| Multiple Sclerosis
Acthar vs Ampyra
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis.Deep comparison between: Acthar vs Ampyra with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsAmpyra has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ampyra but not Acthar, including UnitedHealthcare
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Category
Acthar
Ampyra
At A Glance
IM or SC injection
Corticotropin analog
Oral
Twice daily
Potassium channel blocker
Indications
- Infantile Spasm
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Lupus Erythematosus, Systemic
- Dermatomyositis
- Polymyositis
- Erythema Multiforme
- Stevens-Johnson Syndrome
- Serum Sickness
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis, Posterior
- Choroiditis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Multiple Sclerosis
Dosing
Infantile Spasm 150 U/m2/day IM divided into 75 U/m2 twice daily for 2 weeks, then taper over 2 weeks; Acthar Gel vial only -- do not use the pre-filled SelfJect injector.
Multiple Sclerosis 80-120 units IM or SC daily for 2-3 weeks for acute exacerbations; taper as needed.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Lupus Erythematosus, Systemic, Dermatomyositis, Polymyositis, Erythema Multiforme, Stevens-Johnson Syndrome, Serum Sickness, Keratitis, Iritis, Iridocyclitis, Uveitis, Posterior, Choroiditis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome 40-80 units IM or SC every 24-72 hours; individualize dosing based on disease severity and patient response; taper dose upon discontinuation.
Multiple Sclerosis 10 mg tablet twice daily approximately 12 hours apart; do not exceed 10 mg twice daily; swallow tablets whole; may be taken with or without food.
Contraindications
- Intravenous administration
- Use in infants under 2 years of age with suspected congenital infections
- Concomitant live or live-attenuated vaccines during immunosuppressive doses of Acthar Gel
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of peptic ulcer
- Congestive heart failure
- Uncontrolled hypertension
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
- Sensitivity to proteins of porcine origin
- History of seizure
- Moderate or severe renal impairment (CrCl <=50 mL/min)
- History of hypersensitivity to AMPYRA or 4-aminopyridine, including anaphylaxis
Adverse Reactions
Most common (>=5%) Infections, convulsions, hypertension, irritability, pyrexia (reported in infantile spasm trials at recommended dose)
Serious Cushing's syndrome, adrenal insufficiency upon withdrawal, elevated blood pressure, salt and water retention, hypokalemia, gastrointestinal perforation and bleeding, behavioral and mood disturbances, ophthalmic effects, decreased bone density, negative effects on growth and physical development
Postmarketing Anaphylaxis, necrotizing angitis, pancreatitis, intracranial hemorrhage, subdural hematoma, reversible brain shrinkage, vertebral compression fractures, insomnia, injection site reactions
Most common (>=2%) Urinary tract infection, insomnia, dizziness, headache, nausea, asthenia, back pain, balance disorder, multiple sclerosis relapse, paresthesia, nasopharyngitis, constipation, dyspepsia, pharyngolaryngeal pain
Serious Seizures, anaphylaxis
Postmarketing Vomiting, vertigo
Pharmacology
Repository corticotropin (ACTH) analog that stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and weak androgens; also reported to bind melanocortin receptors, with the trophic effects on the adrenal cortex appearing to be mediated by cyclic AMP.
Dalfampridine is a broad spectrum potassium channel blocker that increases conduction of action potentials in demyelinated axons through inhibition of potassium channels; the mechanism by which it improves walking in MS has not been fully elucidated.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Acthar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
Ampyra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Ampyra
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Ampyra
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
Cost estimate not availableAccessia Health: Multiple Sclerosis - Private Insurance: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.