First Alert 4 Investigates: St. Louis residents hunt for out of stock pharmaceuticals for months, fix could have STL ties

ST. LOUIS, Mo. (First Alert 4) - First Alert 4 continues its work to uncover the solution for the national drug shortage gripping tens of millions of Americans, including many St. Louis residents.

Hundreds of needed prescription drugs are in short supply, with prescriptions taking weeks or months to fill - Drugs needed to maintain quality of life or sustain life.

For St. Louis City resident Kristen Jacoby, staying on task isn't easy. She is one of 15 million adults in the United States functioning with Attention-Deficit/Hyperactivity Disorder, or ADHD – amid a two-year shortage of medication.

"Feeling flustered and overwhelmed," Jacoby explained. "I'm pretty fidgety. my mind goes all over the place. It's tough to sleep at night because my anxiety keeps me up."

She takes a generic version of Adderall because it's covered by insurance, but to stretch her meds, she skips her daily dose on the weekends and days she doesn't work.

"My brain needs it every day to function properly, but it's not something I feel I can do," Jacoby said.

Kristen has been trying to get her script filled for almost two months.

Her records with CVS show her medication was last filed on July 12 and last prescribed on September 9. Since Adderall is a controlled substance, she has to reach out to her doctor any time meds need to be filled. Kristen has had a constant back and forth with her doctor to get insurance to move.

In an email provided to First Alert 4, Jacoby wrote that her prescription has been out of stock for over 30 days because of a CVS/ nationwide shortage. She wants to send her prescription to a nearby Walgreens.

She told First Alert 4 her insurance provider said her age being over 18 made it difficult to approve medication because adults require more allotments than children.

"This isn't something I grow out of. I'll be dealing with this forever," Jacoby said.

She said the federal government and insurance companies are the problem.

"The FDA and DEA are the people blocking the amount of drugs these manufacturers can produce," Jacoby explained. "The insurance companies make it difficult; you know, making people jump through hoops to get the medication approved that they've already been approved. It's difficult."

Other parents across the St. Louis metro, like Mother Stacy Biermann, are having a similar experience with their children.

"For the people who have insurance that only covers generic, now to have to pay for the name brand, eventually those will run out," Biermann explained. "You wonder how long this is going to last and who is going to help fix it."

Impact of overseas production on U.S. supply

First Alert 4 found that the CDC says 71% of people are having trouble finding the right medication for their needs. They can't get their drugs because the manufacturers are not motivated to make generics, and insurance companies won't cover brand-name drugs, which is why people like Kristen have not gotten their script in two months.

WashU Adjunct Lecturer and Senior Research Advisor, Center for Analytics and Business Insights Antonio Sardella said this comes down to a fragile supply chain.

"We started asking why is that the case. It's an economic issue, not a logistical issue," Sardella said.

He told First Alert 4 that for the first time in history, the United States has a record 323 medicines in short supply.

"Many of these medicines are not produced in the U.S.," Sardella explained. "The system is vulnerable and dependent on foreign suppliers, which could result in easy disruptions as those medicines try to make it to the United States."

National chain pharmacist blows whistle and who is to blame

To better understand the nationwide shortage's impact on the St. Louis region, First Alert 4 sat down with a local pharmacist who agreed to go on camera if we hid their identity because his corporate employer did not give them permission to speak.

Amelotti: "Why did you want to sit down with me for this interview?"

Pharmacist: "We are a victim of the system."

He told First Alert 4 Investigates the Drug Enforcement Administration is to blame for this crisis because it didn't enforce that manufacturers make the required amount of drugs.

According to the DEA, it regularly engages with manufacturers about their production of drugs and sets limits. Those quotas are for how much of these drugs can be produced.

In an August 2023 letter from DEA Administrator Anne Milgram, her agency discovered for amphetamine medications like Adderall, manufacturers did not produce the full amounts that these limits permitted them to make, resulting in a billion-dose shortfall for 2022 and a similar trend for 2023.

As a result, the DEA instituted four changes to quotas and reporting to "Help us see shortages coming and adjust more quickly." 14 months later, patients continue to struggle with finding their medication

"I see these patients every day," the pharmacist shared. "I see their face of desperation - another week or day without medication, who knows how long. It's heartbreaking not having a quick solution."

The nationwide fix could be in development in St. Louis

Sardella, with WashU, is also the founder and chairman of the non-profit API Innovation Center. A project using private/public funding Sardella said is making St. Louis the leader in building resiliency for the United States drug supply chain.

Sardella's project is working to replace the 92% of the pharmaceutical medicines produced outside the United States, making our country's supply so vulnerable.

"The key is not just produce, but produce high quality, lower price, more efficient," Sardella said.

The project has the backing of the State of Missouri, backing the project with about $18 million through the Missouri Technology Corporation.

The non-profit's first task, is produce six generic drugs, including one for brain cancer. Sardella said they can produce the year's supply of that drug for the entire United States in just two weeks using advanced pharmaceutical manufacturing technology.

While WashU focuses its research on the economic impact of Sardella's project, the science research is happening at the University of Missouri – St. Louis. At UMSL, medicines are made in small quantities to be increased for mass production. That production won't start until area manufacturers finish upgrading their facilities to house these advanced technologies.

"This allows for great scalability," Sardella explained. "We can use it here in research, then move it into production in the size that is a critical element."

The chemists working on these high-tech machines at UMSL will use ingredients to develop medicines. But this advanced manufacturing changes the profile of the jobs needed for the local drug manufacturers, cutting down the number of chemists on the assembly line, with more quality assurance type jobs. Sardella said this will bring as many as 500 jobs to the St. Louis region in the next 15 years, with head-of-household salaries of $80,000.

"That's transformational because you unlock people who might not want to pursue higher education, not initially, enter this space," Sardella said.

New federal dollars may unlock relief for ADHD patients

Their work is just getting started.

The API Innovation Center – or APIIC – just received a first-of-its-kind $14 million grant from the federal government.

Now, API will ramp up production from six to 25 essential medicines, generating at $1.275 billion economic impact for the St. Louis region over the next 15 years.

One of those new meds will be a generic for ADHD.

But APIIC's products are five years away from getting into the hands of people like Kristen Jacoby who are left balancing life's demands from the dishes to making calls to get her script filled.

"It's not like it's life or death, not one I need to survive," Jacoby shared. "But for my mental state, it's so important. There is a big connection between ADHD and anxiety and depression. When people are not medicated, that can lead to substance abuse or suicide at a time when people are so focused on mental health it's pretty insane insurance companies and the drug manufacturers seem to not care about this problem."

In the next decade, API Innovation Center will bring as many as 500 head-of-household jobs to St. Louis.

Sardella said the endgame for his program is to produce more than 300 medicines nationwide, opening centers across the country, generating a $17.85 billion impact.

What options remain for people needing meds in the meantime...

As mentioned, the APIIC is five years from getting drugs on shelves so in the meantime, there are resources in St. Louis to help people find their prescriptions. Angels for Change is committed to ensuring access to life-saving drugs.

"There are still significant groups that are working effortlessly on the ability to find and source within the current system," Sardella explained. "Enormous efforts doing that to address it. Those groups are key in the interim was we reverse the exit manufacturing and produce our own medicines here so we can supply that. Angels for change is a critical group working diligently to find those medicines."

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