The Rise and Fall of Done Global Inc.: Lessons in Virtual ADHD Medication Management

The Rise and Fall of Done Global Inc.: Lessons in Virtual ADHD Medication Management

The recent charges against Done Global Inc.'s CEO and head doctor highlight critical issues within the burgeoning telehealth industry. Federal prosecutors allege a fraud scheme centered on providing "easy access" to Adderall and other stimulants. The Done Global Inc. case serves as a stark reminder of the potential pitfalls within the telehealth industry and might also help explain some of the supply chain issues regarding ADHD medications across the nation.

Done Global Inc., a virtual ADHD medication management company, faced investigations going back to September 2022 by the Drug Enforcement Administration. Authorities accuse Ruthia He, the founder, and David Brody, the clinical president, of fraud and distributing controlled substances without legitimate medical purpose. According to the Department of Justice, Done generated over $100 million by prescribing more than 40 million pills, often to individuals who didn't medically qualify for such treatment.

What does it say about a company when its priority shifts from patient safety to profit? The DOJ's indictment paints a troubling picture. Done allegedly used deceptive advertisements to attract individuals seeking stimulants, structured its platform to facilitate easy access to these drugs, and limited the information available to prescribers. Initial consultations lasted under 30 minutes, and an "auto-refill" function allowed for monthly prescription renewals with minimal oversight. Despite awareness of overdoses and deaths among its members, the company continued its practices.

The case against Done reveals significant gaps in regulatory oversight. The DEA’s delayed response allowed potential abuses to continue unchecked for years. This reactive approach undermines trust in regulatory agencies and hampers efforts to ensure compliance within the telehealth industry. The temporary suspension of in-person consultation requirements during the COVID-19 pandemic, part of the Ryan Haight Act amendments, facilitated the growth of virtual behavioral health providers. However, it also created opportunities for exploitation, as seen in the Done case.

The fallout from Done’s practices extends beyond legal repercussions. The Centers for Disease Control and Prevention warns that disrupting Done’s services could impact up to 50,000 patients, exacerbating the existing shortage of ADHD medications like Adderall. This shortage, first noted by the FDA in 2022, has made it challenging for individuals with legitimate needs to access their medication. The case also casts a shadow over other digital health startups, particularly those involved in prescribing controlled substances. Retail pharmacies, wary of potential abuses, have already started rejecting prescriptions from digital providers or requiring in-person consultations. This increased scrutiny could hinder the accessibility and growth of legitimate telehealth services.

One of the most disturbing aspects of the Done case is the involvement of licensed physicians in potentially widespread unethical practices. Physicians are bound by a code of ethics to "do no harm," yet the allegations suggest that medical professionals at Done were complicit in practices prioritizing profit over patient welfare. This complicity is not just a legal issue but a profound ethical breach that shakes the foundation of trust between patients and healthcare providers. As telehealth continues to evolve, we must learn from the Done case to regulate future similar practices. Ensuring that digital health platforms operate with integrity and prioritize patient safety will be key to their sustainable growth. Strengthening regulatory frameworks to adapt to the unique challenges of telehealth is critical. This includes updating laws to address new technologies and ensuring robust enforcement mechanisms. Developing patient-centric care models that emphasize comprehensive treatment and follow-up can improve outcomes and reduce the risk of misuse. Investing in research to understand the impacts of telehealth on patient care and outcomes can guide future policy decisions and improve service delivery.

Pharmacies play a crucial role in the prescription and distribution of medications. Major chains like CVS, Walgreens, and Walmart have become increasingly cautious about filling prescriptions from telehealth providers, especially for controlled substances. Their policies often require in-person consultations to verify the legitimacy of prescriptions. This caution, while protective, also creates barriers for patients who rely on telehealth services. Balancing patient safety with accessibility remains a significant challenge.

Telehealth has transformed significantly over the past few decades. Initially limited to basic consultations via phone or video, advanced technologies now enable a broader range of services. The COVID-19 pandemic accelerated this evolution, as lockdowns and social distancing measures necessitated remote healthcare solutions. Companies like Done capitalized on this shift, offering convenient and quick access to medications and mental health services. The rapid growth of telehealth exposed vulnerabilities, particularly in the regulation of controlled substances.

While virtual health services offer significant benefits, including increased accessibility and convenience, we must carefully regulate them to prevent exploitation and ensure patient safety. Any disregard for patient safety underscores a severe ethical lapse and raises questions about the responsibilities of telehealth providers in the digital age. Medical professionals involved in such schemes undermine the integrity of the medical field. Their actions not only endanger patients but also tarnish the reputation of telehealth services. The Done case serves as a cautionary tale about the importance of maintaining ethical standards and vigilance in all forms of medical practice, including telehealth.