Continuing Medical Education (CME)
In 2006, pharmaceutical and medical device industry support for continuing medical education (CME) totaled $1.45 billion, accounting for 60 percent of all income from CME (up from 34 percent in 1998). Industry support of CME has grown in recent years as other avenues of pharmaceutical promotion have come under increased scrutiny and regulation.
Pharmaceutical companies often control events indirectly through Medical Education Communication Companies (MECCs). The MECCs organize events for physicians, but serve the needs of their clients – the industry that pays the bills.
The Accreditation Council for Continuing Medical Education (ACCME) has established standards for commercial support. However, ACCME does not audit individual programs and its standards have not been effective in ensuring the independence of CME events. Many programs continue to receive accreditation, despite serving primarily marketing purposes.
It is critical that policies to address conflicts of interest at academic medical centers (AMCs) include provisions to maintain the independence and rigor of CME. A model CME policy for an academic medical center should aim to eliminate both real and perceived conflicts of interest derived from the involvement of pharmaceutical and device companies playing such a central role in physician education. Policy considerations:
• Incorporation of ACCME standards
• Disclosure is not sufficient
• Reviewing CME for bias
• Establishing a central education fund
• Funding CME solely through academic medical center support and attendance fees