Acthar was first approved in 1952 for the treatment of rheumatoid arthritis, but its acquisition by Questcor from the former Aventis in 2001 allowed the new owner to test out a strategy of label expansions and steep price rises.
In 2010, Questcor won approval to use the drug, which stimulates hormone secretion, in infantile spasms. A quirk of its approval was that it came under a separate New Drug Application from its original OK, which is how the company was initially able to persuade the Centers for Medicare and Medicaid Services to permit rebates based on its 2013 price.
