Did Mallinckrodt pay doctors who prescribed Acthar?

A 2018 study found that 88% of the 235 specialists who frequently prescribed Acthar received payments from Mallinckrodt, and 20% received more than $10,000. Using ProPublica's database, the researchers counted 92,356 Acthar-related payments totalling $15.5 million, with each of the top ten recipients receiving between $329,000 and $476,000.

The lead author noted that nearly 90% payment prevalence far exceeds the 30% to 50% typically found in similar studies of industry-prescriber relationships. Mallinckrodt responded that in 2015 and 2016, 73% to 76% of Acthar prescribers received no payments or only nominal items such as meals and reprints. Such payments, for speaking, consulting or research, can be lawful, but critics argue that where evidence of superior benefit is weak, high rates of payments suggest promotion may be driving prescribing. The study's authors linked the payments to the rise in Medicare spending.