Most neurologists in the United States who prescribe drugs for multiple sclerosis (MS) receive payments from the pharmaceutical industry, and those who do are more likely to prescribe drugs from the companies making the payments, especially if the payments are larger, sustained, and recent, according to a new analysis of Medicare data.

What stood out in the findings, according to lead author Ahmed Sayed, MD, from Ain Shams University, Cairo, Egypt, and Rochester General Hospital, Rochester, New York, was how concentrated the payments were. While the average industry payment per neurologist was $779, the top 10% of prescribers received nearly $156 million, indicating that pharmaceutical companies focus their efforts on high-volume prescribers, Sayed explained.

“There was also a clear link between the amount of payments and the number of prescriptions— the more a doctor prescribed, the more payments they received,” he said.

The study was published online on August 26 in BMJ Open.

Payments to Doctors Still Big Business?
Multiple sclerosis (MS) is a leading cause of neurological disability in young adults, requiring lifelong treatment with immunomodulatory drugs. Brand-name disease-modifying therapies (DMTs) for MS are relatively expensive, with annual average costs per U.S. DMT user ranging from about $57,000 to $93,000. As a result, MS drug prescriptions represent Medicare’s largest neurologic drug expense, despite accounting for a relatively small portion of total claims.