Volume 33 • Number 3 • March 2012
Options for treating ADHD
during medication shortage
by Michael I. Reiff, M.D., FAAP
AAP works to protect
Affordable Care Act as
Supreme Court hears challenges
Parents of children with attention-deficit/hyperactivity disorder (ADHD) have been finding medications to treat this disorder in short supply.
Reports have linked reasons for the shortage to
conflicts between companies trying to maximize
their profits and Drug Enforcement Administration
agents trying to minimize abuse by individuals who
use the medications to “get high” or to stay up all
This shortage primarily has involved generic drugs,
even though several companies produce both the
generic and branded versions of the same medication.
The generics often are the only medications that
many families can afford. A generic medication, for
example, may cost $10 for a one-month supply com-
pared to more than $200 for the equivalent prescrip-
tion of the brand name.
by Jamie Poslosky • Washington Correspondent
See ADHD, page 8
‘Bit of serendipity’ Pediatric surgeon makes career of separating conjoined twins
Pediatric surgeon Gary E. Hartman, M.D.,
FAAP, (above) led the 10-hour procedure to
separate Angelica and Angelina Sabuco, who
were conjoined at the chest and abdomen.
Previously, Dr. Hartman had successfully separated five other sets of conjoined twins.
Photos courtesy of Lucile Packard Children’s Hospital
Although two years have passed since the Affordable
Care Act became law, work to protect its strong child
health provisions is far from over. Legal challenges to the
health reform law’s constitutionality have advanced to
the highest level of judicial review, with the U.S. Supreme
Court set to hear an unprecedented five and a half hours
of oral arguments later this month.
In advance of what could serve as the most significant
medical ruling in the history of the Supreme Court, the
pediatric voice is far from silent. The Academy has signed
on to eight amicus curiae, or “friends of the court,” briefs
throughout the litigation process in support of the health
reform law; submitted public comments to more than 50
rules, regulations and other guidance released by federal
agencies to shape the law’s provisions; and has urged Congress to stop efforts to defund and repeal aspects of the law.
Since the Affordable Care Act became law, 26 lawsuits
have been filed in federal district courts challenging its
constitutionality, six of which were heard at the U.S.
circuit court level. Five of these circuit court rulings were
appealed to the Supreme Court, which agreed to hear
only one — Florida et al. v. Department of Health and
This suit — commonly referred to as the multistate
lawsuit — was filed in Florida by the state’s attorney
general and later joined by 25 additional state attorneys
general and the National Federation of Independent Business. The suit argues that the law is unconstitutional and
has led the Supreme Court to focus its review on four
areas: the law’s individual mandate, its proposed Medicaid
expansion, the concept of severability and the Tax Anti-Injunction Act.
Beginning on March 26, lawyers representing both
sides of the multistate case will summarize their positions
before the nine justices of the Supreme Court in a process
known as oral arguments.
See Affordable Care Act, page 5
In this issue
by Wynn St. Clair • Correspondent
When a very pregnant Ginady Sabuco learned she
was carrying conjoined twins in the summer of 2009,
she cried and wondered why her family deserved
such a fate. Then she began making plans.
Determined to give her daughters the best chance
at leading healthy, happy lives, she and her husband,
Fidel, sought out medical experts and scoured the
Internet. At every turn, they came across the same
name: Gary E. Hartman, M.D., FAAP.
Make the move to mL
Do your part to reduce inaccurate dosing errors. Join the movement
to use milliliters (mL) to measure all liquid medications. Page 10
3 HPV vaccine doses for boys
Read what’s new about recommendations on use of human
papillomavirus vaccine in boys and coding for male patients.
Pages 16, 24