Acthar Gel

Indicated For

Infantile spasms, systemic lupus erythematosus, dermatomyositis, polymyositis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

About This Medication

# Acthar Patient Assistance Program Patient Guide: How to Get Acthar Gel at Low or No Cost Acthar Gel (repository corticotropin injection) is a prescription medication used to treat certain inflammatory conditions, and the **Acthar Patient Assistance Program** from Mallinckrodt helps eligible uninsured or underinsured patients get it at no cost. This guide explains eligibility, the application process, and support options in simple terms to help you access treatment affordably.[1][2] ## About Acthar Gel **Acthar Gel** is an injectable form of corticotropin, a hormone that stimulates your body to produce natural corticosteroids to reduce inflammation. It's FDA-approved for conditions like multiple sclerosis relapses, infantile spasms, rheumatoid arthritis, and others such as nephrotic syndrome or scleroderma-related issues.[6] Your doctor injects it into a muscle or administers it subcutaneously after training. Common side effects include increased blood pressure, weight gain, mood changes, and infection risk—discuss these with your healthcare provider. Acthar Patient Support offers free injection training via a Nurse Navigator.[1][6] ## Who Qualifies for the Program? The program provides **Acthar Gel at no cost** to eligible patients who are uninsured, underinsured, or facing high out-of-pocket costs, with a valid on-label prescription.[1][2][8] There's no strict income threshold listed, making it needs-based rather than purely income-driven.[5] Patients must be permanent U.S. residents.[4] Government insurance holders (Medicare, Medicaid, etc.) are ineligible for co-pay help but may qualify for other assistance—call to check.[2][4][9] Key eligibility: - Valid prescription for FDA-approved use. - No or limited insurance coverage for Acthar Gel. - Willingness to enroll in Acthar Patient Support (automatic upon referral).[6][8] ## Income Eligibility Breakdown No specific income limits are published, unlike some programs. Eligibility focuses on insurance status and financial need. Here's a simple table summarizing factors: | Factor | Details | |--------|---------| | **Income Threshold** | None specified; case-by-case for uninsured/underinsured.[5] | | **Household Size** | Not required; needs-based assessment.[2] | | **U.S. Residency** | Required; permanent residents only.[4] | | **Examples** | Uninsured: Full eligibility. Underinsured: Possible free gel if high costs.[1] | Contact the program for a personalized review, as decisions consider overall financial hardship.[1][5] ## Insurance Requirements - **Uninsured**: Primary candidates—get Acthar Gel free if eligible.[1][2] - **Commercial/Private Insurance**: Use the **Commercial Co-Pay Program** for up to **$15,000/year** coverage of co-pays, coinsurance, deductibles (reduces cost to $0 often).[2][4][9] Not for government plans. - **Government Programs** (Medicare Part D, Medicaid, TRICARE, VA): Ineligible for co-pay aid; explore other needs-based options. Medicare Part D patients should call for details.[4][5][9] - **Warnings**: Accumulator/maximizer plans may limit co-pay help; notify changes in coverage.[4][9] Acthar Support helps with benefits checks, prior authorizations, and appeals.[2][6] ## Step-by-Step Application Process 1. **Get Prescribed**: Ask your doctor for Acthar Gel and have them complete the referral form (includes prescription, proof of medical necessity).[8] 2. **Enroll in Support**: Doctor submits referral—you're auto-enrolled in Acthar Patient Support. Get a Case Manager and Nurse Navigator.[6] 3. **Gather Documents**: - Valid Acthar Gel prescription. - Proof of insurance (or lack thereof, e.g., denial letter). - Healthcare provider referral form.[8] 4. **Apply**: Multiple methods—call **(888) 435-2284**, fax referral, or use online tools like www.ActharConsent.com for consent.[2][7][8] Interactive PDFs available.[5] 5. **Benefits Investigation**: Team verifies coverage, handles prior auth.[2] 6. **Approval**: If eligible, gel ships free to you.[1] **Reauthorization**: Required for refills/ongoing therapy—doctor resubmits as needed.[8] ## Timeline and Delivery Processing varies (no fixed time listed), but Acthar Support prioritizes urgent cases. Expect: - Initial contact from Case Manager soon after referral.[6] - Benefits check: Days to weeks. - Delivery: **Shipped directly to patient** at no cost once approved.[1] Support line: 1-888-435-2284 (Mon-Fri 8am-8pm, Sat 9am-2pm ET).[6][7] Track via Case Manager. ## Alternatives if Denied - **Appeal Insurance Denial**: Use Acthar-provided appeal letters/templates. Patients have appeal rights; Support assists.[2] - **Co-Pay Switch**: If commercially insured, try Co-Pay Program ($15,000 cap).[9] - **Other Help**: Patient Access Network (PAN) Foundation or state programs for rare diseases. - **Contact Support**: Case Manager helps explore options; free gel possible under bridge programs until approval.[2][8] - **Biosimilars**: None available currently. ## Disclaimer This guide is for informational purposes based on program details as of last update. Eligibility, terms can change—Mallinckrodt may amend/revoke anytime.[4][8] Not medical/financial advice. Consult your doctor and call **(888) 435-2284** for latest info. Void where prohibited. Program covers one vial at a time; no reimbursement seeking allowed.[8] (Word count: 942)

Program information last verified: March 30, 2026