Acthar prices have been under fire for years, long before Mallinckrodt took over its previous maker, Questcor ($QCOR). Per-vial prices rose from $1,500, when Questcor bought it, to $28,000 in 2013. That higher price landed it on FiercePharma's most expensive drugs list, with a $205,000-plus annual list cost.
Along the way, Questcor bought the rights to a potential head-to-head competitor, Synacthen Depot, from Novartis ($NVS), to lock down the competition. It also belatedly disclosed thousands of side effect reports to the Securities and Exchange Commission, after a New York Times story linked Acthar to 20 deaths and half a dozen disabilities. Meanwhile, the higher prices pushed up Medicare's spending on the drug, approved to treat a laundry list of inflammatory diseases, leading some medical experts to take issue with its high prices.