AUTHOR RESPONSE: The financial contribution of the multiple sclerosis specialist
Joseph R.Berger, University of Pennsylvania, Philadelphiajoseph.berger@uphs.upenn.edu
Submitted August 16, 2017
Both Dr. Goldenberg and Dr. Torgovnick are absolutely correct in asserting that the cost of medical care in the U.S. is astronomical and that the cost of care should correlate with outcomes and quality of care. Unfortunately, that is not where the state of medicine is in the U.S. currently. Performing such a study for the MS population is no small undertaking and I would challenge anyone to provide a format to do so with the available data.
Health care systems are justifiably concerned about their bottom line. This analysis was performed in an effort to demonstrate that the MS specialist, oft undervalued, contributes substantially to the financial wellbeing of the institution with which they are associated.1 These data provide a framework for physicians providing MS care to negotiate with hospital administrators to provide adequate resources for their programs similar to that provided for cancer care and neurosurgery in light of their well-recognized financial contributions.
As a strong advocate of the value of a "hammer swinging" neurologic examination,2 I agree fully with Dr. Torgovnick's assertion that not every test is required in assessing patients for MS. The studies performed were estimations of what is done in a large academic MS center where patients, often with unusual features, present for a second or third opinion regarding the accuracy of the diagnosis. Therefore, it is likely that the percentage of tests employed for the new patient is higher than in a community practice.
Disclosures: J.R. Berger has served as a consultant and/or on the PML adjudication committees of Amgen, AstraZeneca, Bristol Myers Squibb, Eisai, Janssen, Parexel, and Pfizer; serves on the Scientific Advisory Board of NeuVir and ExcisionBio; has received honoraria from Prime Education and the MS Foundation for lectures; serves as an Associate Editor for the Journal of Neurovirology; serves as an editorial board member of ISRN Education, Neuroscience, World Journal of Rheumatology, and MS and Other Related Disorders; receives publishing royalties for Handbook of Clinical Neurology, Vol. 85 (Elsevier, 2007); has served as a consultant to Alcimed, Amgen, AstraZeneca, Bayer, Biogen, Eisai, EMD Serono, Forward Pharmaceuticals, Genentech/Roche, Genzyme, Inhibikase, Millennium/Takeda, Novartis, Johnson and Johnson, Pfizer, and Sanofi Aventis; receives research support from Biogen; and has participated in legal proceedings for Biogen.
References
1. Berger JR. The financial contribution of the multiple sclerosis specialist. Neurol Clin Pract 2017;7:246-255.
2. Berger JR. Neurologists: the last bedside physician-scientists. JAMA Neurol 2013;70:965-966.
Health care systems are justifiably concerned about their bottom line. This analysis was performed in an effort to demonstrate that the MS specialist, oft undervalued, contributes substantially to the financial wellbeing of the institution with which they are associated.1 These data provide a framework for physicians providing MS care to negotiate with hospital administrators to provide adequate resources for their programs similar to that provided for cancer care and neurosurgery in light of their well-recognized financial contributions.
As a strong advocate of the value of a "hammer swinging" neurologic examination,2 I agree fully with Dr. Torgovnick's assertion that not every test is required in assessing patients for MS. The studies performed were estimations of what is done in a large academic MS center where patients, often with unusual features, present for a second or third opinion regarding the accuracy of the diagnosis. Therefore, it is likely that the percentage of tests employed for the new patient is higher than in a community practice.
Disclosures: J.R. Berger has served as a consultant and/or on the PML adjudication committees of Amgen, AstraZeneca, Bristol Myers Squibb, Eisai, Janssen, Parexel, and Pfizer; serves on the Scientific Advisory Board of NeuVir and ExcisionBio; has received honoraria from Prime Education and the MS Foundation for lectures; serves as an Associate Editor for the Journal of Neurovirology; serves as an editorial board member of ISRN Education, Neuroscience, World Journal of Rheumatology, and MS and Other Related Disorders; receives publishing royalties for Handbook of Clinical Neurology, Vol. 85 (Elsevier, 2007); has served as a consultant to Alcimed, Amgen, AstraZeneca, Bayer, Biogen, Eisai, EMD Serono, Forward Pharmaceuticals, Genentech/Roche, Genzyme, Inhibikase, Millennium/Takeda, Novartis, Johnson and Johnson, Pfizer, and Sanofi Aventis; receives research support from Biogen; and has participated in legal proceedings for Biogen.
References
1. Berger JR. The financial contribution of the multiple sclerosis specialist. Neurol Clin Pract 2017;7:246-255.
2. Berger JR. Neurologists: the last bedside physician-scientists. JAMA Neurol 2013;70:965-966.