Author Topic: (AAN abst.) Industry payments to neuros commonly prescribing H.P. Acthar Gel  (Read 69 times)

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Offline agate

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Presented at the annual AAN meeting in Boston (April 2017):

Industry payments to neurologists who commonly prescribe repository corticotropin
gel (H.P. Acthar)

Dennis Bourdette1,4, Shelby Van Leuvin1, Kirbee Johnston5, Michelle Lei3,6, Daniel Hartung2,6

1Neurology, 2
College of Pharmacy, Oregon Health & Science University, 3Oregon Health & Science University, 4Neurology, VA Portland Health Care System, 5School of Medicine, Oregon Health Science University, 6College of Pharmacy, Oregon State University


To determine if prescribing repository corticotropin by neurologists associates with payments from the manufacturer of this medication.


Some neurologists use 3-5 days of repository corticotropin 80 IU daily to treat relapses of multiple sclerosis (MS). Repository corticotropin has a wholesale acquisition cost of $34,034 per 80 IU vial, making its use very expensive. Despite the availability of lower cost alternatives and an absence of evidence justifying repository corticotropin use for most diseases, in 2014 the US Medicare program spent $391.2 million on the drug, prescribed primarily by neurologists,rheumatologists and nephrologists.


Using 2014 Medicare Part D Public Use File data, we identified neurologists who prescribed repository corticotropin more than 10 times (>10X). (CMS redacts prescriptions counts <11.) We extracted 2014 Open Payments data to determine the presence and magnitude of payments from the manufacturer of repository
corticotropin (Questcor/Mallinckrodt). For comparison, we abstracted industry (Teva) payments for a random sample of neurologists who prescribed glatiramer acetate (GA) >10X.


Fifty-one neurologists prescribed repository corticotropin >10X at a cost of $39.3 million or 10% of total spent by Medicare on this drug. GA and repository corticotropin cohorts prescribed a comparable number of MS disease
modifying therapies (364.5 vs 339.9; p=0.85). All 51 repository corticotropin prescribers and 48/51 (94.1%) GA prescribers received at least one payment from any drug manufacturer (p=0.243). Significantly more repository
corticotropin prescribers received a payment from Questcor/Mallinckrodt than GA prescribers received a payment from Teva (98% vs 67%; p<0.001). Repository prescribers received more transactions (average 40 vs 17; p<0.001) and higher average cumulative payments ($19,756 vs $8,680; p=0.003) compared to GA prescribers.


Nearly all neurologists who prescribed repository corticotropin >10X received payments from Questcor or Mallinckrodt in 2014 averaging nearly $20,000 in payments from the manufacturer. The relationship between
payments and prescriptions of repository corticotropin is uncertain.
Study Supported by: None
MS Speaks--online for 14 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.


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