As the Senate Special Committee on Aging in advance of the Committee Stakeholder Roundtable on the Sunshine Act got under way on September 12, the continuing medical education industry lobbying group the CME Coalition released the results of a recent survey of physicians that would argue against a proposed rule that would require commercial support to be disclosed as “payments to physicians” under the Act. The CME Coalition submitted the survey results to the Senate Special Committee on Aging in advance of the roundtable.
Ninety-five percent of the 515 physicians surveyed recently by the CME Coalition said CME is at least “moderately important”—of those, 66 percent said it was “very important”—to their ability to keep up with the latest medical innovations. According to the survey, 94 percent of the docs attended CME in the past year, and more than half attended four or more activities. Eighty-five percent said it was either “important” or “very important” to their ability to improve patient outcomes.
However, this could change should the Centers for Medicaid and Medicare Services include commercial support in the Sunshine Act’s transparency requirements, as it is considering.
Despite their recognition that CME enhances their ability to practice state-of-the-art medicine, the idea of having a public database showing that they received “payment” from pharmaceutical companies by virtue of the companies’ commercial support of an activity they attended gave them the willies.
When asked if “attendance at a commercially supported CME event was reported in a public, online, government database as a ‘payment’ from the corporate supporter, would this affect [the] decision to attend CME courses,” 75 percent of the docs said it would affect their decision at least somewhat; 47 percent said that their decision would be affected “to a great extent.” It also could shallow the pool of available CME presenters: Almost half (46 percent) said the CMS’ proposed disclosure rule would affect their decision to participate as a panelist or presenter “to a great extent,” and another 25 percent said it would somewhat affect their participation.
While they may not want to be personally associated with the commercial support of CME, the surveyed docs seemed to agree that industry financial support is necessary. Eighty-nine percent said that healthcare companies should be at least “somewhat” encouraged to provide financial support to underwrite accredited continuing medical education programming and online resources, while two-thirds thought their financial support should be encouraged “to a great extent.”
CMS has taken its time in implementing the Sunshine Act provisions, including reporting procedures, which were originally to be in place by October 2011. It didn’t release proposed rules until December 2011, and final rules are still pending, though CMS did say earlier this year that companies did not have to begin collecting data on payments to physicians until January 2013.
The CME Coalition, which supports the public reporting of direct payments from pharma and device companies to the physicians who prescribe their drugs and buy their instruments, states in its comments to the Senate Committee on Aging that it believes “payments to CME providers for education fall outside of the Sunshine Act’s intentions because CME providers are not covered recipients,” and that “publication of such grants and payments would be detrimental to CME providers in many ways, such as finding sufficient subject-matter expert, planning and budgeting high-cost and high-quality CME, and soliciting funding.”
- Do you agree that commercial support should be counted as payments to physicians, or do you think it should be exempt from Sunshine requirements?
- Do you think these requirements, should they be enacted, will cause fewer physicians to attend and/or participate as presenters in accredited CME?
- Do most physicians even know about the Sunshine Act requirements and their possible repercussions?
Update: Thomas Sullivan, president and founder of medical education company Rockpointe Corporation, has posted details about the Senate Special Committee on Aging Committee Stakeholder Roundtable on the Sunshine Act on his Policy and Medicine blog.
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