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Since the emergence of the specialty,neurologists have worked with a rather restricted list of relatively inexpensive pharmacologic agents.This is rapidly changing with the development of new agents for the treatment of migraine,multiple sclerosis,Parkinson's disease,Alzheimer's disease,and epilepsy,accelerated in part by designation of the 1990s as the"Decade of the Brain."Exciting as these developments are,they are very costly when applied to the large number of patients who may benefit,perhaps exceeding$ 6.4 billion.Since this cost exceeds the$1.5 billion income of all practicing neurologists,it enhances the value of the neurologic consultation,which can provide more accurate diagnosis and more expertly directed therapy.Our relationships with the drug manufacturers are changing as our prescribing habits become a more likely determinant of profits. |
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