Is there good evidence that Acthar works better than cheaper steroids?
OHSU researchers found no evidence of superiority over steroids costing hundreds of dollars per course — versus Acthar's $100,000+ — and an Annals of Internal Medicine review used it as a case study of old drugs with limited evidence and questionable value.
This is one of the central criticisms. The OHSU researchers found no evidence that Acthar is superior to much cheaper forms of steroids. A course of prednisone costs at most a few hundred dollars, while an Acthar course can exceed $100,000. One researcher said many of Acthar's FDA-approved indications lack substantial evidence that it is effective at all, let alone better than inexpensive corticosteroids. An Annals of Internal Medicine review examined whether older drugs with limited trial evidence are worth the expense, using Acthar as its case study. Mallinckrodt has argued that Acthar works through mechanisms beyond steroid production and benefits patients who do not respond to other treatments, and it has funded further studies. But the evidence base has not persuaded many independent analysts.