Transparency Implications on Industry Support for Continuing Medical Education

By: Jess Ebert, CIS Compliance Associate
jessicaebert@cis-partners.com

At a time when transparency is being called for in many different aspects of the pharmaceutical and medical device manufacturing industry, it’s important to realize the effects that such transparency can have on physicians and patient care. The Physician Payments Sunshine Act of 2009 requires the public disclosure of payments to physicians and physician-owned entities related to marketing, education and research with a value of $100 or more, with a few exceptions. How is physician education tied into this?

Continuing Medical Education (CME) is required of every physician, but has recently come under fire from “public interest” critics and a few leading members of Congress. Pharmaceutical and medical device manufacturers are responsible for funding approximately half of CME activities, and many critics believe that the support creates bias, and unjustly influences the physicians to use their products. The need for transparency in this area is understandable, but it’s important to establish regulations that do not impede the exchange of valuable information between pharmaceutical and device manufacturers and physicians.

The Center for Medicine in the Public Interest (CMPI), a non-profit public policy group that is dedicated to promoting solutions that advance medical progress, and the Coalition for Healthcare Communication, a drug marketing group that defends the right of healthcare professionals and consumers to receive truthful information regarding pharmaceutical and medical products, released a report in April 2009 titled ‘Industry Support for Continuing Education of Healthcare Professionals – An Evidence-Based Evaluation.’ The report contains the views of physicians and others who organize and conduct private sector CME programs that were brought together in a conference to discuss how recently proposed legislation will impact physicians and patients.

The general message of each participant was that commercially supported medical education is greatly benefiting physicians and patients alike. Manufacturers have a responsibility to present information concerning their product’s safety and efficacy, whether favorable or not. Supporting CME is the best way to keep physicians updated on the latest medical advances, and in turn, the physicians are able to use this information to offer new therapies to their patients [1].

Marissa Seligman, Senior VP of the Pri-Med Institute, a for-profit education company, also participated in the conference, and spoke about how physicians would be impacted if industry support was no longer available. Pri-Med’s analysis revealed through a survey that 92% of physicians said banning commercial support for CME activities is not a good idea. “Physicians stated that loss of commercial support would increase their personal cost of getting CME and their resources to do this are limited. Second, it would decrease the quality of CME out there by eliminating the ability of providers to do the education that matters, and it would also provide them with fewer opportunities” [1].

In addition to the large number of physicians that favor industry support, several professional associations are also in agreement with the CMPI’s report, including the American College of Cardiology. Jack Lewin, M.D. and CEO of the American College of Cardiology was also a participant in the conference, and stated that “were we not to have these additional services which we believe rapidly advance the education of our members and the translation of science to the point of care, the patients and doctors who serve them will be harmed’ [2].

Another concern of several participants is the effect that reducing industry support will have on the underserved communities. “Underserved” implies inner city practitioners who are working in clinics, with scarce resources, and for little pay, offering care to the homeless and those with insufficient or no insurance coverage. Offering industry supported CME is critical to these practitioners, who otherwise would not have the resources to pay for CME, further lessening the quality of care they are able to provide [2].

Those interviewed for the report do not deny that there have been some problems and abuse within the current system, and some even agree that transparency is a good idea. If not ‘overdone’, the Physician Payments Sunshine Act, and other similar legislation, could be beneficial.

The report contains many more supporting arguments and information on the issues discussed above, and is certainly worth reading to gain a better perspective on how industry support of CME is beneficial to both physicians and patients.

Sources:
[1] http://cmpi.org/uploads/File/CMPI_CME_Report.pdf
[2] http://www.policymed.com/2009/05/cme-commercially-supported-medical-education-benefits-those-who-need-it-most.html
For prior PCB coverage of the Physician Payments Sunshine Act, see: http://pharmacomplianceblog.blogspot.com/search?q=sunshine