Posted on 08/26/2025 4:58:48 PM PDT by aimhigh
Nearly 80% of US neurologists prescribing drugs for multiple sclerosis (MS) received at least one pharma industry payment, with higher volume prescribers more likely to be beneficiaries, finds a 5 year analysis of Medicare database payments, published in the open access journal BMJ Open.
And those in receipt of these payments were more likely to prescribe that company’s drugs, especially if the sums involved were larger, sustained, and recent, the findings indicate. Because of the lifelong nature of MS, effective therapies are usually continued indefinitely unless a patient’s clinical response changes, explain the researchers. And MS drug prescriptions are Medicare’s largest neurological drug expense despite making up a relatively small portion of total claims, they add.
While previously published research indicates that industry payments are associated with increased prescribing of marketed products, none of these studies focused on a market as competitive as the MS drugs market, say the researchers. They therefore set out to characterise industry payments to neurologists prescribing MS drugs and find out if the receipt of such payments might be associated with the likelihood of the preferential prescribing of that company’s drugs.
They used publicly available data on payments made by pharma companies to doctors from the Centers for Medicare & Medicaid (CMS) Open Payments platform from 2015 to 2019. Payments are classified as: research payments; ownership and investment interests; and general payments. The researchers focused on general payments to neurologists, linking these to Medicare Part D data, which covers prescription drugs, using National Provider Identification numbers and drug names.
Their analysis included 7401 neurologists who had prescribed disease modifying therapies (DMTs) for at least 1 year, issuing a minimum of 11 prescriptions, and 20 DMTs manufactured by 10 companies. In all, 5809 (78.5%) neurologists received 626,290 distinct industry payments from at least one drug company, totalling US$163.6 million between 2015 and 2019; 4999 (67.5%) neurologists received payments from two or more companies.
The average individual amount received was US$779, but 10% of recipients amassed US$155.7 million between them—95% of the total sums received–which suggests that drug companies may selectively target high-volume prescribers, say the researchers. Higher prescription volumes were associated with a greater likelihood of receiving any payment type, particularly for consulting services, non-consulting services, such as speaking at an event, and travel/accommodation; the highest number of discrete payments was made for food and drink.
The amount received was positively associated with prescription volume. Compared with those who received no payments from a company, those who did, were 13% more likely to prescribe that company’s drugs. The strongest association between industry payment and prescribing tendencies was observed for non-consulting services. These neurologists were 53% more likely to prescribe that company’s drugs. Larger payments were also associated with a greater likelihood of preferential prescribing, rising in tandem with the size of the payment received: US$50 was associated with a 10% greater likelihood of prescribing that company’s drugs; US$500 with a 26% greater likelihood; US$1000 with a 29% greater likelihood; and US$5000 with a 50% greater likelihood.
Longer duration of payments was another seemingly influential factor, ranging from a 12% greater likelihood of prescribing that company’s drugs for one year of payments to 78% greater likelihood for 5 consecutive years. The recency of payments also seemed to be influential. A payment made 4 years earlier was associated with a 3% greater likelihood of prescribing that company’s drugs, but a 34% greater likelihood when made in the same year.
This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge that their study was limited to the prescribing of Part D drugs, and couldn’t establish the appropriateness of prescribing, nor for which patients more expensive brand-name drugs were most suitable. A doctor’s decision to prescribe is informed by many different factors, including national guidelines and/or institutional protocols, insurance cover, and patient preferences. These drivers are difficult to assess using publicly available data, but should be considered when interpreting the findings, emphasise the researchers.
Nevertheless their “findings raise concerns about excess pharmaceutical promotion efforts and their implications for physician prescribing for patients,” they suggest. “Promotional efforts to influence prescribing are especially concerning given the drugs’ substantial costs, particularly if more expensive brand-name drugs are being prescribed instead of appropriate, effective, generically available alternatives,” they point out. “The Physician Payments Sunshine Act, which led to the creation of the Open Payments Database, was an important step forward in making transparent the financial conflicts of interest among physicians receiving industry payments.
“However, it remains unclear whether increased transparency has mitigated these conflicts of interest and their impact on prescribing behaviour, or simply given the public greater insight into the large scale of industry payments made to prescribers,” they conclude.
sorry to hear that, it can be a devastating disease.
Have a friend that just passed from MS. Progressively worse. It’s a horrible disease.
Sorry to hear that. Is she still with us? If not I am truly sorry.
I know a lot of Freepers don’t like it, but I am very passionate about Ai, I predicted 20 years ago it would take off in 2020 and here we are although I may have been a few years off.
What this technology is going to do is cure diseases we thought impossible, diseases we have thrown billions at with no result. Ai is already giving new ideas and new plans.
Check out ChatGPT and subscribe to it, it’s cheap only $20 a month and the conversations I have with this thing is unbelievable, talks about vaccines for cancer, ALS which my brother died from, dementia, even politics and its just getting started.
Every month if not every day it advances more and more and gee whiz, here come the people claiming it’s dangerous. Yeah, to their profits.
This has the potential to figure out how to grow new organs from a persons DNA elminating rejection from foreign transplants, repair spinal damage, control immunity, reconstruct the central nervous system getting the paralyzed moving again.
The potential is mind blowing .........GRANTED democrats do not take the White house and congress again. That happens it’s all over, Just our luck they are more insane than ever right now.
There was that twin study last week, which showed gut bacteria of affected identical twin had two pathogenic bacteria, the unaffected twin did not have. Unfortunately, the FR search for key words didn’t come up with that one for me, though there was an older article along the same lines.
If they ever go beyond a study and actually find some medication or treatment that halts the disease my prayers will be answered
Mine neither. She did get a number of really nice restaurant dinners by the pharmas pushing their latest drug, at least until covid lock down. (She passed 3/2021, nobody would say it but we knew it was liver failure from her drugs.)
I’m shocked. 🙄 They’re taking cash.
It took decades to link heliobacter pylori to peptic ulcer disease, now ,for 30 years , antibiotics are part of standard treatment.
especially since they can’t even hand out pens to doctors offices any more. I thought most of this was outlawed 20 years ago or more.
There are two cures for MS. In a California University (San Diego, I believe) a researcher injected MS mice with Beta-Amyloid. Within two weeks, they were all cured. Their boss told them to repeat the test, and they got the same results. They have spent the law 12 years trying to figure out why it works. No human tests so far. They can’t patent Beta-Amyloid, so no $$$ with that route.
There were tests on MS patients with fecal transplants. Cured and walking again. shhhh. No $$$$$ in this either, so the FDA is slow walking this into oblivion.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10745313/
Many moons ago I datied a PA. Her entire house was filled with gifts from the pharma reps. My favorite was a clock she had that said “It’s always time for Viagra.”
That is almost sinister.
The fecal transplants work for Parkinson’s. I heard about this a few years ago from a woman at my Pilates studio. She has Parkinson’s and goes to Houston to MD Anderson to see a specialist who told her about it.
Yikes, I didn’t know. Kinda like Ivermectin, mono clonal atbs and Hydroxychloroquine?
I won’t tell the husband of his deceased wife. Twelve years of disintegrating for politics on a cure.
Whaaat??? Why doesnt Trump do something??
I had a doctor prescribe a medication to lower my potassium level in my blood. It’s a relatively new patented medication. Cost is about $500 for less than a month.
Several months earlier, a doctor said I needed to get a sodium bicarbonate prescription. I asked her, “Isn’t that just baking soda?” She couldn’t just offer that information, but was ready and willing to agree; and thanked me for bringing that up.
Turns out, I just needed 1/2 teaspoon mixed with cool water every day. Two weeks later, my potassium level was just barely above the maximum normal range.
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