It's time for some brief comments about the topic of corporate support for CME conferences. A recent blog note (see: If the pharmaceutical industry won't pay for CME, who will?) provides a glimpse of some of the issue that are being raised with regard to this topic:
The purging of drug companies from continuing medical education courses continues....CME is a big money industry, and ...Pfizer contributed some $12.3 million to the University of Wisconsin's courses. So, if medical schools were to ban the drug industry from funding their CME, who will pay for them? Cash-strapped medical schools? Likely not. It's probably going to fall on individual physicians who, in many states, need CME credits to maintain their licenses. I suspect that CME will become significantly more expensive to attend in the near future.
First of all, let's take a look at the proposed Massachusetts law entitled Pharmaceutical and Medical Device Manufacturer Conduct that is considered by some to be draconian. One of its requirements is that pharmaceutical and medical device manufacturing companies supporting conferences being held in the state must have a code of conduct in place by July 1, 2009. For me, the key element in this law is that drug and medical devices companies are prohibited from tampering with the educational content of medical conferences. In my opinion, this goes without saying and is both long overdue and warranted given the history of Big Pharma putting a spin on educational content directed to physicians. This document also speaks to the financial sponsorship of conferences in 970.007:4 from which I quote below, with boldface emphasis mine:
a. compensation or reimbursement made to a health care practitioner serving as a speaker or providing actual and substantive services as a faculty organizer or academic program consultant for a CME event, third-party scientific or educational conference, or professional meeting, provided that the payment: 1. is reasonable; 2. is based on fair market value; and 3. complies with the standards for commercial support as established by the relevant accreditation entity.
b. sponsorship or payment for any portion of a third-party scientific or educational conference, charitable conference or meeting, or professional meeting, where the payment is made directly to the conference or meeting organizers.
c. the use of hotel facilities, convention center facilities or other special event venues for CME or other third-party scientific, educational or professional meetings or conferences.
Industry trade associations have scurried to update their codes of conduct in response to this Massachusetts legislation as well as similar actions in other states. One such association, the Advanced Medial Technology Association (AdvaMed), has posted its new ethical code, adopted last December, on the web (see: CODE OF ETHICS ON INTERACTIONS WITH HEALTH CARE PROFESSIONALS). I quote below from Part IV of the document labeled Supporting Third-Party Educational Conferences:
Advertisements and Demonstration. Companies may purchase advertisements and lease booth space for Company displays at conferences.
Unless I am missing some of the fine points and please correct me if this is the case, I am having trouble perceiving how or why any of this regulation is harmful to the planning of CME conferences or the registration for them. Here are my reasons:
- The conference organizers control the lecture content and lease tables or booth space to vendors who then interact with conference registrants in the vendor area. There needs to be a fire-wall between the vendor space and the lecture hall.
- These rental fees from vendors will offset a large proportion of the cost of the conference in the same way that advertising revenue offsets the cost of the publication of magazines and newspapers. I cannot envision why the registration fees for such conferences would rise unless there is gross mismanagement and waste.
- It would seem, however, that unrestricted corporate educational grants to the CME units of medical schools and professional societies will now be verboten. Such grants have probably been the source of much of the influence of pharmaceutical and medical device companies in the past. Perhaps this is what all the crying has been about. I personally believe that vendor funds should be tied to individual educational events and obtained in exchange for leasing tables or booths.
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