Statement of the Coalition for Healthcare Communication On the Value of Independent Commercial Providers of CME
NEW YORK, July 10, 2008-While a
strong supporter of self-regulation in the CME enterprise, the
Coalition for Healthcare Communication believes that Pfizer's
recent decision to eliminate direct funding of CME through
"independent commercial providers" is an honest but misguided
attempt to blunt public criticism of commercial support.
Unfortunately, this decision supports much of the misinformed
criticism of the industry, flies in the face of objective evidence
and does not address the true challenges facing health care
providers and patients today.
In the midst of recent public criticism of industry supported CME,
accredited medical education companies have an unequaled record of
compliance with conflict of interest rules and provide much of the
best CME available today to the nation's physicians and other
healthcare providers. Indeed, the Coalition believes accredited
medical education companies should continue to receive strong
support from the industry and the public given their leadership in
improving patient care with CME through innovation, excellence, and
entrepreneurship.
ACCME's 2006 Accreditation and Compliance Report documents that commercial providers achieved the highest ratings of compliance (94.8%) of any group surveyed for all elements relating to the ACCME's Standards for Commercial Support (i.e.
3.3A-3.3D).
These data clearly demonstrate that accredited medical education
companies lead all other accredited providers in the top two
categories: Compliance and Exemplary Compliance, for standards of
commercial support - calling into question Pfizer's logic for
excluding them.
Furthermore, ACCME's recently
commissioned report, The
Relationship between Commercial Support and Bias In Continuing
Education Activities: A Review of the Literature, failed to
find "any objective evidence or studies documenting that 1
commercially supported CME activities are biased." The report
recommends that further "rigorous scientific studies" be conducted
before conclusions are drawn. It also recommended answering the
question: does
commercially-sponsored CME lead to better patient care?
Addressing these questions with needed research offers significant
opportunities to advance patient care. Favoring one group of
providers over another in an effort to mitigate the risk of bias
does not.
Instead, the Coalition and many others believe that patient care is
best served when accredited medical education companies are allowed
to compete in the education marketplace because their
entrepreneurship spurs innovation and competition for excellence in
education as well as regulatory compliance. Many further believe
that patient care is best served by quality education from multiple
qualified and regulated providers.
Meanwhile, there is broad agreement that conflicts of interests are
best managed by full disclosure, robust reporting and transparency.
In addition, leading providers have incorporated three important
additional components designed to manage conflicts of interest:
reassignments, peer review and recusal.
Unfortunately, Pfizer's decision to redirect its education grants
may reduce the robust innovation commercial CME providers bring to
medical education.
Historically, independent commercial providers have been the first
to introduce new techniques and educational formats to the medical
community. They have demonstrated willingness to take financial and
other risks needed to move beyond the boundaries of traditional
education in at least four key areas: 1. Development of interactive
and multi-media techniques that actively involve the learners in
programs and outcomes 2. The undertaking of comprehensive clinical
needs assessments and the creation of innovative long-term
educational programs specifically designed to meet those needs 3. A
heightened focus on fostering measurement of clinical outcomes
derived from educational activities 4. The development of web-based
learning platforms and programs designed to address the immediate
needs and time constraints facing clinicians.
Indeed, as a result of the recent focus on the management of
conflict of interest, commercial providers are uniquely qualified,
staffed, committed, and funded to create and implement compliance
and reporting functions demanded by policymakers and the public.
Because conflict of interest compliance has largely focused on
commercial support from the private sector, commercial providers
have aggressively addressed this issue and currently lead the
industry in compliance.
By contrast, other accredited providers, including medical schools,
hospitals and professional societies are often less equipped to
effectively deal with transparency and other compliance issues.
Shifting the burden of regulatory compliance to institutions that
often lack the necessary resources such as staffing, adequate
funding and mature compliance management systems will not 2
accomplish the desired results. Instead, the likely outcome will be
fewer highquality CME activities, which will negatively impact
patient care.
Moreover, it should be noted that Pfizer's preferred group of CME
providers are also among their most important direct customers. For
example, these groups employ prescribers and oversee many of the
formulary decision-makers that are critical to the financial health
of the pharmaceutical industry. Thus, Pfizer's decision -- made in
the absence of any objective scientific evidence -- may generate
more controversy around conflict of interest, increase oversight by
federal and state regulators and lead to further calls for
additional restrictive legislation.
In summary, we stand proud of the record of accredited medical
education companies and continue to believe that patients are best
served when all provider types -- including private sector
providers -- are allowed to fully participate in the enterprise and
are subject to the same oversight by government and regulatory
bodies. Moreover, these providers have led the way in meeting or
exceeding the standards of support set by these regulatory
bodies.
We respectfully disagree with Pfizer's decision and urge other
grantors to work with the Coalition to develop better long-term
solutions aimed at maintaining public confidence in
industry-supported education with tactics that truly resolve these
issues.
Sincerely, Brad Bednarz Marty Cearnal Mark Schaffer Co-Chairmen, CME Committee Coalition for Healthcare Communication
Contact Us:
Coalition for Healthcare Communication
John Kamp
Executive Director
Coalition for Healthcare Communication
405 Lexington Ave
NY, NY 10174-1801
(NYC) 212-850-0708
(DC) 202-719-7216
Email: jkamp@cohealthcom.org
Posted: July 2008
