Medical society meetings around the world have long relied on support from the pharmaceutical industry in the form of sponsorships, exhibits, and funding for delegates' travel expenses. Although American Medical Association and Accreditation Council for CME guidelines prohibit U.S. doctors from receiving pharma company subsidies to pay their way to CME conferences, non-U.S. physicians are under no such restrictions — and medical associations, including those within the U.S. that draw international participation, have benefited from these sponsorships. But now, between the economic crisis and the worldwide proliferation of U.S.-style codes restricting pharma/physician relationships, those funds are under the microscope.

The International Congress and Convention Association, whose members represent supplier organizations (convention bureaus, hotels, airlines, and professional congress organizers) in more than 80 countries, assembled a panel at its annual meeting held this past November in Victoria, British Columbia, to discuss how these looming changes will affect medical congresses in the future.

Prepare for the Worst

Bair: What do you see coming down the road for the pharmaceutical industry?

Frick: We are feeling increasing political pressure in Europe regarding the sponsorship of delegates at medical meetings, and we expect that the system will change dramatically in the future. We all have to be prepared for the worst.

In addition, we are seeing the restructuring of companies, including a major restructuring of our own congress department. It means we outsource most of our logistics. It also means that we have less money to spend on meetings.

My guess is that the number of delegates, the size of exhibits, and the selling of promotional items, will all be affected. From a global perspective, we are going to focus on the major meetings in the U.S., Asia Pacific, and Europe. Some of the smaller meetings will suffer and our recommendation is that they join one of the bigger meetings.

Spencer: Meetings are going to have to justify the investment. Within individual pharmaceutical companies, structures have changed and reporting lines are different. People are more accountable than they used to be. They can't just say, “We are going to support this meeting with $200,000 next year because we always have been a major sponsor.” Perhaps someone in the procurement department might say to Anna [Frick], “Why have we got to spend money on this meeting? What's the benefit?” I think the meetings that will survive are the ones that can demonstrate value, whether that be in terms of science or in education, or that can link participation in congresses to business success.

Gomel: Most medical societies would not survive without support from the pharmaceutical and medical device industries.

Vietor: If we lose our sponsors, participants won't be willing to pay that money out of their own pockets. We will get a very reduced range of meetings that are leading science in some areas in Europe, Asia, and Latin America. Will the specialist meetings disappear? What can we do to keep them alive?

Frick: I believe very small specialized or highly specialized meetings may have a chance of surviving. But every single congress is going to have to work on its unique selling proposition in order to actually gain that business.

Spencer: Perhaps you will find some meetings becoming shorter, national meetings becoming just a one-day event. Stronger regional meetings may develop. It could well be that certain world congresses might be considered redundant.

Castex: What will happen in the less developed countries that are organizing congresses and events, which may no longer receive funding? Will Brazilians or Argentines and Chileans have no opportunity to network with professors from Europe and the States?

Frick: We see this as a big threat to continuing the medical education of doctors globally. We can foresee that if the U.S. and Europe prohibit us from funding delegates' travel, the rest of the world will follow suit. We have our people trying to tell regulators our perspective. But, as you can understand, governments don't really believe what the pharmaceutical industry says. We need help from other spokespeople and from medical societies. We all play a key role in educating government. Our concerns need to be voiced at every level.

New Funding Solutions

Bair: Could a larger congress that makes a surplus support some of the smaller conferences that are not self-sustaining?

Frick: One example is the European Society of Cardiology. They have a huge, 30,000-delegate meeting, which brings them a profit. They are willing to take some of that revenue and support the smaller meetings.

Spencer: Medical associations need to be more creative and perhaps determine other means of sponsorship. One of the aspects that we might take into account is the economic benefit to cities and communities in hosting meetings. Perhaps there has to be more discussion about meeting destinations offering support.

Or perhaps health systems need to find more money for medical education. I haven't heard about health insurance companies sponsoring much medical education. So, if pharmaceutical money does become limited, then we shouldn't give up hope.

Gomel: We have approached industries that have nothing to do with medicine. Sponsors know that medical congresses draw an audience that has purchasing power. Perhaps we should exploit this more.

Audience member: Some luxury car companies want to exhibit at a cardiology congress. Cardiologists are well-off and can afford nice cars.

Castex: I actually don't believe in those sponsors from the outside. Sponsors must be in line with the mission of the associations. It is difficult to imagine a bank or credit card company as a sponsor of a cardiology or gynecology meeting.

Audience member: My company is in Italy. Sometimes, the other types of sponsors don't give you money, but they give you services. For example, we've gotten shuttles from Mercedes-Benz and ground transportation from a local company, so it cuts our cost.

Audience member: I'm from the Hawaii Convention Center in Honolulu. Someone in our state told me there are pockets of Hawaii that do not have good health providers, and asked how we could reach medical meeting delegates to let them know this is a viable place to live. I'm working with our department of economic development and the homebuilders association to buy a booth or sponsor an event at a medical meeting we are hosting, which will allow us to showcase our state, especially to students. This is a viable way for a destination, a community, to rally around a medical meeting and try to attract long-term healthcare for their area.

Frick: It is really, really important that destinations work to ensure that the medical meeting actually gets the delegates. Remember, attendees can always come back. They will spend a lot of money in your city.

Spencer: When destinations prepare bids for a medical society meeting, they should include the amount of help that might be available from the destination, so that the society can take that into account in their decision-making process.

Gomel: My experience is that one is offered very little in terms of effective support from cities where the congress is held.

Future Focus

Bair: What do you foresee for medical congresses near and long term?

Spencer: Unfortunately, one gets the impression sometimes that there is a head-in-the-sand mentality among medical societies that “We can keep going because the pharma industry will come up with the money.” Perhaps we [in the pharma industry] are our own worst enemy. We have cried wolf so many times before, saying that the money is not always going to be there. But this time, the chances seem really very high that there are going to be more impressive constraints on the money that will be available.

If medical societies want their meetings to survive, they may have to improve some aspect of the organization or the scientific quality or even look at the scale of the meeting, and in some cases the frequency of the meeting. There are major meetings that might benefit from being held every other year. Some of these annual meetings, particularly where there is little new science, do tend to degenerate into a bit of a circus atmosphere.

Castex: Probably congresses today that have 10,000 delegates will have 5,000. My concern is regarding the size of the venue and hotel accommodations. When we have to book the venue and hotels six, seven, even eight years out, it is difficult to know the number of delegates that we will attract. That's the key issue in the next 10 years.

Vietor: We may see in the years to come the e-revolution, the virtual conferences we've been talking about for almost 10 years. I don't think that they are going to take over. But virtual events will play a much bigger role in the future, particularly for those meetings that have a good target group but are not financially viable as face-to-face conferences.

Gomel: With all the technology we have today that permits individuals to see each other through a television or a computer screen and talk freely, we will still have meetings. Human beings need to get together. They need not only to look at each other, but to be together. Meetings will continue because we need — especially in science — to collaborate, to discuss [face to face].

Spencer: In many ways, this is all related to the problem we are always hearing about: the aging population and pressures on health systems to get the price of drugs down so that they can treat a lot more people who are a lot more ill and living much longer. We are all part of that problem and it is not going to go away. We have to develop ways of confronting change.

Frick: Of course meetings are going to survive. The important thing also is that pharmaceutical companies are going to survive. Pharma companies will start launching products again and I hope that will happen around 2011. But they won't produce more blockbusters. Smallish products will come back into the markets, which will probably form a need for other kinds of meetings, new meetings. We have to be creative and work together to find a solution. We've been through rough times before and we can survive this as well.

Sidebar: The Panelists

ANDRÉ VIETOR, managing director, Viajes Iberia Congresos, Barcelona, Spain; and immediate past president, International Association of Professional Congress Organizers. His organization manages medical meetings in Spain and in other European countries.

ANNA FRICK, president, International Pharmaceutical Congress Advisory Association, Basel, Switzerland; and marketing services director, AstraZeneca, Mölndal, Sweden, where she heads up the global conference department, which holds approximately 200 large meetings per year.

MARIANO CASTEX, managing director, ICS Congresos Internacionales, Buenos Aires, Argentina. Eighty percent of ICS' clients are medical congresses.

VICTOR GOMEL, MD, secretary, International Society of In Vitro Fertilization; and professor, department of obstetrics and gynecology, University of British Columbia, Vancouver.

KEITH SPENCER, executive director, International Pharmaceutical Congress Advisory Association, Basel, Switzerland. Before joining IPCAA, Spencer spent 35 years in the healthcare industry in sales, marketing, and general management, including responsibility for corporate participation in health congresses and events.

BETSY BAIR, moderator; editorial director, Medical Meetings and the MeetingsNet magazines.

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