Is there good evidence that Acthar works better than cheaper steroids?
Independent researchers at Oregon Health & Science University found no evidence that Acthar is superior to much cheaper steroids — yet Medicare spending on the drug rose tenfold to more than $500 million in 2015 alone.
This is one of the core criticisms of Acthar's use. Researchers at Oregon Health & Science University found no evidence that Acthar is superior to much cheaper forms of steroids. A course of prednisone costs at most a few hundred dollars; an Acthar course can exceed $100,000. One researcher said that a variety of Acthar's FDA-approved indications lack strong evidence that it is effective at all, let alone better than inexpensive corticosteroids.
Medicare spending on the drug nonetheless rose tenfold between 2011 and 2015, reaching more than $500 million in 2015 alone, and was concentrated among a small group of specialists. An Annals of Internal Medicine paper used Acthar as a case study of older drugs with limited trial evidence and whether they are worth the expense. Mallinckrodt has argued the drug helps patients who do not respond to other treatments.