I read an online article today from Benzinga, a financial media company that empowers its readers with daily actionable market analysis and commentary.  It reported on a new ADHD drug that the FDA had just approved, called Cotempla XR-OTD, a methylphenidate extended release orally-disintegrating tablet for treating ADHD in kids aged 6-17.  According to BMO Financial Services:  ”Management believes it can leverage the existing ~125 reps and generate considerable synergies, particularly with Cotempla . . .  it will be the only company promoting both amphetamine and methylphenidate products to high-prescribing ADHD physicians in a category with a lot of switches back and forth, and comfortably covering a wide age range.” [italics mine].

This italicized phrase troubles me in that it seems to imply that there are high-prescribing ADHD physicians and low-prescribing ADHD physicians, and my question is, if ADHD is a biomedical disorder and physicians are trained to diagnose and treat it, and ADHD as a disorder is spread out relatively evenly from region to region (as ADHD experts claim), then shouldn’t there be just ”prescribing ADHD physicians?”

What are the factors that make for a high-prescribing physician versus a low-prescribing physician?  Are low-prescribing physicians being negligent, or conversely, are high-prescribing physicians being profligate?  Are there other, psycho-social or economic factors that go into determining whether a physician will be high or low prescribing?

The other item that caught my eye in the note was the reference to ~125 reps, which I’m assuming means sales representatives for the company.  Is there a relationship between sales representatives and whether or not a physician will be high-prescribing or low-prescribing?  For more information on the relationship between sales reps and ADHD prescribing physicians, see Alan Schwarz’s book:  ADHD Nation:  Children, Doctors, Big Pharma, and the Making of an American Epidemic.

Just for fun, I thought I’d include this NEOS  graphic (below) on how  Cotempla XR-OTD is made, taken from its 10-K filing (a form required by the federal securities laws).  It takes a lot of work to medicate a child into submission!

For lots of non-drug interventions for ADHD-related behaviors, order my book:  The Myth of the ADHD Child:  101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion.

This article was brought to you by Thomas Armstrong, Ph.D. and www.institute4learning.com.  Follow me on Twitter:  @Dr_Armstrong

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I am the author of 16 books including my latest: The Myth of the ADHD Child: 101 Ways to Improve Your Child's Behavior and Attention Span Without Drugs, Labels, or Coercion (Tarcher-Perigee). http://amzn.to/2ewwfbp.

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