Promotional Med Ed: Med Ed Makeover

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The days of luxe dinner sessions in exotic locales may be long gone, but all the pressure on certified and accredited CME seems to be driving dollars over to non-accredited medical education, med ed pros say.
“The biggest trend we've seen is that pharma companies are increasing the quality and substance of their non-CME programs,” says Dara Warn, VP at Pri-Med, whose meetings and conventions business hosts a ton of medical education, accredited and non- alike. “We've also seen increased usage on the physician side. They're going to these programs because they're quality and high-information.”
Warn had just stepped out of a med ed session on hyperlipidemia where participants weren't served so much as a glass of water. There were 126 physicians there nonetheless. “Physicians are out of the office, they want this education and they'll do it on their own time, but the quality of programs have gotten better, so physicians are interested in attending,” says Warn. In part, that's because non-accredited, or promotional, medical education has cleaned up its act—and toned down the “promotional.”
“For non-accredited programs, in terms of content, we've seen in the last two years movement toward more of a problem for which a product provides the solution,” says Linda Klein, president and CEO of Klein and Co. “Clearly, these are not just product promotion programs but well-balanced ones presenting where the product fits into the scheme of clinical practice and the rationale for that, obviously staying within the label. Healthcare professionals are not going to attend a commercial, whether it's offered in-office, through a webinar or at a dinner program.”
Like many medical education and communication companies, Klein's firm is getting out of CME ahead of the ACCME's August deadline for companies to impose strict firewalls between promotional and accredited content. She sees industry funding trending that way, too.

“CME has simply become so hands-off, so regulated,” says Klein. “It's very difficult. Companies can't see a return on their dollars, so they're still committed to continuing education, and they will support some of that, but they're businesses. They want to be able to control the message. They can have no control over CME, and they respect that, but as a result, we've seen a decline in that part of their programming.”

Companies are in a bind. They have to educate healthcare professionals about their products—indeed, as Klein points out, they're required by FDA to do so—but their access to physicians through their sales teams is vastly diminished, and commercial support of certified and accredited CME is under withering scrutiny from Congress, academia and an assortment of watchdogs. “So what's happening is companies are providing a much higher quality of non-accredited education than we've seen in past years,” Klein says.

If that's due to market demands, it's probably also partly owing to companies fearful of getting a letter from Sens. Kohl or Grassley being scared straight.

“Clients are making very sure they're not violating the guidelines,” says Carleen Kelly, president of Surge Worldwide, who has presented the guidelines to clients—in part, to demonstrate that her firm knows and can uphold them. She sees tremendous anxiety among pharmas about steering clear of regulatory trouble, and says that's holding some back unnecessarily in their professional communications.

“I attended a convention over the weekend, and I couldn't believe that reps had nothing they could share with physicians except their sales aids,” says Kelly. “Pens and pads are off limits now, but there's an appropriate venue for a med ed company to be developing materials that could be used at the booth.” Think thumb drives loaded with presentations, podcasts, even Tweets. “There's still a fair amount of conservatism in clients, but for non-accredited med ed, it's really about how creative you can be in using some of these new tools.”

KnowledgePoint360 is another firm that's bailing out of CME to focus on the non-accredited side. “We've made a strategic decision to leave the CME business, but our growth on the promotional side will offset that,” says president and CEO Jon Bigelow.

In particular, the firm is seeing its electronic initiatives gain traction. “A few years ago, physicians were considered slow adapters of new electronic tools, but this has completely changed,” says Bigelow. “KnowledgePoint360 has been introducing additional web-enabled educational initiatives and looking at ways to employ social media, podcasts and other technologic advances to serve healthcare providers. So far, this has been additive—we are seeing larger audiences than ever for this year's live events, but we are also seeing growing web traffic.”
With traditional means of educating physicians on the wane, electronic media could soon subplant events and printed materials as the top venue for medical education, just as e-CME is booming and mobile CME offerings are gaining steam.

“Non-accredited medical education gives clients an opportunity to tell their story with a little more freedom, but counterbalancing that you have their own regulatory departments,” says Dave Leyden, president of Alert Marketing, which is seeing an increase in multi-channel education projects. “It gives companies a little more leeway in terms of setting and presenting their product story, but they're still going to have to be in compliance with the product labeling.”

The scrutiny around CME has had some positive effects, says KnowledgePoint360's Bigelow, who cites widespread adoption of Good Publication Practices guidelines aimed at increasing transparency around content and funding, as well as clinical trials registries and the use of opinion leaders.

“The CME market has gotten bogged down in disputes, misperceptions and misguided initiatives, and many of the pharma industry's critics have gone to illogical extremes that will hurt the healthcare system and patient care,” says Bigelow. “But at the heart of the issue, it is important for the healthcare system to operate more transparently and with appropriate recognition or avoidance of conflict of interest. Through most areas of non-accredited medical education, market leaders like us are working to ensure greater transparency in the process, while still providing the communications services that are so important to educating clinicians.”
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