A new study has shed light on just how closely tied pharmaceutical money is to the treatment of multiple sclerosis (MS) in the United States. Between 2015 and 2019, nearly 80% of neurologists treating MS patients received payments from drug companies—totaling $164 million. And the more money a doctor received, the more likely they were to prescribe that company’s drugs.
Published in BMJ Open, the research analyzed prescribing data from over 7,400 neurologists. The findings reveal a stark imbalance: while the median payment was just $779, the top 10% of recipients collected over $155 million, accounting for more than 95% of all money distributed. These payments included meals, travel, consulting fees, and high-dollar speaking contracts.
The link between payments and prescribing was clear. Even modest sums made a difference:
- A $50 payment correlated with a slight increase in prescribing.
- At $500 or more, the preference grew stronger.
- Doctors who collected ongoing payments for five years were nearly 80% more likely to prescribe that company’s drug.
Leading the pack were Biogen ($33.1 million to nearly 5,000 doctors) and Sanofi ($71.3 million to 4,183 doctors). Speaking fees carried the strongest influence, with recipients 53% more likely to choose the paying company’s medication.
The financial stakes are massive. MS affects nearly 1 million Americans, and annual drug costs range from $57,000 to $93,000 per patient. Disease-modifying therapies for MS make up Medicare’s largest neurologic drug expense, costing billions each year.
While pharmaceutical companies argue that their practices adhere to transparency rules, critics point to recent federal settlements—over $1.5 billion combined from Sanofi, Novartis, and Biogen—for improper payment schemes. For patients, the question remains pressing: are treatment decisions being driven by science—or by sales?
