Starting Patients on Acthar
Acthar is available through independent, in-network Specialty Pharmacy distribution. Patients cannot get their Acthar prescription filled at most retail pharmacies.*
When filling out the Acthar Start Form, following these guidelines will help expedite initiation with insurance companies:
- Be sure to include phone numbers for both the direct office contact and backup office contact
- Provide clinical documentation and copies of detailed patient charts/notes
- Since prior authorizations and appeals are common, a Letter of Medical Necessity may be needed
If the referral is denied, you may have the option to appeal to the patient’s plan with the support of the Acthar Hub.
- If your office receives a denial letter or any correspondence from the insurance company, fax it to the Acthar Hub immediately
- Having all relevant insurance company communications helps the Case Manager better support the reimbursement process
- If the appeal process is unsuccessful, patients will be referred to the Acthar Reimbursement and Support Program to determine eligibility about receiving Acthar at no cost†
For questions about the Acthar referral process or the status of an existing referral, please call the Acthar Hub at 1-888-435-22841-888-435-2284 Monday through Friday from 8 AM to 9 PM ET, and Saturday from 9 AM to 2 PM ET.
*CVS and Walgreens can arrange prescription pickup at their locations but require some advance notice to ensure medication is available at a local pharmacy.
†Program administered via a third-party organization.
Acthar offers downloadable resources and tools to help your patients at every step.
- Download Your Guide to Acthar, an educational resource for your symptomatic sarcoidosis patients who have been newly prescribed Acthar
- Download the Acthar Treatment Journal, containing useful sarcoidosis information, tips, tools, and more
- Download Your Journey With Symptomatic Sarcoidosis, an educational resource with information on sarcoidosis, symptoms, and treatment options
- Download the Access to Acthar Overview, a comprehensive patient support resource for your patients—from prescription through treatment