Acthar Gel Patient Assistance Program (Questcor)

Questcor Pharmaceuti

Contact Information
c/o NORD
PO Box 1968
New Fairfield, CT 06812
1-(800) 459-7599 (phone)
Eligibility is based on income and lack of prescription coverage. Each application is reviewed individually to determine eligibility.
Other Information:
Anyone can call to start the process and an application can be mailed to patient, doctor or social worker. The completed application can be faxed back to NORD. The patient needs to fill out a section with detailed financial and insurance information. The patient will also need to provide proof of income, and sign the form.
Product(s) covered by program:
  • Acthar® Gel