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1. Trust me I'm a docter works from the get go and doesn't need access to other research projects such as Sales Reps, Marketing or Disease Awareness Campaigns. One of the nice things about this is you can concentrate on researching new machines, getting access to new cures earlier than the AIs who go for a more Executive-based strategy.
2. Local Networks is for sure really powerful, but its effect is lessened the higher up the product tree you go where it's more high margin and low volume. Having said that, it does give a pretty ridiculous tempo boost in the early game! ;)
Overall I'd say you're right, some perks are undoubtedly stronger than others from a pure profitably standpoint. Others are more situational or work well in combination. Or some work well depending on the scenario objective.
For example, I quite like Rigorous Trialer and Trust me I'm a doctor for scenarios where you have to maintain a high cure rating on your products. If you're having to make side-effect free products at max strength concentration anyway, you might as well get some nice sales ratings out of it!
I'm interested to hear what combos other people are using or whether people mainly stick to the ones FringeHunter has singled out?
I think perhaps part of the issue with 1. is that you don't have to specialise, you can afford to research machines and National HQ/Sales simultaneously if you want to. Trust me I'm a doctor will probably be better for those first 6 months, but once you get sales reps it already gets equalled or surpassed. Trust me I'm a doctor is also a bit of an ingredient lottery, it seems quite rare to have more than 1 of the 3 starting lines you can make be easily side effect free, which hampers its effectiveness a lot.
I like your point about rigorous trialer for beefing up cure rating instead of sales rating, but Trust me I'm a doctor says it's sales rating on the tooltip, so I don't see how that one would be better than one of the other options for getting cure ratings up. I wonder if I'm missing something?