Amphetamine/dextroamphetamine Shortage Guidance — Covered Alternatives and Prescribing Coordination
Guidance for providers and pharmacists about ongoing shortages of amphetamine/dextroamphetamine combination salt tablets (generic Adderall) and covered alternative ADHD medications; affects prescribing and dispensing for Florida Blue members.
No material clinical or coverage changes in this revision.
Coverage Criteria
Pharmacists are not permitted to change the drug name on a prescription for a DEA Schedule II controlled substance. Therefore, when a prescription for amphetamine/dextroamphetamine (a Schedule II agent) cannot be filled as written, the pharmacist cannot substitute another product without action from the prescriber. To ensure the patient receives therapy, the prescriber should cancel and reissue the prescription for an alternative or ePrescribe an alternative if DEA rules permit. Failure to cancel and reissue a new prescription may prevent dispensing of an alternative medication.
Provider Actions and Dispensing Guidance
Prescribing and coordination required
If amphetamine/dextroamphetamine tablets are out of stock, prescribe an alternative covered ADHD medication or coordinate with the pharmacy to cancel and reissue a new prescription. Because amphetamine/dextroamphetamine is a DEA Schedule II controlled substance, pharmacists cannot change the drug on a Schedule II prescription — the original prescription must be cancelled and a new one issued. ePrescribing an alternative (when DEA-authorized) can expedite treatment.
- Covered alternatives include: amphetamine-dextroamphetamine ER (generic Adderall XR) — note this may have limited supply, atomoxetine capsules, clonidine ER tablets, dexmethylphenidate tablets and ER capsules, dextroamphetamine ER capsules and dextroamphetamine 5 mg/10 mg tablets, guanfacine ER tablets, methylphenidate ER formulations (capsule, solution, tablet).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.