r/science 2d ago

Medicine Most US neurologists prescribing MS drugs have received pharma industry cash | 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, 5 year study finds

https://www.eurekalert.org/news-releases/1095648
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u/Relax_Dude_ 2d ago edited 2d ago

As a physician I can maybe shed some light on this. I'm a pulmonologist, received maybe about $1500 in my lifetime from pharma. None in cash, just lunch and dinners. They might bring lunch for the entire clinic staff or trainees. They might host a dinner session where an expert will speak on the subject while we attend, ask questions, and get a free dinner. It adds up over the years. Lunch might be $20-30 while dinner might be a bit more. It can add up to a few hundred per year and over several years it can certainly add up to the thousands. The ones that are in the tens of thousands or hundreds of thousands are not because they're getting kickbacks for prescribing, it's usually some combination of consulting fees and/or flying them out to give talks. So it's not hard to imagine if theres some renounced expert who strongly believes in the drug would be willing to give educational talks to other neurologists about it. If they get flown out, their travel, hotel, food, and speaking fee will be paid for. That usually amounts to fees in the tens of thousands range over several years. The ones getting 100k+ are most likely to be in the form of research grants or consulting fees. A research grant can easily be 100k for each individual grant. Thats just the reality of things. And while all this seems sketch to outsiders, I think there is some benefit to us attending these dinners and educational sessions. If theres new medications that actually work well and we're interested in prescribing them, we can pick the brains of these experts who are actually using it as well as the manufacturers themselves can guide us on how to get it through insurances. In my field, I was prescribing biologics for asthma. A new one came out a few years ago that I thought was fantastic on paper, could help alot of people for whom the other biologics weren't working. Theres some benefit in attending a dinner to ask them questions about the logics of administration, teaching, insurance coverage, dosing, certain adverse events to look for, etc. And of course for some of the more basic meds like inhalers they often give free samples which we're constantly giving them away to patients, preferably ones that are really tight on budget. I may give them samples to see if a certain inhaler works well for them before making them pay hundreds every month to maintain it. It's easy to say, "doctors are getting their pockets lined by big pharma" and get clicks but the reality is 99% of docs are just ordinary people who genuinely want to learn about the drug while also having a nice dinner with colleagues and de-stress a bit. Theres certainly bad apples out there, but thats the case with anything.

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u/TheUnicornCowboy 1d ago

Your entire industry seems so far beyond corrupt it’s ridiculous, the fact that you think it’s ok to accept hundreds of thousands of dollars in kickbacks for prescribing particular drugs and that’s just an ok part of the job. THATS A BRIBE. Full stop. It’s insane reading that you think that’s normal and ok. I would have my license revoked in a heartbeat if I accepted a bribe in my field. Insane.

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u/Nyrin 1d ago

You either didn't actually read what you're replying to or didn't understand it.

The parent commenter made it explicitly clear that, even in the nominally large cases, it's not a kickback system. But you're peddling that to yourself anyway because hey, manufactured outrage.

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u/thinkbetterofu 1d ago

its an actual concern. and its absolutely a kickback. but reddit leans neoliberal and is okay with things as long as the system manufactures enough consent. and guess what, most of the people in this thread have a financial interest in keeping this system going, either working for the pharma companies or are doctors admitting to receiving the benefits reported on in the study. but please keep attacking the person who has a reasonable response of justified outrage at this system which does not benefit patients.