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No Longer Under The Radar: Aetna Narrows Coverage For Questcor’s Acthar

 
• By Cathy Kelly

Aetna’s decision to no longer cover Acthar in patients with multiple sclerosis or nephrotic syndrome suggests the cost of covering the high-priced niche drug has grown to the point that it is prompting closer scrutiny; promotional campaign has also drawn government review.

Aetna’s decision to significantly limit coverage for Questcor Pharmaceuticals Inc.’s Acthar Gel (repository corticotropin injection) may be a cautionary example of how an aggressive marketing push for a high-priced niche drug can draw payer push-back.

Aetna now will only cover Acthar for infantile spasms, a form of childhood epilepsy

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