Saturday, August 25, 2007

Industry CME Spending Increases; What Does It Signify?

Medical Marketing & Media reports that total commercial support for continuing medical education (CME) programs rose 8 percent in 2006, following an increase the previous year of only 4 percent--surprising some experts who had expected the slowing trend to continue.

HOOKED explains that in 2003-4, two events occurred that would have appeared to make CME a less attractive investment for the drug industry. First, the Office of the Inspector General, DHHS, issued a stern report warning the industry that if they did not create secure firewalls between their marketing activities and CME support, they might be in violation of Federal anti-kickback laws. Second, the group that oversees CME, ACCME, introduced strict new rules to prevent speakers from parroting the industry message at conferences.

It was an open question what the response of industry would be to these changes. Some predicted a major falling-off in commercial support for CME. Others wondered if the industry, as it always had before, would simply find the seams in the new rules and continue on its merry way. My conclusion in HOOKED: too soon to tell.

The announced increase in industry CME support might at first glance persuade the paranoids that the new "strict" guidelines must after all not be working. My own conclusion at this point is the same as before--too soon to tell. Some factors mitigate the possibility that the industry is again in the CME driver's seat. The low 2005 funding figures might simply represent that the industry was holding back, waiting to see what action DHHS planned to take on the anti-kickback front. The slight increase in 2006 vs. 2005 might show that the industry is now confident that it has figured out the legally safe ways to invest in CME. MM&M notes that the venues seeing the largest increase in 2006 were medical schools and medical societies. The industry may have reasoned that supporting CME in those institutions was safest overall in terms of showing the Feds that a real firewall was in place, and that marketers were not controlling CME content. (This does not mean that CME at medical schools and medical society meetings is free of commercial bias; but it may mean that at least, the industry continues to live in fear of the DHHS Inspector General.)

Iskowitz M. Pharma pursued safe haven for its CME spend last year. Medical Marketing & Media On-Line, July 19, 2007;

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