Acthar (corticotropin (ACTH))

Company: Questcor Pharmaceuticals

Program name: Acthar Gel Patient Assistance Program

Program address: C/O NORD PO Box 1968 Danbury, CT 06813-1968

Phone number: 888-435-2284

Fax number: 203-798-2964

Eligibility guidelines
and notes: The patient must have no insurance and

Application process: With the patient's permission, anyone concerned can call for an application.

Application requirements: The doctor must fill out a section, sign the application and attach a prescription.

Program details: The medication is sent to the doctor's office, hospital or pharmacy.

Last updated: 6/9/2008

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