CME professionals worldwide are debating how to develop independent education and ethical relationships with pharmaceutical companies. That was one of the trends discussed at the Global Alliance for Medical Education annual conference, held June 20 to 22 at the Westin New York at Times Square. The meeting drew about 100 attendees from the United States, Canada, Europe, and as far away as Malaysia and China, all of whom offered a fascinating view of CME provider/physician/pharma relationships around the globe.

As CME programs become formalized, many countries, like the United States, depend heavily on pharmaceutical industry funding for CME. In Canada, as in the United States, there is a growing gap between what physicians expect and what pharmaceutical companies are allowed to provide. To help close that gap, the Canadian CME community is considering developing workshops for doctors about the regulations.

To maintain ethical standards, Spain, Italy, and Germany have developed their own pharma codes. Malaysia has taken an interesting approach—-allowing pharmaceutical companies to develop 25 percent of the content for CME events. In China, the biggest challenge in developing independent CME is that docs are in favor of pharmaceutical-company-controlled programs, said Howard Ho, CEO, EMO Healthcare Communications in Beijing. "The content is good, the programs are free, and there is great entertainment," Ho said. "Doctors are human." (Sound like a familiar problem?)

His company formed a partnership with Rockpointe Productions and the American College of Cardiology to bring highlights of the ACC annual meeting in April to China via telecasts. Through this initiative, Chinese doctors experienced an unbiased program, said Ho, which will encourage them to push for more independent programs in China.

Not only must CME professionals around the world develop systems to ensure the independence of programs, but they must also prove CME's effectiveness, speakers stressed. With the passage of the Medicare prescription drug benefit bill, the U.S. government will become the largest single payer of pharmaceuticals and medical devices by 2006, which means the current environment of government scrutiny will intensify, and there may be even more regulation of the pharmaceutical industry. These U.S. trends will affect pharmaceutical funding of CME worldwide, speakers said.

A heads-up for CME providers: If you haven't yet developed outcomes measurements for your programs, start now. Drug firms must mitigate their risk by investing in programs that are evidence-based and have a proven, positive effect on patient care.