To avoid processing delays, please make sure:
Since prior authorizations are common, a statement of medical necessity may be needed.
If you have any questions or need assistance filling out your form, contact A.S.A.P.
Monday to Friday, 8 AM to 8 PM ET.
A.S.A.P. will keep you and your patient informed about the delivery status of their Acthar prescription.
H.P. Acthar® Gel (repository corticotropin injection) is indicated as monotherapy for the treatment of infantile spasms in infants and children under 2 years of age.
IMPORTANT SAFETY INFORMATIONContraindications