Bloomberg News

Questcor Falls as Aetna Keeps Acthar Limits: Los Angeles Mover

November 30, 2012

Questcor Pharmaceuticals Inc. (QCOR:US) slipped the most in two months after a review by insurer Aetna Inc. (AET:US) left in place limits on coverage for the drugmaker’s top- selling drug.

Questcor fell 8.1 percent to $25.90 at the close of New York trading on Aetna’s review yesterday that found the drug H.P. Acthar Gel was “medically necessary” only for infant seizures. It was the biggest one-day decline for the Anaheim, California-based company since it said on Sept. 24 that the U.S. government was investigating its marketing practices and shares dropped 37 percent.

Questcor plunged the most in 20 years on Sept. 19 after Aetna said it would limit payment for H.P. Acthar, which is also used to treat multiple sclerosis, allergic conditions and other illnesses. In a follow-up review posted on Aetna’s website this week, the insurer said the drug’s benefit still hadn’t been proven for conditions beyond the infant spasms known as West syndrome.

“There are a lack of clinical studies comparing the effectiveness” of Acthar and steroids, according to the posting from Aetna, the third-biggest U.S. insurer by membership. “In addition, there is no reliable evidence of the effectiveness” of the product “in persons who have failed to respond to corticosteroids.”

Aetna generally reimburses drugs only when they’re deemed medically necessary, a spokeswoman for the Hartford, Connecticut-based carrier, Cynthia Michener, said Sept. 19. The insurer will still cover Acthar for members who have been using the drug in the past 12 months, she said at the time.

Questcor said in a Sept. 19 statement that it did not expect the Aetna decision to have a “material impact” on the company’s finances. Aetna has accounted for about 5 percent of shipped prescriptions for the gel, Questcor said.

The shares have dropped 38 percent so far this year.

To contact the reporter on this story: Alex Nussbaum in New York at anussbaum1@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net


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Companies Mentioned

  • AET
    (Aetna Inc)
    • $78.25 USD
    • 1.80
    • 2.3%
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