Pfizer's Saxton: healthcare professionals must lead CME

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Pfizer med ed head Mike Saxton dismissed the notion that the company was bowing to pressure in its decision to eliminate direct support for CME programs sponsored by medical education and communication companies (MECCs).

“This is about performance improvement,” Saxton told MM&M. “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.”

Saxton, who is senior director for medical education at the firm, said Pfizer is taking its cue from ACCME's revised guidelines, aimed at eliminating industry influence on CME, and that the company's philosophy is that CME provision must be led by organizations closer to the point of care.

Many MECCs feel Pfizer is caving to pressure from Congressional and other industry critics that paint med ed agencies as marketing firms. In a statement last week, 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. “It exists throughout the spectrum of providers. The issue is how to manage it more effectively.”

The North American Association of Medical Education and Communication Companies (NAAMECC) said in a recent statement that Pfizer was giving up the fight for commercial speech 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 says such institutions, by themselves, would be incapable of performing all the certified CME needed by the medical community. 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.

“It's entirely up to the qualified provider,” said Saxton. “They're independent of our influence and they decide who to work with.”

Meanwhile, a MECC-sponsored survey of 1,527 physicians found that 82% opposed a ban on provision of CME by MECCs, as proposed by the AMA's Council on Judicial and Ethical Affairs in May. Of the physicians surveyed by Professional Postgraduate Services, 71% said industry-funded CME was fair balanced, not favoring one product over another, and more than two-thirds said industry-supported CME ws just as rigorous, effective and evidence-based as non-industry supported CME.
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