Several other commercial supporters of CME grants will follow Eli Lilly’s lead in disclosing med-ed funding, officials said at a recent industry conference.
Lilly set a precedent when it launched its online CME grant registry last week. The Web site lists names of grantees, amounts and a description of grants given in the first quarter, and the drug firm pledged to update the list quarterly.
According to senior officials, Pfizer hopes to gain approval in time to apply a similar kind of disclosure to all 2008 education grants. CME executives from Wyeth and Novartis added that they plan to meet with upper management on disclosing grants, as well.
“We can easily do it,” Tiffany Cummings, MBA, said of disclosing grants. The professional education consultant for Shire Pharmaceuticals added, “The reality is we have nothing to hide.”
Lifting the curtain on grants is one way firms are seeking to adjust in the wake of the two-year Senate Finance Committee investigation on CME. While that probe culminated last month with a report that found risks remain for fraud and abuse in several areas, the “promising strides” taken by drug firms listed in the report by Sens. Max Baucus (D-MT) and Charles Grassley (R-IA) may have emboldened manufacturers. Lilly launched its CME registry the week after the report came out.
“One of the [project] leads said, ‘Why should we be apologetic for doing the right thing and funding education?’” recalled Jason Singer, PharmD, Lilly senior grants associate. “We’re just going to put it all out there and not be apologetic any more and be proud of what we’re doing.”
While that unabashed posture may be new, transparency has been growing for some time. The issue grew in importance after Merck withdrew Vioxx and companies began to change the way they communicate with the public and the scientific and investor communities. Pfizer posted its drug pipeline last year and its post-marketing studies in 2007. Lilly launched an online clinical trials database in 2004. Most grantors have made CME funding criteria accessible via the Web.
“Pharmaceutical companies right now are very, very interested in being as open and as transparent as we can be, because we feel we actually have an excellent story to tell around drug safety, clinical trials and innovation,” explained Cathryn Clary, MD, MBA, Pfizer US Medical SVP. Speaking at IIR’s Medical Education Congress in Philadelphia last week, Clary said, “The same is going to apply to CME…Everything that we jointly do is going to end up being very open and transparent to the public.”
But not everyone feels comfortable with the newest level of transparency. With online registries putting grants to third-party providers out in the open, education providers say it invites more scrutiny on them.
Moreover, some say that grant disclosure doesn’t directly address the Senate’s concerns about CME acting as “veiled advertising.” To do that, the ACCME—the main accreditation body in CME—would need to divulge the compliance status of accredited providers. The Senate report said that manufacturers rely on the grant recipient’s accreditation by ACCME and the recipient’s promise to abide by ACCME rules of independence as “safeguards that the educational grants will be used for legitimate purposes.” Right now ACCME releases only a provider’s accreditation status, not its compliance with those rules.
Another way to defuse the criticism over CME funding would be a continued decrease in the percent age of commercial support. Pharma chipped in $1.1 billion for medical education in 2005, just under half the total revenue of $2.25 billion. Pharma accounted for 54% of total revenue in 2004, according to ACCME.
If companies cannot, to the satisfaction of critics, balance their for-profit motive with the need for independence in education, perhaps some of the money would be better spent on brand promotion, Clary conjectured. “We all think it’s a good thing to not have industry supporting 100% of CME.”
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