s Starliner capsule. But Boeing’s capsule remains in development, with costly delays putting the start of operational Starliner flights years behind schedule. More

The Professional Pickleball Association and Major League Pickleball are now at odds after announcing in November that they would join forces and merge team competition leagues.
The PPA told CNBC that MLP has not yet signed the partnership deal they verbally agreed to 10 months ago.
In the last year, MLP has seen continued growth with new, high-profile ownership groups, growing team valuations, new sponsorships and media deals.

Season One Super Finals at the Life Time Rancho San Clemente in San Clemente, California. The Seattle Pioneers play the Los Angeles Mad Drops in the Premier League mixed doubles competition.
Source: Major League Pickleball

There’s trouble in pickleball paradise.
The Professional Pickleball Association and Major League Pickleball are now at odds after announcing in November that they would join forces and merge team competition leagues.

The PPA told CNBC that MLP has not yet signed the partnership deal they verbally agreed to 10 months ago. PPA owner Tom Dundon and MLP owner Steve Kuhn had agreed to operate the joint league under the MLP brand name and format. Terms of the agreement were not disclosed at the time.
“I don’t know what Steve Kuhn’s intentions were the entire time,” Connor Pardoe, PPA Tour CEO told CNBC. “I don’t know if he led us down a road to get access to our players to try to be in a stronger position here later.”
Pardoe claims MLP executives have recently gone radio silent. He also said PPA was made aware by some of its players that MLP had begun reaching out with lucrative offers. He said PPA would consider litigation if MLP were to improperly poach players.
Kuhn told CNBC that there are “numerous misrepresentations of reality” taking place, without providing specifics.
On Thursday, MLP announced it has begun to sign top players to multi-year, guaranteed contacts. The deals include a player off-season and enhanced financial security.

“We think this is a great thing that will make MLP more valuable. So we’ll make the players lives more successful and better. And we’ll also continue to elevate the sport and help the sport grow,” said Kuhn.
He said if the PPA is willing to pay their players more, he’s willing to talk about aligning with the league.
“We asked the PPA to join us in paying players more, and their reaction was that we pay the players too much,” Kuhn told CNBC.
In the last year, MLP has seen continued growth with new, high-profile ownership groups, growing team valuations, new sponsorships and media deals. In July, MLP announced Julio DePietro was taking over as CEO. He took over negotiations of this deal from Zubin Mehta, who resigned from the board.
The competing leagues have had a complicated relationship.
The PPA historically has acted as a tour-style league for the best players in the world. Two  years ago, Kuhn introduced team style pickleball. Since then, the two leagues have operated independently. More

Wegovy, the popular weight loss drug from Novo Nordisk, significantly reduced symptoms of a common type of heart failure in patients with obesity, according to a late-stage clinical trial.
The treatment also resulted in lower blood pressure and reductions in inflammation – two important markers of heart health. 
The results add to Wegovy’s growing list of potential health benefits beyond shedding unwanted pounds, which could potentially lead to increased coverage by insurers. 

A selection of injector pens for the Wegovy weight loss drug are shown in this photo illustration in Chicago, Illinois, March 31, 2023.
Jim Vondruska | Reuters

Wegovy, the popular weight loss drug from Novo Nordisk, significantly reduced symptoms of a common type of heart failure in patients with obesity, according to a late-stage clinical trial released Friday. 
Wegovy helped alleviate symptoms like shortness of breath, fatigue, swelling in the legs and irregular heart beat. It also resulted in lower blood pressure and reductions in inflammation – two important markers of heart health. 

The results add to Wegovy’s growing list of potential health benefits beyond shedding unwanted pounds. That could potentially lead to expanded use of the drug and increased coverage by insurers. The results also complement the groundbreaking trial data Novo Nordisk released earlier this month, which found that Wegovy slashed the risk of serious heart-related problems by 20%. 
“We look forward to working closely with the clinical community and regulators to help realise this potential over the coming months,” Martin Lange, Novo Nordisk’s head of development, said in a release. He was referring to the heart health benefits observed in both trials. 
The new study on 529 obese patients focused on a heart condition known as preserved ejection fraction, or HFpEF – a condition that comprises roughly half of all heart failure cases in the U.S. and occurs when the heart’s lower chamber pumps less blood than the body needs.
An estimated 2.5 million people in the U.S. have that condition and more than 80% of those patients also have obesity. 
The study, published in the New England Journal of Medicine, found that Wegovy led to a nearly 17-point improvement on a 100-point scale that’s used to assess symptoms of HFpEF. 

By comparison, patients who received a placebo had a 9-point improvement.
Wegovy also led to improvements in physical limitations: Patients who took the drug were able to walk further in six minutes than those in the placebo group. 
Those on Wegovy also lost about 13% of their body weight, compared with 2.6% for those on a placebo, over the course of the year-long trial.
There were fewer serious safety events in patients who took Wegovy compared with those who took the placebo. But more patients stopped taking Wegovy because of gastrointestinal issues, which are commonly observed with other weight loss drugs. 

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One limitation of the trial was its lack of diversity: 96% of the participants were white.
Wegovy and Novo Nordisk’s diabetes drug Ozempic sparked a weight loss industry gold rush last year for helping patients lose unwanted weight. They are part of a class of drugs called GLP-1 agonists, which mimic a hormone produced in the gut to suppress a person’s appetite. 
But Novo Nordisk is grappling with supply constraints that have led to shortages of both drugs. 
There are also recent reports of patients who had suicidal and self-harm thoughts after taking Wegovy and other weight loss drugs, which raised questions about the unintended and potentially life-threatening side effects of the treatments More

UAW members overwhelmingly granted union leaders authorization to call strikes during ongoing contract negotiations with GM, Ford and Stellantis, if warranted.
The “strike authorization vote” is part of the union’s constitution and viewed as a procedural step in the negotiations.
UAW President Shawn Fain has been far more vocal than past union leaders about its ability to use work stoppages as a weapon in its arsenal against the companies during the negotiations.

Striking United Auto Workers members and supporters attend a speech by Vermont Sen. Bernie Sanders outside General Motors’ Detroit-Hamtramck Assembly plant on Sept. 25, 2019 in Detroit.
Michael Wayland / CNBC

DETROIT – United Auto Workers members overwhelmingly granted union leaders authorization to call strikes during ongoing contract negotiations with General Motors, Ford Motor and Stellantis, if warranted.
The union on Friday said an average of 97% of combined members at the automakers approved the action, however final votes are still being tallied. That’s in line with support during negotiations four years ago, when 96% of workers who voted supported authorization for a strike.

The “strike authorization vote” is part of the union’s constitution and viewed as a procedural step in the negotiations. The voting results are historically high in support of the authorization. The vote does not mean there will or will not be a strike.
“Our goal is not to strike. I want to make that very clear. Our goal is to bargain good agreements for our members,” UAW President Shawn Fain said Friday during a Facebook Live. “But all we’ve tried to do with this is prepare everybody in the event that we have to take action to get a fair and just contract.”
However, Fain has been far more vocal than past union leaders about its ability to use striking as a weapon in its arsenal against the companies during the negotiations.
“The Big Three is our strike target. And whether or not there’s a strike — it’s up to Ford, General Motors and Stellantis, because they know what our priorities are. We’ve been clear,” Fain has said.

UAW President Shawn Fain (right) speaks with union member Jerome Buckley outside of General Motors’ Factory Zero plant on July 12, 2023, in Detroit.
Michael Wayland / CNBC

Those priorities are far richer than during prior contract negotiations between the two sides. The union’s demands include a 46% wage increase, restoration of traditional pensions, cost-of-living increases, reducing the workweek to 32 hours from 40 and increasing retiree benefits.

The UAW said 98% of hourly workers and 99% of salaried workers at Ford voted in favor of the strike authorization. GM passed by 96%, while the action was approved at Stellantis by 95%. Voter turnout and how many votes still needed to be counted was not immediately available.
Strikes could take various forms, including a national strike, where all workers under the contract cease working, or targeted work stoppages at certain plants over local contract issues. A strike against all three automakers, as Fain has alluded to, would be the most impactful but also the riskiest and most costly for the union.
The UAW has more than $825 million in its strike fund, which it uses to pay eligible members who are on strike. The strike pay is $500 per week for each member — up from $275 per week last year.
Assuming 150,000 or so UAW members covered by the contracts, strike pay would cost the union about $75 million per week. A fund of $825 million, then, would cover about 11 weeks. One caveat: that doesn’t include health-care costs that the union would cover, such as temporary COBRA plans, that would likely drain the fund far more quickly.
National or targeted strikes at any of the automakers could be detrimental to business. A 40-day strike against GM during the last round of negotiations in 2019 led to a production loss of 300,000 vehicles, the company said at the time. It also cost the automaker $3.6 billion in earnings, GM said. More