ACTHAR SUPPORT AND ACCESS PROGRAM (A.S.A.P.)

 

Contact the Acthar Support & Access Program (ASAP) to start a patient on therapy

• You can call the Acthar Support & Access Program (ASAP) at 1-888-435-2284 Monday-Friday 8:00 am-8:00 pm ET
• You can also fax the Acthar Referral/Prescription Form to ASAP at 1-877-937-2284

Questcor is Committed to Helping Your Patients from Referral to Relief

Created and sponsored by Questcor, A.S.A.P. is a free resource staffed with knowledgeable specialists who help your patients by providing:

Reimbursement and coverage support

• Secures the best insurance coverage with the lowest possible copay
• Assists Healthcare Providers with insurance prior authorization processes

Patient assistance and access programs

• Helps obtain copayment assistance for qualified patients
• Provides qualified uninsured and underinsured patients with free Acthar

Medication shipment tracking

• Ensures timely shipment from the Specialty Pharmacy chosen by the patient's insurance

Home injection training

• Provides easy-to-use, multimedia home injection training materials
• Coordinates free Home Injection Training Services by licensed nurses

A.S.A.P. is simple

1. Complete the A.S.A.P. referral and prescription form on behalf of your patient

   Forms are available from your Acthar specialist, by calling A.S.A.P., or at www.acthar.com

2. Fax the completed form to A.S.A.P. at 877-937-2284

3. Respond to any inquiries that A.S.A.P. has as soon as possible to help reduce the turnaround time

   Representatives at A.S.A.P. will keep you and your patient informed regarding delivery of the medication