MedCentralMost Industry Payments in Neurology Fall Outside the Sunshine Act

78.6% of $2.8 billion in neurology industry-sponsored research payments flowed to entities exempt from Sunshine Act disclosure requirements between 2015 and 2023, leaving the majority of pharma funding to neurologists invisible to public scrutiny. Four companies, Genentech, Biogen, Novartis, and Eli Lilly, controlled $1.89 billion of that total.

Professional Impact

• Searching a neurologist’s Open Payments profile may reflect only a fraction of their actual industry relationship, undermining the transparency the Sunshine Act was designed to provide.
• Funding is consolidating: median payments per physician fell $26 annually while maximum payments rose $1.57 million per year, concentrating industry dollars among fewer, higher-profile neurologists.
• The top three drugs tied to research payments, ocrelizumab, ofatumumab, and fingolimod, are all MS therapies, signaling where industry influence is most concentrated in neurology.

Action Items

• Disclose all industry relationships proactively, including those routed through research institutes or universities.
• Review institutional policies on noncovered entity payments to ensure internal transparency standards exceed legal minimums.
• Monitor proposed Sunshine Act expansions that would require disclosure of payments to noncovered entities.

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