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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.


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

Posted: July 2008