I had high expectations going into the hot-topics session about the ongoing Senate investigation into pharmaceutical companies' educational grants at the Alliance for CME annual conference — but I left disappointed and concerned about the CME community's lack of response to this extremely important development. (See news story, page 14.)
During the session, Bruce Bellande, PhD, executive director, Alliance for CME, said that he had initiated productive conversations with a Senate Finance Committee staffer. After the conference, the Alliance sent a letter to the committee, offering to assist in clarifying issues related to certified CME.
While I commend the Alliance for these steps, the CME community needs to go much further, fast. One attendee from a major pharmaceutical company suggested that CME leaders visit the senators to present their perspective. Expanding on that excellent idea, I think the CME industry needs to form a government advocacy task force, ideally comprising leaders from a cross-section of provider types and including people who are experts in government affairs. Somehow this has to be accomplished without the effort getting mired in a mudslide of bureaucracy — perhaps it needs to be an independent group. The task force must create an action plan that includes sending a contingent to visit the Senate Finance Committee.
This contingent will need to be armed with data. The task force should collect research demonstrating that pharmaceutical industry support of CME can result in better and lower-cost patient care. Individual CME providers conduct outcome measures to demonstrate the efficacy of their activities — the task force could compile and analyze that data, highlighting the results in an educational packet. Since the government is particularly concerned that off-label prescriptions drive up costs, and that industry funding is influencing the development of treatment guidelines, materials should address those issues head-on. To comply with the updated Standards for Commercial Support, providers need to demonstrate how they manage and resolve conflicts of interest; these examples can show the government that educators are increasing their vigilance in protecting their activities' independence.
In addition, I think CME professionals should examine — unflinchingly — the finance committee's concern that medical organizations are relying on pharma funding to such an extent that it compromises their independence. Perhaps societies should consider setting limits on the percentage of revenue that comes from industry grants; and/or establish caps on the amount of funding received annually from individual companies.
In the nine years I've been covering CME professionals' conferences, I've heard numerous speakers recount the scary days in 1990 when Sen. Kennedy convened hearings on pharmaceuticalpractices — and the CME community narrowly avoided government regulation by deciding to regulate itself. Now, although it appears that another congressional hearing is not imminent, how much more of a wake-up call do we need than the Senate Finance Committee investigating pharmaceutical companies' educational grants? It's time for the CME profession to make an organized, concerted, and comprehensive effort to establish the benefits of CME provider/industry collaboration to the government.
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