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Getting started: Your guide to prescribing Acthar Gel

A support team is available to assist with the process at no additional cost to you or your patient.

To help your patients start their Acthar Gel treatment, please enroll them in the Acthar Hub, a support program designed to simplify access, helping patients and healthcare professionals alike.

Getting started is simple

1

Complete the Acthar Start Form and fax it to the Acthar Hub at 1-877-937-2284.

DOWNLOAD START FORM
2

The Acthar Hub will fax back a confirmation and contact your office within 4 business hours to explain the next steps, including prior authorization requirements.

3

The Acthar Hub may contact your office staff with questions. Responding in a timely manner helps to ensure that patients receive Acthar Gel as soon as possible. If you have questions, contact the Acthar Hub:

Phone: 1-888-435-2284

Fax: 1-877-937-2284

The Acthar Hub Case Manager will keep your office staff and patients informed about the status of their Acthar Gel prescription.

If your patient is ready to begin therapy, you can simply access the Start Form on the Acthar Gel home page.

Learn more about how the Acthar Hub may help you and your appropriate MS relapse patients.

View Patient Support Services
Instructions for downloading the Acthar Referral Form

Download the PDF to your computer to enable all form fields and begin editing. Be sure to save the completed document before printing.