Drug Companies Increasing Their Sponsorship of Doctors’ Continuing Medical Education

The Wall Street Journal on Dec. 4 looks at how drug companies are "stepping up" their participation and influence in continuing medical education courses. Pharmaceutical companies "intensified" their involvement in CME this summer, when the industry adopted voluntary marketing guidelines that "emphasizes educating, rather than entertaining," doctors, the Journal reports. In the past, CME courses primarily were run by not-for-profit medical societies and academic institutions. But now, they are increasingly sponsored by drug companies and managed by for-profit medical-education firms, creating the potential risk that the courses will focus on promoting brand-name drugs, the Journal reports. In addition, the "growing reliance on corporate sponsorship also means that drug companies rather than doctors often determine the overall agenda for CME," according to the Journal. Further, some experts are concerned that drug companies, which are prohibited by the FDA from promoting their treatments for off-label uses, could use CME classes as a "backdoor way" to provide such information to physicians, the Journal reports. The Society for Academic Continuing Medical Education reports that at a "typical" medical school, over 40% of funding for CMEs now comes from commercial sponsors, compared to 17% in 1994. In 2001, direct commercial funding for CME was up 22% from 2000 to $569 million, according to the Accreditation Council for Continuing Medical Education.

Both Sides of the Issue
Some officials say that many medical schools need funding from the industry because the institutions cannot afford to cover the total cost of CME. Dr. William Carey, director of continuing education at the Cleveland Clinic, said that "expenses for most CME activities exceed the amount that can reasonably be met by registration fees." Meanwhile, many doctors "have grown accustomed" to industry-subsidized CME and oppose paying "even modest amounts" to attend a course, according to the Journal. But some are adopting a "just-say-no stance" on industry-funded education, the Journal reports. "We docs make very respectable incomes, and we should be able to budget [for CME with no industry funds]," Frederick Sieries, a psychiatrist at Finch University of Health Sciences, said. However, Jeffrey Lieberman, a professor of psychiatry at the University of North Carolina in Chapel Hill, said, "For academic medicine to not avail itself of the resources of the pharmaceutical industry and private sector would be foolish." According to Lieberman, the "bedrock of professional propriety" among doctors and the current guidelines for commercial sponsorship "will protect against distortion of CME," the Journal reports (Hensley, Wall Street Journal, 12/4).