CME: Big Business Just Got Bigger

The recent release of the “ACCME Annual Report Data 2003” makes it official: CME just keeps growing — to the tune of $1.77 billion in total income reported in 2003. This is an 11 percent increase over 2002's income of almost $1.6 billion, which in turn was up 14.5 percent over the previous year. Average income per organization also is up to $2,545,935, a 9.4 percent increase over the previous year. Specialty physician-member organizations reported the highest total income, followed by medical schools and education companies. “The number of activities are rising, the number of providers is rising, and the amount of money they're spending is rising. That's a good thing,” says Murray Kopelow, MD, chief executive of the Accreditation Council for CME, Chicago. “That means more education is happening.”

Commercial Support Booming

Not surprisingly, total commercial support also keeps on rising — at almost triple the rate of total income for ACCME-accredited providers. It jumped more than 30 percent between 2002 and 2003, to more than $971 million in 2003, compared to $746 million in 2002. This is just the latest in a series of giant leaps: a 31 percent increase from 2001 to 2002; and a 23 percent increase between 2000 and 2001. “The rate of change seems to be a little more accelerated in the past couple of years,” says Kopelow. “Our assumption is that this is a redistribution issue. The pharmaceutical industry is using a larger proportion of the $15 billion they have for promotional funds for [certified] education.”

Education companies led, receiving more than $250 million in total commercial support for 2003. This is the second year that these firms moved ahead of medical schools — the former leader in receiving commercial support — and the 2003 numbers show the gap growing. The difference in commercial-support dollars between education companies and medical schools was only $4 million in 2002; in 2003, it was $54 million. Communications companies came in third, as they did in last year's report.

While the bulk of commercial support for all but insurance/managed care companies derived from income received from firms that manufacture FDA-regulated products, medical schools in particular are getting adept at receiving commercial support from other sources, although the total amount all provider types received from non-FDA-regulated entities grew only 6.3 percent, against FDA-regulated commercial support growth of 31 percent. Specialty societies continue to make the most from advertising and exhibits, with more than $143 million coming from these sources in 2003. Next are education companies, which reaped almost $10 million from advertising/exhibits in 2003.

Most Active Activities

One slightly disturbing result is that the number of activities and hours for regularly scheduled conferences slipped downward from 2002 to 2003. Directly sponsored conference activities were down 19 percent; and they included 5 percent fewer hours in 2003 than in 2002. Jointly sponsored conferences also were down 19 percent, with a 9 percent reduction in hours. Interestingly, directly sponsored courses were up 30 percent, while jointly sponsored courses were down just slightly from their 2002 numbers. But, according to Kopelow, “This is probably ‘artifactual.’ We've worked hard over the last couple of years to standardize the way everyone counts activities. The realignment is changing the activity and participant counts.” He says he has no direct knowledge of any medical centers that have stopped designating regularly scheduled conferences for credit.

Internet CME showed some big changes, with an explosive 62 percent growth in directly sponsored enduring materials and almost double the number of hours. For jointly sponsored Internet enduring materials, the jump is even bigger: a 313 percent rise between 2002 and 2003. The difficulty with this data, says Kopelow, is that it doesn't separate text-based online offerings from interactive activities. Other enduring materials also saw huge growth, as did most journal CME, while directly sponsored live Internet activities rose just 12 percent. Jointly sponsored live Internet activities dropped from a total of 162 in 2002 to just 40 in 2003. “We're not doing a lot of live streaming video,” says Kopelow. “That might be because we still have some bandwidth issues.”

TOTAL INCOME

Up 11 percent from 2002 to 2003

TOTAL COMMERCIAL SUPPORT

Up 30 percent from 2002 to 2003

TOTAL NON-PHARMA COMMERCIAL SUPPORT

Up 6.3 percent from 2002 to 2003

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