Acthar(corticotropin)
Acthar Gel 40 UNT in 0.5 ML Prefilled SelfJect Injector
NO BOXED WARNING
Dosage & Administration
Dosage & Administration
drug label
Acthar Prescribing Information
prior authorization
Acthar Prior Authorization Resources
Most recent state uniform prior authorization forms
Verified: Jun 26, 2024Arizona - Uniform Prior Authorization Form
Verified: Jun 26, 2024Colorado - Uniform Prior Authorization Form
Verified: Jun 26, 2024Hawaii - Uniform Prior Authorization Form
Verified: Jul 26, 2024Illinois - Uniform Prior Authorization Form
Verified: Jun 26, 2024Indiana - Uniform Prior Authorization Form
Verified: Jun 26, 2024Louisiana - Uniform Prior Authorization Form
Verified: Jun 26, 2024Minnesota - Uniform Prior Authorization Form
Verified: Jun 26, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Jun 26, 2024New Mexico - Uniform Prior Authorization Form
Verified: Jun 26, 2024Oregon - Uniform Prior Authorization Form
Verified: Jun 26, 2024Texas - Uniform Prior Authorization Form
Verified: Jul 07, 2024Washington - Uniform Prior Authorization Form
Verified: Jul 07, 2024Wisconsin - Uniform Prior Authorization Form
Benefits investigation
Reimbursement help (FRM)
financial assistance
Acthar Financial Assistance Options
Copay savings program
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Overview
- Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)
Patient benefit
- A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max
Patient eligibility
- Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
- Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
- May never be used with government insurance
How to sign up
- Cards may be downloadable digital cards or hard copies
- Some pharmacos offer debit cards with pre-loaded copay benefit
- Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
- Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form
Bridge program
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Overview
- Provide patient immediate access to therapy during an insurance delay (typically new starts; some may cover change in insurance)
- Limited time/ fill (typically 7-30 days; some may offer additional fill for continued delay up to certain limit)
Patient benefit
- 100% free (outside of insurance)
Patient eligibility
- HCP must enroll patient
- May be limited to commercially insured patients (i.e., no government beneficiaries); some programs may allow government beneficiaries
How to sign up
- Typically HCP assisted enrollment (via form)
Foundation programs
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Overview
- Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
- These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned
Patient benefit
- Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and copays) until the grant is exhausted
Patient eligibility
- Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.
How to sign up
- Patients submit proof of out-of-pocket drug costs to charities for reimbursement
patient education
Acthar Patient Education
Getting started on Acthar
Instructions For Use (Spanish): All Indications
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link
Patient toolkit
Infantile Spasms Caregiver Brochure - Spanish
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
Infantile Spasms Injection Guide - Spanish
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
Infantile Spasms Treatment Tracker - Spanish
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
people also ask
Acthar FAQs
How is the dosage of Acthar?Acthar is available in 3 dosages, including 80 unt/ml Prefilled Syringe 0.5 ml, 80 unt/ml Prefilled Syringe 1 ml and 80 unt/ml Sol
What does Acthar treat?Acthar treats Collagen Diseases, Erythema Multiforme, Multiple Sclerosis, Nephrotic Syndrome, Optic Neuritis, Rheumatic Diseases, Sarcoidosis, Serum Sickness, Infantile Spasms and Uveitis
What is Acthar made of?Acthar contains corticotropin which is a Adrenocorticotropic Hormone
How Is Acthar Administered?Acthar is administered as a Injectable
FAQ Data Source
We receive information directly from the FDA and PrescriberPoint is updated as frequently as change are made available