Acthar marketing drives prescriptions and anger

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Questcor Pharmaceutical's marketing push for the injectable Acthar has simultaneously driven prescription rates and scorn.

ProPublica and the New York Times note that the drug is a curiosity of sorts: the biologic has been on the US market since 1952, when the FDA only required manufacturers to prove a drug is safe, not that it was effective. Since then the number of its approved uses has climbed to as many as 50 and has been pared back to as few as 19.

The safety-only approval criteria is what has payers taking note, since doctors have been prescribing the medication for multiple sclerosis even though there is little in the way of clinical trials showing that it is an effective treatment. It is, however, an expensive one, costing around $32,000 for each five-dose vial.

This seems small, considering the uproar surrounding Gilead's hepatitis C treatment Sovaldi, which clocks in at around $84,000, but as ProPublica and the Times note, Gilead has documented Sovaldi's hepatitis C impact, whereas Acthar is getting by on robust marketing support and supportive physicians.

The significance of this combination is clear by the numbers the two news groups have dug up, including that the drug's top prescriber, who also talks about the drug for Questcor, accounted for more than $4 million in Acthar prescriptions two years ago.

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