Provider Briefing: The Focalin XR Shortage in 2026

The national shortage of ADHD stimulant medications continues to affect clinical practice in 2026. Among the medications most consistently impacted is Focalin XR (Dexmethylphenidate ER), a Schedule II extended-release stimulant used in the treatment of ADHD across pediatric and adult populations.

This briefing summarizes the current state of the shortage, its implications for prescribing, and practical resources to help you support your patients during ongoing supply disruptions.

Shortage Timeline

The current wave of stimulant shortages began in October 2022, when the FDA first reported supply issues with amphetamine mixed salts (Adderall). By mid-2023, the shortage had expanded to include multiple stimulant medications:

• October 2022: FDA reports Adderall shortage
• 2023: Shortage expands to include Focalin, Focalin XR, Ritalin, Vyvanse, Concerta, and other ADHD stimulants
• August 2023: Joint DEA/FDA statement reveals manufacturers produced only ~70% of their allowed quota in 2022, approximately one billion fewer doses than permitted
• 2024: DEA increases aggregate production quotas for stimulant medications; some improvement in supply for amphetamine products
• 2025: Dexmethylphenidate ER remains on ASHP shortage list; intermittent availability from manufacturers including Par, Teva, and others
• Early 2026: Shortage continues. Some manufacturers have released short-dated product (expiring mid-2026). Overall supply remains inconsistent across strengths and regions.

Prescribing Implications

The shortage creates several clinical challenges for providers managing ADHD treatment:

Treatment Continuity

Patients who have been stable on Focalin XR may be forced to switch medications or go without treatment during gaps in supply. Discontinuation of stimulant therapy can lead to symptom recurrence, impaired occupational and academic performance, and increased safety risks (e.g., driving accidents in adults with untreated ADHD).

Dose Equivalence Considerations

When switching patients from Dexmethylphenidate to alternative medications, accurate dose conversion is essential:

• Dexmethylphenidate → Methylphenidate: 1:2 ratio (e.g., Focalin XR 20 mg ≈ Concerta 36-54 mg or Ritalin LA 40 mg)
• Dexmethylphenidate → Amphetamine salts: No direct conversion; start at low dose and titrate based on response
• Dexmethylphenidate ER → Dexmethylphenidate IR: Same total daily dose, divided into 2 doses approximately 4 hours apart

Prior Authorization Burden

Switching medications often triggers prior authorization requirements from insurers, adding administrative burden to already strained practices. Proactively documenting the shortage as the reason for the switch can help expedite approvals. Consider including language such as "switching due to national drug shortage — previous medication unavailable" in prior authorization submissions.

Current Availability Picture

As of early 2026, the availability of Dexmethylphenidate ER varies significantly by manufacturer, strength, and region:

• Par Pharmaceutical: Has 5 mg, 10 mg, 15 mg, 20 mg, 25 mg available in limited supply; other strengths on back order
• Teva: Intermittent availability across strengths
• Other generics: Variable supply; some strengths available with short-dated expiration
• Brand-name Focalin XR (Novartis): Limited availability

The ASHP Drug Shortage Resource Center (ashp.org/drug-shortages) maintains updated information on manufacturer supply status. Providers should check this resource regularly for the latest updates.

Cost and Access Considerations

The shortage has exacerbated cost-related access barriers:

• Brand-name Focalin XR: $250-$580 per 30-day supply without insurance
• Generic Dexmethylphenidate ER: $40-$100 with a discount coupon; as low as $29.92 at some pharmacies
• Insurance coverage: Most plans cover generic Dexmethylphenidate ER, but brand-name often requires prior authorization or step therapy
• Medicare: Part D covers generic; copays typically $60-$80

For patients experiencing financial hardship, the following resources may help:

• Novartis Savings Card: Covers up to $60/month for commercially insured patients
• Novartis Patient Assistance Foundation: Free medication for uninsured patients meeting income criteria
• Discount programs: GoodRx, SingleCare, RxSaver, and other platforms offer coupons that can significantly reduce out-of-pocket costs

For a comprehensive overview of cost-saving options to share with patients, see How to Save Money on Focalin XR.

Tools and Resources for Providers

Several tools can help you and your patients navigate the shortage more effectively:

Medfinder for Providers

Medfinder offers a pharmacy availability search tool that helps locate which pharmacies currently have Focalin XR or its generic equivalent in stock. This can be integrated into your workflow to help patients at the point of prescribing — rather than sending them out with a prescription they may not be able to fill.

ASHP Drug Shortage Resource Center

The ASHP maintains the most comprehensive and up-to-date database of drug shortages, including manufacturer-specific supply updates and estimated resupply dates.

FDA Drug Shortage Database

The FDA's drug shortage page provides official shortage status and information about any regulatory actions being taken to address supply issues.

State Prescription Monitoring Programs (PMPs)

While PMPs don't track inventory, they can help you verify patient prescription history when managing transitions between medications or prescribers during the shortage.

Looking Ahead

The DEA has taken steps to increase production quotas for Schedule II stimulants, and additional generic manufacturers have entered or expanded their presence in the Dexmethylphenidate market. However, industry experts suggest that full resolution of the ADHD stimulant shortage may take through the remainder of 2026 or longer.

In the meantime, providers can best support their patients by:

• Maintaining open communication about availability and backup plans
• Proactively discussing alternative medications before patients run out
• Using tools like Medfinder to direct patients to pharmacies with stock
• Documenting shortage-related medication switches to streamline future insurance authorizations
• Staying current with ASHP and FDA shortage updates

Final Thoughts

The Focalin XR shortage represents an ongoing challenge at the intersection of regulatory policy, manufacturing capacity, and clinical care. While the factors driving the shortage are largely outside your control as a provider, the strategies above can help minimize disruption to your patients' treatment.

For additional provider-focused resources, visit medfinder.com/providers. For guidance on helping patients find medication in stock, see our companion article: How to Help Your Patients Find Focalin XR in Stock.