I have just returned from the EAN in Oslo. A strange meeting of encore abstracts and talks; clearly 2nd tier for the MS community.
There were very few MSologists who attended. Why? They have all already attended either ECTRIMS and/or the AAN. All the MSologists I met at the EAN were either bused in to talk, to attend private MS meetings or to film CPD activities, but not to learn or be influenced as the abstract below suggests.
The EAN, however, is a meeting that Pharma, Big Pharma, has earmarked to get the message across to the general and other specialist neurologists that MS is an important disease, which they need to take seriously. That is (1) recognising the symptoms ASAP, (2) to diagnose the condition ASAP and (3) to refer the patient to a specialist MS unit ASAP (4) were they will be started on a high efficacy DMT ASAP.
Is this ASAP philosophy such a bad thing? No.
The whole premise underpinning our ‘Brain Health: Time Matters’ policy document is to try and activate the MS community to treat MS as a semi-emergency or an emergency. Why wait to be diagnosed, treated or treated with highly effective DMTs if time is brain (or spinal cord)?
The EAN, however, is dominated by MS marketing. I would estimate that 75% of the money spent on marketing at the EAN was MS-related without many MSologists in attendance. The scale and quality of the Pharma MS stands were impressive. Interesting or not? This is the Red Queen Effect in action.
The Red Queen Effect is a term taken from the Red Queen’s race in Lewis Carroll’s Through the Looking-Glass. The Red Queen said, ‘It takes all the running you can do, to keep in the same place.’ The marketing departments of Big Pharma are simply feeding the Red Queen as they try to compete with each other; in reality, they are simply running on the spot with the downside of reputational damage to neurology, themselves and the industry as a whole. When MSers see and hear about the marketing extravaganza that comes with conferences it is no wonder they don’t respect Pharma and neurologists. This is one of the issues that feed social phenomena such as CCSVI and HSCT and divides society. It is simply another example of the haves and have-nots.
I would like to suggest to Big Pharma that it looks at itself in the mirror and rejects the Red Queen Effect and comes up with something more sustainable that will help us regain our self-respect and more importantly the respect of the community that we serve. Note the ‘Royal We’; by participating, I am part of this jamboree.
Despite my criticisms, I suspect nothing will happen. Turkeys’ are as likely to vote for Christmas as Turkey Farmers’ are to vote for cancelling Christmas.
Despite my overt cynicism, I believe that a leader, a true leader, will emerge and slay the Red Queen. And from the ashes, a Phoenix will arise that will change the way Pharma sees and interacts with the world.
For example, why doesn’t one brave Pharma company hire a stand and keep it empty? Empty, except for maybe a few white pinboards with the publications of the peer-reviewed papers that led to the licensing of their product(s). They could also have a board or box for post-it notes for suggestions to donate the money saved on not having an expensive stand to be donated to an MS charity, to support a specific research project or provide DMTs for people living with MS in resource-poor countries. However, doing this would put the marketing teams, designers, builders, booth bunnies, hospitality and logistics staff, etc. out of business. With the latter perspective maybe the Pharma gravy train should be embraced as being a net contributor to society and the economy in general and we should support the Red Queen instead; maybe even increasing the speed of her treadmill?
I maybe a grumpy old man, but I don’t like the underbelly of conferences and what they represent. Maybe it’s time to throw in the towel?
Saposnik et al. Does attendance at the ECTRIMS congress impact on therapeutic decisions in multiple sclerosis care? Mult Scler J Exp Transl Clin. 2019 Mar 18;5(1):2055217319835226.
Conferences traditionally play an important role in the ongoing medical education of healthcare professionals. We assessed the influence of attending the ECTRIMS congress on therapeutic decision-making in multiple sclerosis (MS) care. A non-interventional, cross-sectional study involving 96 neurologists was conducted. Treatment escalation when therapeutic goals were unmet and management errors related to tolerability and safety scenarios of MS therapies were tested using different case-scenarios. Attendance at ECTRIMS was associated with an increase likelihood of treatment escalation in the presence of clinical progression (cognitive decline) and radiological activity (OR 2.44; 95% CI 1.06-5.82) and lower number of management errors (OR 0.26; 95% CI 0.07-0.98). Attendance at ECTRIMS may facilitate therapeutic decisions and reduction in management errors in MS care.