High anxiety concerning the future of pharmaceutical funding of continuing medical education permeated the Alliance for Continuing Medical Education annual conference, held January 28–31 in San Francisco. In numerous sessions, attendees and speakers discussed how the increasingly strict regulatory environment and negative public, media, and government perception of CME is threatening collaboration between CME providers and pharmaceutical company grantors.

“Continuing medical education will continue to be attacked in 2009, and we need to start controlling our own destiny," said one speaker from a pharmaceutical company during a standing-room-only session. "If we don't control inappropriate bias, CME will be tainted. We need to look deep into ourselves and take [commercial] influence out of content.”

Companies are becoming much more discriminating about approving grants. One speaker reported that five years ago her company approved 70 percent of the grant applications it received; that figure has dropped to 26 percent. It's particularly important that providers include a mechanism for measuring and publishing the outcomes of education activities so that grantors can demonstrate the value of the programs internally to their higher ups, as well as to the public, speakers said.

The location of CME events continues to be a hot-button issue. Polled via an audience-response system, attendees at one session were asked whether it was acceptable to hold conferences in ski resorts. The largest number of respondents—53 percent—said no, because of the perception issue. Twenty-five percent said ski resorts are acceptable sites as long as the education, rather than skiing, is the focus of the conference; while 22 percent of respondents were on the fence. However, the speakers from pharmaceutical companies were much more definite. "Nine times out of 10, if we see a ski resort on the grant application, we will decline the application because of that,” said one panelist.

A frustrated audience member from a medical specialty society pointed out that the revised PhRMA Code on Interactions with Healthcare Professionals, which went into effect last month, specifically states that accredited providers should control all aspects of CME, including venue selection. "How can you say you comply with the PhRMA code and then decline grants for meetings held at resorts?" she asked.

”Yes, it is up to you to choose the venue, and you can choose resorts, but we may not be able to authorize the grant due to internal corporate policies," responded one panelist.

To mitigate against conflict of interest, providers should try to get support from multiple pharmaceutical companies, speakers said, and seek funding from outside the life-sciences industry. Large corporations, such as Microsoft and Nike, could be convinced to support CME, said one pharma speaker, if providers explain that doctors will give patients better care as a result of CME, which might result in employees losing less work time due to chronic illnesses.

For more coverage of the Alliance for CME conference, watch for the March/April issue of Medical Meetings.