The way pharmaceutical companies sponsor CME is akin tomoney laundering, a TuftsMedicalSchoolprofessor asserted in a New York Timesop-ed yesterday.
That’s because, while ACCME guidelines prevent drug firms frompaying educational speakers directly, a “loophole” allows firms to hirefor-profit medical education and communication companies (MECCs) to organizethe courses, noted Daniel Carlat, a practicing psychiatrist and editor-in-chiefof The Carlat Psychiatry Report, a sometimesirreverent monthly newsletter which Carlat says offers unbiased information onpsychiatric practice.
MECCs get paid by pharma to create course work and paydoctors to deliver it, but the content is “rarely” developed by the identified experts,he argued. Instead, it is developed by the MECC.
Carlat’s solution: limit drug firms to sponsoring promotional, non-accredited education. That isthe best way to prevent situations like the one in which GlaxoSmithKline paid forCME courses that emphasized the benefits of diabetes drug Avandia overother drugs while downplaying Avandia’s cardiovascular risks, he stated.
Carlatis not the first to wage this argument. A 2006 article in the Journal of the American Medical Association,exploring the “widespread influence” drug firms have over medical education, citedthe provider-grantor relationship as a conflict of interest and said manufacturersshould not be permitted to provide CME support “directly or indirectly.”
Guidelinesmay be getting more stringent, though. Following April’s Senate FinanceCommittee Report on the use of educational grants by drug firms, CMEauthorities are exploring several ways of addressing what the committeecalled their “lack of proactive or real time oversight for educationalgrant programs.” The ACCME will take up the issue at its board meeting next month.
