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A diagnosis of a chronic illness brings significant changes to many areas of life. While the journey of learning to live with a condition looks different for everyone, the importance of support is universal.

Support can and should take many different forms. New physical and mental health needs are both common when navigating a chronic condition, and there are resources to draw on for both facets of your wellness.

Finding Support After a Chronic Illness Diagnosis

A diagnosis of a chronic illness brings significant changes to many areas of life. While the journey of learning to live with a condition looks different for everyone, the importance of support is universal.

Support can and should take many different forms. New physical and mental health needs are both common when navigating a chronic condition, and there are resources to draw on for both facets of your wellness.

We encourage you to think broadly in building your support system, even when focusing more specifically on your physical or mental health. In the case of physical health, specialists like diabetes educators can supplement a provider’s care with more personalized guidance. And with mental health, different forms of support may be necessary to address the various ways that a diagnosis affects you individually as well as your relationships.

Here are some suggestions to help you build a strong support system after a chronic illness diagnosis.

Many chronic illnesses require medical care from a specialist with the expertise to address specific symptoms rather than a primary care physician. Medical specializations for chronic conditions include the following.

A pulmonologist specializes in the treatment of respiratory conditions including chronic obstructive pulmonary disease (COPD).

An endocrinologist specializes in the treatment of endocrine disorders including diabetes.

A rheumatologist specializes in the treatment of inflammatory autoimmune diseases including rheumatoid arthritis and lupus.

A gastroenterologist specializes in the treatment of digestive health conditions including celiac disease and inflammatory bowel disease.

A neurologist specializes in the treatment of diseases of the brain, spinal cord, and nervous system including dementia, Parkinson’s disease, and epilepsy.

Your primary care provider can help you make sure you’re seeing the right specialist for your diagnosis. In some cases, they may have the necessary expertise to treat your condition themselves. For example, if a primary care provider is board-certified in infectious diseases and internal medicine, they may be able to oversee antiretroviral therapy treatment for HIV.

There are many possible ways to look for a specialist. You can ask your primary care provider for referrals, contact your insurance company, or reach out to others you know with the same condition. If you don’t know many people affected by your illness, joining a support group can be a great way to build connections and get recommendations.

Many of the factors that people consider when looking for a primary care physician — communication style, for instance — are also relevant to finding a specialist for treatment of a chronic condition. How comfortable you feel around your provider can significantly affect your experience of living with an illness. Facing a diagnosis head-on requires you to feel informed, and to feel informed, you need an open dialogue with your medical team.

A provider’s background and training is particularly important when looking for a specialist, since treatment is often more complex. How many years they’ve been practicing can be an indicator of experience, but remember that it’s just one metric. Depending on your needs, you may be well served by working with a physician in the middle of their career.

Other factors that reflect a provider’s qualifications include research interests, and active involvement in research, and their affiliation with organizations related to their field. You may also consider where they completed residency and fellowship training — some hospitals and institutes are known for certain medical specialties.

Depending on your specific diagnosis, it may be important to look for a provider who is affiliated with a specific hospital. For example, more advanced COPD can cause flare-ups, or periods of intensified symptoms, which in some cases may require treatment in a hospital setting.

You may encounter treatment-related decisions that depend on personal preference. For example, some people who experience chronic pain as a result of their illness want to explore non-pharmacological options, or ways to manage pain without medication. If that’s of interest to you, look for a provider whose care philosophy aligns with your needs and views.

You may benefit from working with specialized healthcare professionals in addition to your medical team. Diabetes educators are professionally certified to coach individuals living with the condition. They offer support for numerous aspects of diabetes management, from insulin administration to insurance navigation and lifestyle changes.

Read What Does a Diabetes Educator Do and How Can They Help You?

Similarly, registered dietitian nutritionists who specialize in COPD can help you make dietary changes as part of treatment for the condition. (Since food affects your breathing, people with COPD are typically advised to consume more fats while reducing their intake of carbohydrates.)

Building a support system often involves asking for more help from your friends and family. Since stress management is part of navigating a chronic illness, look for opportunities to take responsibilities off of your plate. Communicate what you need as specifically as possible, and remember that people are ready to help.

You may find that you have less energy to focus on others. Prioritize relationships with supportive people who are sensitive to what you’re experiencing, and whom you want with you on this journey — it’s your decision who you share personal health details with.

Chronic illnesses can bring shifts in identity as you make changes to your routine and lean more heavily on others. Stress is common, too, as a diagnosis often comes with much uncertainty. For these reasons and others, your diagnosis may affect your mental health. In fact, some studies have found that living with a chronic condition increases a person’s risk of depression.

Therapy offers the support you need to process the emotional experience of a diagnosis. For many people, individual counseling provides a safe space to openly share their feelings and concerns related to illness. Many therapists have special training to support you in coping with a chronic illness, so look for this expertise as you search for the right practitioner.

If you have kids, a therapist can also support you in sharing your diagnosis with them in age-appropriate ways. If you are concerned about how your diagnosis has affected the entire family unit and your relationships, family and/or couples therapy may help you navigate the changes together.

There’s no substitute for support from those who have been in your shoes and faced the same challenges. Peer-led support groups give you the opportunity to express your feelings to people who have firsthand experience of your condition. They can also share the coping strategies they’ve found most helpful.

As a starting point, look for a nonprofit related to your specific diagnosis. Many organizations offer both in-person and virtual groups, so connecting with others is not confined to geography. 

One final component of a strong support system: a reliable pharmacy partner. Our pharmacists are here with information and answers, even during nights and weekends, and the Alto app gives you control and convenience in managing your medications, with auto refills, medication bundling, and custom dosing reminders.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Last month, Alto celebrated the well-deserved promotions of many Altoids across the company. Among those promoted is Elnaz Moshfeghian, who is now Alto’s VP of Strategic Planning & Business Operations. Elnaz shares more about her new role, what she’s most excited about at Alto, and advice she has for those looking to make a career pivot.  

Catching up with Elnaz Moshfeghian, Alto’s new VP of Strategic Planning & Business Operations | Alto

Last month, Alto celebrated the well-deserved promotions of many Altoids across the company. Among those promoted is Elnaz Moshfeghian, who is now Alto’s VP of Strategic Planning & Business Operations.

Elnaz joined Alto in 2016 as a software engineer and when we last connected with her in 2020, she shared her thoughts on building a career in engineering. Since then, Elnaz has pivoted to a truly cross functional, strategy-focused role, where she applies learnings from her engineering experience with her ability to identify opportunities for growth. 

Below, Elnaz shares more about her new role, what she’s most excited about at Alto, and advice she has for those looking to make a career pivot.  

To start, congratulations on your new role! You joined Alto 6.5 years ago, and so much has changed both within the company and the industry at large. Can you tell me a little bit about your journey at Alto? 

I’ve always been attracted to problems that are cross functional and can be solved by bringing together different teams - pharmacists, technicians, logistics, dispatch, sales. I really enjoyed it as an engineer, given that when I joined there were no product managers. We all had to figure out what we were going to build and build it ourselves. I loved working with teams, which is why I pursued the manager track. I noticed pretty quickly that the most interesting and challenging problems rarely came down to technical decisions, but more-so to people and priorities. 

As I grew in my engineering career, and got to lead teams solving problems, I was always searching for how to expand my understanding and impact across the business. I had the opportunity to shift into a strategy and operations role, which allowed me to shadow the CEO and learn a great deal while also identifying the company’s key priorities, understanding how they're doing, and ensuring that they stay on track. The new role allows me to use everything I’ve learned over the last 6.5 years at the company while at the same time, learning a lot from a seasoned leader like Alicia on how to run a business. 

Your previous experience was in engineering, and you didn’t work in healthcare or pharma before joining Alto. What has been the biggest surprise to you since joining the company? 

There are a lot of different hands in healthcare; it's a really complex space and there’s a lot at stake. I’m always mystified by how hard it is to align different parties’ incentives to result in the right outcome for patients. It underscores the importance of Alto’s mission: to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

Tell me a little bit about your current role. What are you most excited by? 

I’ve loved seeing how the different pieces of the company connect, and being able to connect the dots when we’re missing something. It’s been really fun to see how a little bit of communication and collaboration can go a long way. I also love thinking about how what we’re doing today could set us up for bigger things in the future, and how we build today in a way that opens a lot of doors for us down the line. 

In your opinion, what are the biggest opportunities for the company? 

There’s always an opportunity to be excellent at the basics. Are we consistently providing the best patient experience? Are we getting patients the best price? Are we saving time for prescribers and their offices? Those are problems that we’ve been solving for a long time, but it just gets more interesting and challenging as we’ve gone into new markets and therapeutic areas, and worked with different kinds of patients and prescribers than we used to. 

Something that I’ve always been intrigued by is - how do you bring more transparency around pricing to prescribers and patients at the earliest possible time, so that they can make the best decisions? It’s something that’s really missing in the industry. It’s not easy to do, and that’s definitely something I think a lot about - ‘How can we be the one who makes it easy for prescribers to know what they’re about to send to the patient, and for the patient to know what their other options are?’ Because a lot of times, what your insurance may cover and what your doctor may prescribe may not always be the best option. There might be other options, and I think a lot of people don’t know to ask about that. 

What are the biggest challenges in the pharmaceutical industry today? 

I think there’s been a lot of great activity from different patient advocacy groups and state governments to regulate the worst of what’s happened in healthcare. It’s been cool to see that take shape over the last five years. The challenge is that it’s very hard to write legislation and force some of these things, and so I’ve honestly gotten more interested in how do you write the right laws and approach regulation in a way that allows innovation to still happen and thrive, and still protects the patient at the end of the day. 

Back to your engineering roots – what advice do you have for young engineers?

Given the state of venture capital and the industry, a lot of engineers are going to earlier-stage companies, because there’s a little bit more investment and activity happening. I had to figure that out along the way - how do you operate as the third engineer on the team? Being anyone in an early-stage, small company - and an engineer especially - comes with its own unique challenges and skills. It’s not something there’s a ton of resources around. There’s a lot of resources about how to start a company, but not a lot for how engineers can grow their career at a company at that stage. So, my advice would be to seek out mentorship and cross functional peers from whom you can learn and grow. 

You pivoted from engineering to operations and strategy. What advice do you have for someone looking to make a career change? 

As an engineer, I’ve really focused on making an impact, whether that’s through building a product or shaping the business with what I know, with tech being the backbone. And I think that’s something we don’t talk about as much in engineering - how do you take your skills and really channel them for maximum impact and better understanding of a business? And for people who want to start their own companies someday, taking the path I did could be really valuable. It allows you to be a better entrepreneur and a better contributor if you can see the connection between engineering choices and the systems you’re building, and how they impact your customer and other parties. 

The other piece is being comfortable with wearing a lot of different hats. It’s what really helped my growth, and it’s counter to a lot of advice you get. People will tell you to go deep, get specialized and go down one path. You need to, to some extent; I absolutely had to figure out how to be a better engineer and a better leader. But the most growth for me wasn’t necessarily to stay in engineering – it was to take a turn. Hopefully, I can give colleagues a little more confidence who want to take a turn and increase their impact, growth and learning. 

Catching up with Elnaz Moshfeghian, Alto’s new VP of Strategic Planning & Business Operations 

Alto Pharmacy is thrilled to announce that The Honorable Alex M. Azar II, the 24th Secretary of the U.S. Department of Health and Human Services, has joined our board of advisors. Read more here.

Alto Welcomes Secretary Alex M. Azar II to Board of Advisors

Alto Pharmacy is thrilled to announce that The Honorable Alex M. Azar II, the 24th Secretary of the U.S. Department of Health and Human Services, has joined our board of advisors. 

Since its formation in 2020, the Alto board of advisors has provided the company with strategic guidance and helped ensure that our efforts are both impactful and efficient, with services grounded in the highest standards of operational excellence. Secretary Azar brings deep experience in both public health and the private sector, and his personal commitment to the health of all Americans mirrors Alto’s mission and focus on patient outcomes. 

During his tenure as Secretary, Secretary Azar led the historic transformation of the healthcare system in the United States and the HHS’s response to the unprecedented COVID-19 pandemic. He was the architect of Operation Warp Speed, delivering COVID-19 vaccines and therapeutics in record time, and led a team of more than 85,000 employees. Among many other accomplishments, Secretary Azar drove efforts to reduce drug prices, increase private insurance options, bring transparency of price and quality information to healthcare, expand telehealth, enable healthcare provider collaborative care models and remove regulatory barriers to low-cost, high-quality care. 

He has also played significant roles on the global health stage and championing the U.S.’s global health security efforts, including representing the U.S. in the World Health Assembly, working with the WHO to end Ebola outbreaks in the Democratic Republic of the Congo, chairing the most active G7 health ministerial in history in 2020, and convening and leading western hemisphere coordinated efforts to assist with the Venezuelan refugee crisis.

In addition to his public sector work, Secretary Azar served for ten years at Eli Lilly and Company, including five years as president of Lilly USA, LLC, its largest affiliate. He serves on several corporate and advisory boards and is a part-time Adjunct Professor of Business and Senior Executive-in-Residence at the University of Miami Herbert Business School. 

“Alto is honored to welcome Secretary Alex M. Azar II to our board of advisors,” said Alicia Boler Davis, CEO of Alto Pharmacy. “Secretary Azar is one of the most tenured experts in public and private healthcare, and his career-long commitment to improving public health perfectly reflects our top founding value – to put patients first. We are grateful for his service and are excited to leverage his deep experience and learnings as we continue to grow.” 

“Alto’s commitment to its mission of fulfilling medicine’s true purpose — to improve quality of life — for everyone who needs it sets it apart from other pharmacies,” said Secretary Azar. “I’ve dedicated my career to developing solutions for providing and enhancing healthcare outcomes for all, and I look forward to working with the Alto team and the board of advisors to continue doing just that.

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list celebrates the most innovative and game-changing private companies across various industries. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Alto Named to 2023 CNBC’s Disruptor 50 List

At Alto, our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. By putting patients first, we’re increasing accessibility to medicine, improving prescription adherence and making a meaningful difference in the lives of patients. 

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list recognizes private companies that are chasing some of the market’s biggest opportunities, and growing despite a tough capital markets environment and slowing economy. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Despite the challenging economic headwinds that all industries are facing, we’ve remained competitive, agile, and committed to delivering outstanding patient care. Just last year, we launched Essentials from Alto, allowing customers to purchase pharmacy items along with their prescription medication in the Alto pharmacy app. This provides even more access to individuals who are disabled, lack physical mobility, or otherwise can’t reach a pharmacy. 

As we celebrate this achievement, we are also mindful of the challenges that lie ahead. The healthcare industry is complex, and there is still much work to be done to ensure that every patient receives the care they deserve. But with our innovative offerings and unwavering commitment to our customers, we are confident that we can make an even bigger difference. 

Alto Named to 2023 CNBC Disruptor 50 List

Mental health disorders are among the most common health issues, affecting more than 1 in 5 U.S. adults. But despite how widespread these challenges are — and despite greater awareness of them in recent years — the stigma of mental illness remains a significant problem, one that keeps many people from seeking vital support. Of all the U.S. adults living with a mental health disorder, more than half don’t receive treatment.

Breaking the Stigma of Medication For Mental Health Disorders

Anxiety, depression, bipolar disorder, and other mental health disorders are medical conditions. Treating them with medication is no different than lowering cholesterol levels with statins or maintaining balanced blood sugar with insulin. However, there are many misconceptions and negative connotations unique to mental health treatment.

No one should be discouraged from seeking the treatment that they need to feel their best. Here are a few reasons why there is no shame in taking medication for a mental health disorder.

Taking medication doesn’t mean you’re unable to manage your health on your own.

Despite the benefits of psychiatric medication, many people consider it a last resort to explore only after trying therapy and lifestyle habits like mindfulness and exercise. Often, this stems from a misconception that those who take medication for a mental health disorder aren’t working hard enough to manage their problems.

Living with a mental health condition looks different for everyone. While some people are able to manage symptoms of depression or anxiety with therapy and lifestyle changes alone, others need a treatment plan that includes medication.

Given how difficult it can be to seek a mental health diagnosis — not to mention to share your feelings openly with a healthcare professional — taking medication is not at all a sign of weakness. It reflects a commitment to your health and wellness, one to be proud of.

Keep in mind, too, that medication and therapy aren’t mutually exclusive tools, and in deciding to take medication, you’re not choosing between the two. Far from a substitute for therapy, medication is in some cases necessary for therapy to be impactful. For example, many people with a depressive disorder find that they need to first address symptoms with medication in order to benefit from therapy sessions. Research has also affirmed this approach: some studies have found that a combination of therapy and medication is more effective at treating depression and eating disorders than either individual treatment.

It isn’t “taking the easy way out.”

Many who equate medication use with weakness see this treatment option as putting a band-aid over a problem, or taking the easy way out. On the contrary, psychiatric medications are far from a quick fix. Medication therapy can take time and a fair amount of trial and error.

With many of these medications, it can take several weeks or more before you experience the benefits. For example, many selective serotonin reuptake inhibitors (SSRI) — a type of medication commonly used to treat depression and anxiety — take two weeks to begin to have a therapeutic effect, and up to six weeks to reach a full therapeutic effect. This is why it’s important to be patient when starting a new medication, and to continue to take it as prescribed even if you don’t feel like it’s working. If you have concerns after several weeks, speak with your provider.

Also, while a medication may be able to relieve symptoms of a mental health disorder, it is not a cure. Rather, it is often what allows many people to do the challenging work of managing an ongoing condition.

Psychiatric medication is a valid and effective treatment option for a medical condition.

Mental health disorders are medical conditions with physiological components. They are frequently rooted in genetics or an imbalance of chemicals in your brain. Many psychiatric medications adjust the balance of your brain chemistry to relieve symptoms of depression or anxiety. For example, SSRIs like sertraline (Zoloft®), fluoxetine (Prozac®), and escitalopram (Lexapro®) increase serotonin levels. Serotonin and norepinephrine reuptake inhibitors (SNRIs) — another group of medications that includes venlafaxine (Effexor®) and duloxetine (Cymbalta®) — increase serotonin and norepinephrine.

Another common misconception about psychiatric medications is that they will alter your personality or make you less “you.” Many people who take medication find that they actually feel more like themselves with treatment — symptoms of mental health disorders can greatly interfere with your relationships and work and keep you from experiencing a full life.

Like most medications, some medications for anxiety, depression, and other mood disorders do have the potential for side effects. There are a variety of medication options for these conditions, so if you have concerns about side effects associated with one option in particular, your provider can help you explore alternatives.

Keep in mind that each person’s response to medication is unique. If you know someone who had side effects from one medication, it doesn’t mean that you will have the same experience.

A combination of medication and therapy can be an effective treatment option for many mental health disorders. Like determining the best medication for your symptoms, finding the right therapist can take time. Here are some tips.

If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point.

Look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator.

Some therapists offer sliding scale fees to make sessions more affordable.

If you are having thoughts of suicide, need emotional support, or are concerned for a loved one, the 988 Suicide and Crisis Lifeline is available 24 hours a day, seven days a week.

Taking care of your mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer same-day delivery and medication management tools like reminders and auto refills in our app.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Generic medications, which can cost an average of 80-85% less than their brand-name counterparts, have made treatment more accessible for many, improving medication adherence and health outcomes. They currently account for 90% of all prescription medications dispensed in the United States.

Frequently Asked Questions About Generic Medications

Despite the extensive use and effectiveness of generic medications, they are often a source of confusion. To help demystify how these medications work — and how they differ from branded options — we’ve compiled answers to commonly asked questions.

A generic medication has the same active-ingredient formula — and the same therapeutic benefits — as an already marketed brand-name equivalent, typically for a much lower cost. It can be considered an equal substitute for its branded version.

There are generic options for both over-the-counter and prescription medications. For example, ibuprofen is the generic name for Advil® and Motrin®, and acetaminophen is the generic name for Tylenol®. 

Are there any differences between generic and brand-name medications?

In order to become available for use, a generic medication must undergo a rigorous approval process from the U.S. Food and Drug Administration (FDA). Generic medication manufacturers must demonstrate that their product is equivalent to the brand version in several key ways:

It contains the same active ingredient — the substance in a medication formula directly responsible for that medication’s clinical benefits

It has the same strength, dosage form, and administration method

Given these similarities, a generic will not produce different side effects than its branded counterpart.   

A generic medication can differ from its brand-name counterpart in ways that do not affect its safety or effectiveness. This includes differences in appearance, such as shape, size, and color, as well as inactive ingredients, like binding materials, dyes, and preservatives. In fact, given trademark and branding laws, a generic has to look at least slightly different from the branded option.

If a generic has been approved, the FDA has determined its inactive ingredients are safe. However, there is the possibility that you are sensitive or allergic to an inactive ingredient contained in one version but not the other. 

Why do generic medications cost less than brand-name medications?

A common misconception about generic versions of medication is that their lower cost means that they don’t meet the same standards as their brand-name equivalents. There are two main reasons why generic medications are more affordable, and they have nothing to do with quality.

The cost of developing a new medication and then bringing it to market is very high. Manufacturers of an original brand-name medication have to spend millions of dollars on clinical trials and marketing. Companies making generics don’t have to go through the same process and can charge much less for their medications as a result.

Secondly, generics create marketplace competition, further driving down medication costs. This is especially true when multiple generic options have entered the market.

Does every brand-name medication have a generic equivalent?

No. A generic medication cannot be produced until the patent on the original brand-name option expires. The current term of a medication patent is 20 years. Periods of market exclusivity and the testing and approval process also factor into the timeline for developing a generic.

To find out if there is a generic option for your medication, check with your pharmacist or search the FDA’s catalog of approved medications.

Will my insurance cover both versions of a medication?

Insurance coverage varies by plan, but in general, many companies offer better coverage of generic medications due to their lower cost. Some plans don’t cover branded options unless there is no generic equivalent. Always verify the details of your insurance coverage before filling a prescription.

Can a pharmacist substitute a generic for a brand-name medication?

In most states, pharmacists are allowed to automatically substitute a generic for a brand-name medication when filling your prescription unless your doctor has instructed them not to.

There are some exceptions, however. Some medications have a narrow therapeutic window, which means that they require careful dosing and often frequent monitoring. (They may be referred to as narrow therapeutic index (NTI) drugs.) Some people are more sensitive to the differences between generic and brand-name NTIs than others. For this reason, a pharmacist will often consult with a provider before making a substitution for one of these medications.

If I started taking a brand-name medication, can I switch to the generic version?

Generally speaking, yes — since generics are bioequivalent to their branded counterparts, with the same safety, quality, and effectiveness, you can easily switch between versions. However, NTIs may require additional consideration. Your provider or pharmacist can help clarify any questions or concerns you may have about switching to a generic.

Questions about generic medications? Ask away!

As your pharmacy partner, we’re here to give you all the information you need to feel confident taking your medication. If you have questions about generic options, side effects, or anything else related to your treatment, reach out through in-app messaging.

Generic medications, which can cost an average of 80-85% less than their brand-name counterparts, have made treatment more accessible for many, improving medication adherence and health outcomes. They currently account for 90% of all prescription medications dispensed in the United States.

Despite the extensive use and effectiveness of generic medications, they are often a source of confusion. To help demystify how these medications work — and how they differ from branded options — we’ve compiled answers to commonly asked questions.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions. Read on.

Medication Shortages, Explained | Alto Pharmacy

Few things are more frustrating — or frightening — than being unable to access the medication your doctor has prescribed. But it has become a common experience in recent years, as medication shortages remain a persistent healthcare challenge in the U.S. And if you take medication, you may be familiar with the panic of struggling to find enough of what you need.

Not only are these shortages incredibly frustrating and debilitating, they are also confusing and unpredictable, arising seemingly at random, and with little known about an anticipated resolution.

While Alto will always go above and beyond to bring you your medications without delay, these shortages are beyond our control, and we share your frustrations and concerns. To provide more clarity and context as to why these shortages occur — and why, unfortunately, there are few short-term solutions — we’ve compiled answers to some of the questions we hear most frequently.

Like every pharmacy across the country — as well as many around the world — Alto has been affected by medication shortages in the last few years. Each pharmacy’s stock fluctuates in tandem with demand, so if you call multiple pharmacies, it’s possible that one will have a greater supply of an affected medication than another on any given day. But ultimately, no pharmacy is immune to these challenges, and if a medication is in short supply, each pharmacy may feel the impact at some point.

If Alto currently does not carry your medication and you would like to transfer your prescription to another pharmacy, be sure to call that new pharmacy to confirm availability of your medication — medication shortages often impact most pharmacies within a specific region. 

The causes of medication shortages are complex, with multiple, and often intersecting, factors at play.

Any issues that affect the production of a medication may lead to reduced supply. This includes disruptions to manufacturing, like when Hurricane Maria damaged production sites in Puerto Rico in 2017.

Covid is another example of how a natural disaster or global crisis can disrupt medication production. The United States relies heavily on other countries for the raw ingredients needed to manufacture a medication.* This leaves us incredibly vulnerable to changes in workforce capacity or manufacturing activities overseas.

*As of 2019, only 28% of our country’s supply of active pharmaceutical ingredients (APIs) — the substances directly responsible for a medication’s therapeutic benefits — were manufactured domestically.

Even when manufacturing circumstances are ideal, rising demand for a medication can lead to low supply. This winter’s difficult cold and flu season, with high cases of Covid, the flu, and R.S.V., contributed to a decreased supply of children’s formulations of ibuprofen, acetaminophen, and several commonly prescribed antibiotics.

Adderall®, a stimulant used to treat attention-deficit/hyperactivity disorder, is another medication whose demand has increased in recent years. Prescriptions for the medication increased by 15.1% in 2020, in comparison to a 7.4% increase in 2019. This comes after a surge in new ADHD diagnoses, which more than doubled between 2007 and 2016 and continue to rise. Worker shortages and production delays experienced by Teva, a leading manufacturer of Adderall, have added additional pressure and compounded the challenges.

High demand has also contributed to recent shortages of the diabetes medications Ozempic® and Wegovy®,  as they have been increasingly prescribed for weight loss.

Addressing increased demand is often easier said than done. Most generic manufacturers decide how much of a medication to produce at the beginning of the year, with virtually no flexibility, so it isn’t an option to simply make more. This is why there is often a seasonal pattern to shortages, with many intensifying at the end of the year.

In the case of Adderall, a Schedule II controlled substance, the Drug Enforcement Administration (DEA) imposes strict production quotas to prevent misuse. With quotas based on estimates, our manufacturing system isn't prepared to respond to unexpected factors like the recent rise in ADHD diagnoses. 

Why are shortages happening more frequently?

Medication shortages are in the headlines more these days, but they are not a new occurrence. They have steadily increased since 2006, becoming a public health crisis in more recent years. The American Society of Health-System Pharmacists (ASHP) reports that, at the end of 2022, ongoing and active shortages were the highest they’ve been since 2014.

The growing intensity of these shortages reflects the strain that Covid put on our entire healthcare system — which we still haven’t fully recovered from — along with other unpredictable healthcare patterns, like growing demand for ADHD medications.

Are certain medications more likely to be affected than others?

Ultimately, any medication can go into shortage, but some types are more prone to recurring supply chain issues.

Medication shortages frequently occur with commonly used (and low-profit) generic medications — like the antibiotic amoxicillin — as pharmaceutical companies have little financial incentive to produce more of them.

Some injectable generics are especially vulnerable to shortages. Fewer manufacturers make these medications, so any production disruption can become a larger issue.

The Adderall shortage illustrates that low stock of a single medication can create a class-wide issue. For many people with ADHD, switching to another medication has proven challenging, as alternatives grow scarce too. This is also the case with Ozempic and other diabetes medications.

Medication shortages are rooted in factors that are far beyond any one person’s control, and unfortunately, there is little we can do to prevent them. Industry experts have proposed solutions, including ramping up domestic production of key pharmaceutical ingredients and building a more resilient medical supply chain. These aren’t quick fixes, and government action is needed for meaningful progress.

What can I do to navigate a medication shortage?

While many medication shortages are unavoidable, there are steps you can take to potentially minimize their stress and impact.

You can track medication shortages on the U.S. Food & Drug Administration or ASHP websites to learn more about a medication’s supply.

To give yourself more time to figure out a short-term solution — such as switching to an alternative medication — refill your medication as far in advance as you can. In some cases, it may be possible to get a 90-day supply of your medication, though this isn’t always an option for controlled substances, and your insurance plan may also limit coverage of refills.

If your medication is in scarce supply, speak with your doctor about alternatives. In addition to taking a different medication, you may be able to switch to a different dose or formulation. Many medications require that you safely taper off of them, which is another reason it’s important to stay on top of refills and ideally learn about supply issues before the last minute.

If an alternative medication costs more or is not covered by your insurance plan, there are resources to help alleviate some of the burden, including coupons, manufacturer-sponsored copay cards, and patient assistance programs. Alto is here to support your savings investigations, and we also suggest reaching out to your insurance provider and verifying your plan’s details — they may be required to cover a branded option if a generic is unavailable.

Our team can answer any questions you have about your medications. We also offer same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with treatment.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions.

Winter’s shorter, darker days often bring out feelings of sadness, lethargy, and fatigue. In many cases, these feelings are symptoms of seasonal affective disorder (SAD), a form of depression triggered by seasonal shifts. 

While the nature of SAD means that symptoms tend to improve as the season changes, the condition should be taken as seriously as any other mental health disorder; untreated symptoms of SAD can interfere with daily life. And since SAD is often a temporary but recurring health concern, making a plan before the seasons change can help reduce the severity of future episodes.

How to Treat Seasonal Depression

Winter’s shorter, darker days often bring out feelings of sadness, lethargy, and fatigue. In many cases, these feelings are symptoms of seasonal affective disorder (SAD), a form of depression triggered by seasonal shifts. 

While the nature of SAD means that symptoms tend to improve as the season changes, the condition should be taken as seriously as any other mental health disorder; untreated symptoms of SAD can interfere with daily life. And since SAD is often a temporary but recurring health concern, making a plan before the seasons change can help reduce the severity of future episodes.

Here’s what to know about seasonal affective disorder and effective treatment options.

What is seasonal affective disorder (SAD)?

Seasonal affective disorder (SAD), also referred to as seasonal depression, is characterized by season-related mood changes and other depressive symptoms. In the majority of cases, SAD symptoms begin during fall and peak during winter. It is also possible to experience the opposite pattern, with symptoms that present during spring or summer.

Since SAD is considered a type of depression rather than a separate mental health disorder, many symptoms overlap with those of major depressive disorder, the clinical term for what we commonly think of as depression. Those symptoms include:

Loss of interest or pleasure in activities

Feelings of low self-worth, guilt, or hopelessness

Symptoms specifically associated with winter-pattern SAD include:

Withdrawal from social activities or a desire to hibernate

Symptoms specifically associated with summer-pattern SAD include:

If you believe you are experiencing symptoms of seasonal depression, speak with your healthcare provider or a mental health specialist for an evaluation and diagnosis.

Specific causes of seasonal affective disorder haven’t been identified, but reduced sunlight during winter is likely a significant factor, resulting in the following physiological changes.

Shifts in circadian rhythms: As seasons change, a shift in your body’s internal clock, or circadian rhythms, can disrupt your sleep and energy levels. This can also disrupt your body’s production of certain chemicals, like the stress hormone cortisol, which can also contribute to feelings of depression.

Imbalanced melatonin levels: Seasonal changes can also disrupt your levels of melatonin, a hormone that helps regulate your circadian rhythms, sleep patterns, and mood.

Decreased serotonin levels: Reduced sunlight is linked to decreased serotonin, a chemical in your brain that affects mood.

SAD is diagnosed in more women than in men, for reasons not entirely understood. It also affects younger adults more frequently than older adults.

Given the correlation between reduced sunlight and symptoms of SAD, the condition is more common among those who live further from the equator in either direction, where there are fewer daylight hours during winter months.

The following factors may also increase your risk of seasonal depression:

Family history: Many people who experience SAD have a relative with the condition or another type of depression.

Other depressive disorders: SAD may occur when symptoms of major depression or bipolar disorder intensify with seasonal shifts.

Decreased levels of vitamin D: It’s common to have less vitamin D during the winter as the result of less sunlight. This may play a role in the development of SAD, as vitamin D can boost serotonin activity. If you aren’t getting enough vitamin D from food or other sources, ask your doctor if you would benefit from taking a supplement.

Fortunately, there are many ways to treat symptoms of SAD, including light therapy, medication, and psychotherapy. For many people, a combination of treatment approaches leads to better results. While symptoms tend to naturally resolve as the seasons change, treatment can provide earlier relief.

Light therapy, which consists of daily exposure to bright light to compensate for less daylight, is a frontline treatment option for SAD. In this approach, an individual with SAD will sit in front of a very bright light box for 30 to 45 minutes every day. Treatment typically happens first thing in the morning, but a supplemental evening session may also be necessary in some cases.

Light therapy is safe for most people, as the light boxes filter out harmful UV light. However, it may not be a good fit if you have certain eye diseases or take medication that increases your sensitivity to sunlight.

Never begin light therapy without consulting your provider, and make sure to discuss your options for bright light boxes.

Psychotherapy, or talk therapy, is another common treatment option for seasonal depression. Cognitive behavioral therapy (CBT) is considered one of the most effective therapeutic approaches for this condition.

CBT focuses on changing thoughts and behaviors. If you experience SAD, CBT may offer the following benefits:

Finding the right therapist can take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.

Some people with SAD benefit from increased exposure to sunlight, whether it means spending more time outside during daylight hours or working from a space with ample sunlight.

Prioritizing your general health and wellness by staying physically active, eating a nutritious, balanced diet, and getting enough sleep can also ease symptoms. 

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