From reimbursement assistance to injection training for parents or caregivers, support specialists from the Acthar Support & Access Program (A.S.A.P.) coordinate efforts to ensure efficient, seamless service.

Working with A.S.A.P.

When you prescribe Acthar for a patient, A.S.A.P. jumps into action. It’s important for your office staff to respond to A.S.A.P. requests quickly throughout the process.

Download the Physician Referral/Prescription Form or request one from your Acthar specialty sales consultant.
Complete the form about your patient and prescription. Fax it to A.S.A.P. at 1-877-937-2284.
Notify the parent or caregiver that A.S.A.P. will call them with updates and questions. It is important that they take these calls and provide full information when it’s requested.
A.S.A.P. will fax you a confirmation and a case number. They will also contact your office within 2 hours with a status update, after they’ve determined the patient’s coverage situation or eligibility for Mallinckrodt’s Patient Assistance Program.
A.S.A.P. may contact you with questions as they work through any prior authorizations and appeals required. Responding quickly and completely helps ensure your patients get Acthar as soon as possible.
A.S.A.P. sends the approval to the specialty pharmacy, who then contacts the parent or caregiver to confirm their co-pay and schedule delivery of Acthar.
The refrigerated container of Acthar is delivered to the parent or caregiver, who must sign for it.
The parent or caregiver begins administering treatment to their baby according to your prescribed directions.

If you have any questions about A.S.A.P., please call 1-888-435-2284, Monday to Friday, between 8 AM and 8 PM ET.

Reimbursement support

A.S.A.P. will provide support throughout the reimbursement process.

  • Benefits verification and payer coverage information, patient advocacy groups, and other sources of assistance, if applicable
  • Research for payer-specific information regarding prior authorization and coverage appeals

A large majority of patients with IS have Acthar covered by their insurance plan.

  • 91% of commercially insured IS patients are covered for Acthar.23 There is also a Patient Assistance Program (PAP) available for uninsured and underinsured patients who qualify

Commercial Co-pay Assistance Program

  • Up to 100% co-pay costs covered for eligible patients
  • A.S.A.P. will refer eligible patients’ caregivers to charitable organizations
  • Patients must meet certain eligibility criteria

Patient Assistance Program (PAP)

Administered by a third party, PAP makes Acthar available at no cost to patients in financial need who meet certain eligibility criteria. PAP assistance is limited to patients who are uninsured or whose insurer does not cover Acthar.

Helpful Resources

Request a rep visit

Contact your Acthar sales specialist.

Physician Referral/Prescription Form

Download for your practice to complete.

Caregiver Injection Training and Starter Kit

Information about Infantile Spasms and how to inject Acthar.