Op-Ed portrays CME as crooked enterprise

The way pharmaceutical companies sponsor CME is akin to money laundering, a TuftsMedicalSchool professor asserted in a New York Times op-ed yesterday.

That’s because, while ACCME guidelines prevent drug firms from paying educational speakers directly, a “loophole” allows firms to hire for-profit medical education and communication companies (MECCs) to organize the courses, noted Daniel Carlat, a practicing psychiatrist and editor-in-chief of The Carlat Psychiatry Report, a sometimes irreverent monthly newsletter which Carlat says offers unbiased information on psychiatric practice.

MECCs get paid by pharma to create course work and pay doctors 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 is the best way to prevent situations like the one in which GlaxoSmithKline paid for CME courses that emphasized the benefits of diabetes drug Avandia over other drugs while downplaying Avandia’s cardiovascular risks, he stated.

Carlat is 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, cited the provider-grantor relationship as a conflict of interest and said manufacturers should not be permitted to provide CME support “directly or indirectly.”

Guidelines may be getting more stringent, though. Following April's Senate Finance Committee Report on the use of educational grants by drug firms, CME authorities are exploring several ways of addressing what the committee called their "lack of proactive or real time oversight for educational grant programs." The ACCME will take up the issue at its board meeting next month.