Public Health Crunch

CME is an acronym for Continuing medical education. It is a type of continuing education that serves to maintain, develop, or increase the knowledge, skills, and professional performance of a physician after they leave medical school. CME activities are usually educational interventions that rely on evidence based medicine to provide unbiased direction to medical practitioners to meet educational needs and ultimately improve patient care. In April, a Senate Finance Committee study found that the Accreditation Council for Continuing Medical Education, the main accrediting body for education providers, does not scrutinize course materials for accuracy or evidence of bias toward sponsors’ products. At times, sponsors have been able to select topics, and presenters have discussed off-label uses for drugs, the report found.

Recently, pharmaceutical companies have become the biggest sponsors of CME courses, even at the nation’s top medical schools, a development that critics say raises health-care costs, skews doctors’ treatment decisions and allows the industry to skirt laws against advertising “off-label” uses for its products. The trend toward pharmaceutical industry sponsorship  accelerated after the government backed off a plan to limit commercial sponsorships in 2002 at the urging of the industry.

Now, nearly two-thirds of the cost of continuing education courses sponsored by medical schools, popular for their prestige, are paid for by drug and medical device companies and other commercial interests, figures show. Overall, commercial sponsors pick up about half of the $2.25 billion annual cost of the courses doctors must attend to keep their licenses.

Scott Lassman of the Pharmaceutical Research and Manufacturers of America state the following for the practice of pharma funding:

• a way to educate physicians about the latest medical and scientific research.

• are viewed as running independently of the pharmaceutical company. The company may be providing the funding for it, but they are not directing the content.”

• Allows for physicians to learn about “off-label”  uses of drugs since “A lot of times, the regulatory process lags behind the science,” Thus “[he] think it’s a benefit for physicians, as long as it’s independent and as long as the scientific information is solid.”

J. Gregory Rosenthal, of Physicians for Clinical Responsibility For doctors and others states the following against the practice:

• “[Pharma] makes it very difficult [for a physician] to know what research to believe”

• “[a physician] can’t go onto a CME Web site without being confronted by sponsorship logos.”

• the drug industry does hold some sway over which topics are covered in the courses.

• “[CME] are promotional activities disguised as education.”

Read more: Conflict Alleged in Drug Firms’ Education Role, Elizabeth Williamson and Christopher Lee, Washington Post Wednesday, June 27, 2007; Page A03 .