Funders of continuing medical education are becoming increasingly critical of satellite symposia. The catalyst for their disapproval: the extraordinary costs attached to these events.

“One of the more controversial approaches is the request for slot fees to secure a commitment from a company to support a satellite symposium during the conference,” observed Pamela Mason, director, medical education grants, AstraZeneca.

“The request for the slot fee comes directly to the commercial supporter from the association before any grant request is submitted,” she said.

Such payments may float below regulatory radar.

According to Murray Kopelow, MD, chief executive of the Accreditation Council for CME (ACCME), satellite activities are subject to all of the Standards of Commercial Support (SCS).
However, of the slot payments, he said, “That exchange of money is not recognized by the ACCME,” adding, “The specialty society has no responsibility or accountability for those activities in the context of accreditation.”

The business relationship between the commercial supporter and the association is separate from the accredited provider and therefore beyond the purview of the ACCME. But it’s an area frought with complication.

“There is a lack of consistency across the board in how the associations/specialty societies handle satellite symposia,” Mason noted. “There are a variety of approaches, from the society handling all aspects to the involvement of a MECC. Some are certified for credit while others are not.”
Those that are accredited sometimes throw CME credit in with other perks for the grantor in return for the slot fee.

Meanwhile, societies are finding it harder to justify the extra room costs to stakeholders.
“All of us have our own experience where only a handful of people came to a satellite event,” said Eric Peterson, EdM, VP, Academy for Healthcare Education. “And yet, the upfront cost for developing the content remains the same. That’s the big complaint. It’s a huge investment for an uncertain return in terms of number of people who will be educated. Often this happens because the ‘business’ side of the association is so focused on maximizing revenue from satellites that they provide more satellite ‘slots’ than they can possibly provide an audience to attend.”

Just how big are the fees? Societies might reserve all the hotel rooms in the vicinity of their annual gathering and then parcel out the space at $20,000-$50,000 a pop. One well-known society charges $150,000 just to reserve a room for a satellite talk.

That’s a revenue stream for associations. Adding fuel to the fire is how some require pharma firms to be a gold, silver or bronze sponsor of the main conference and/or an exhibitor before allowing them to get a crack at a prime satellite spot.

Some see a possible conflict of interest in associations, which are responsible for the educational content of the main conference, taking in these large sums. Reiterated Peterson: “What’s going wrong with how satellites are being handled by most associations is they’re letting the business side run what the educational side should be responsible for.”

But societies may be able to reconcile the two.

“A different approach that many associations are doing now is the request for a grant from a commercial supporter with all costs associated with the educational activity included in the request,” noted Mason. “It is important that all aspects of a conference’s educational activities certified for credit including satellite symposia conform to the ACCME [SCS].”

She called for more guidance on appropriate models for satellite symposia.