Pfizer's announcement that it would no longer support accredited CME programs directly through commercial providers has beleaguered medical education and communication companies (MECCs) scrambling.
Pfizer announced that it would henceforth support CME programs at academic medical centers and teaching hospitals as well as programs sponsored by associations, medical societies and community hospitals. “This is about performance improvement,” said Pfizer med ed senior director Mike Saxton. “We're assertively stating that we're going to put our dollars in the direction of education where we can best contribute to patient care.”
Many MECCs feel Pfizer is caving to pressure from congressional and other industry critics that paint med ed agencies as marketing firms. The Coalition for Healthcare Communications called it “an honest but misguided attempt to blunt public criticism of commercial support.” Not so, says Saxton. “Our policy is not in any way impugning them,” says Saxton. “They're missing the main point. Basically, our view is that only those organizations directly involved with patient care meet the highest level of accepted medical standards and can deliver on the promise most optimally of the new system. That doesn't mean that there is not a role for MECCs. We've taken no action that excludes them, and the best proposals we see continue almost universally to involve MECCs at some point in the process.”
In Saxton's view, the framework being advanced by the ACCME suggests that medical societies and institutions should be leading provision of medical education—but doesn't in any way preclude the involvement of MECCs, the better of which provide valuable contributions to continuing education. He acknowledges that academic and medical institutions and medical societies are no less vulnerable to conflicts of interest than commercial providers. “Conflicts of interest is an important issue and it's not exclusive to any provider group,” says Saxton.
The North American Association of Medical Education and Communication Companies said in a statement that Pfizer was giving up the fight for First Amendment rights, where the company has been a leader, and worried that, “If med ed companies do not merit Pfizer's direct support, then [academic medical centers] and others may wrongly conclude that med ed companies likewise do not merit their support either.”
NAAMECC notes that MECCs outperform all other provider types, including academic medical centers, professional and medical societies and hospitals, in compliance with the ACCME Standards for Commercial Support, and aruged that such institutions, by themselves, would be incapable of performing all the certified CME. Some will surely call on MECCs to execute programs supported by Pfizer, though it's likely that less will trickle down to them under the new policy.
Pfizer was already shifting its grants away from MECCs. Saxton said that the percentage of Pfizer med ed grants going to CME companies has dropped from more than 50% to around 25% over the past couple years. With pharmas under pressure to cut costs all around, he expects to see levels of support drop across the industry, he said, but thinks support will rebound once the dust settles.
So far, the pile-on by other companies that MECCs fear hasn't materialized, but in an era of diminished industry support, Pfizer's policy change alone will hurt some.