Articles examining industry-supported CME

(Note: This is a page in progress. The following few studies were lifted directly from the Institute of Medicine 2009 Report on Conflicts of Interest in Medicine. There are a lot more to include, some that support commercial CME, and some that do not. We will work diligently to update this list regularly.)

Gilbert, S. 2008. The invisible hand in medical education. Bioethics Forum, March 14.

This article, based on personal experience of the author, describes how accredited continuing medical education providers can tailor programs to secure company grants. A commercial provider selected a program concept to “provide a platform for one of the sponsors,” which was working on a drug covered by the program. The provider also organized informal workshops with experts who were hired on the basis of their support for the sponsor’s message.

Takhar, J., D. Dixon, J. Donahue, B. Marlow, C. Campbell, I. Silver, J. Eadie, et al. 2007. Developing an instrument to measure bias in CME. Journal of Continuing Education in the Health Professions 27(2):118-123.

Using a checklist that they developed to assess bias in education programs, Takhar and colleagues concluded that nine of the 17 continuing medical education programs that they assessed were biased (eg, by limiting the discussion to the sponsor’s product and ignoring alternatives).

Katz, H. P., S. E. Goldfinger, and S. W. Fletcher. 2002. Academia-industry collaboration in continuing medical education: description of two approaches. Journal of Continuing Education in the Health Professions 22(1):43-54.

These researchers found that courses on primary care directed by academic faculty covered a broader range of topics than symposia sponsored directly by industry. Moreover, 91 percent of the industry-sponsored symposia were sponsored by a company that had recently obtained FDA approval for a drug related to the symposium topic. The industry-sponsored symposia did not cover preventive screening, dermatological diagnoses, child abuse, alcoholism, or the technology resources available for clinicians, which were considered important in the academic program. In that study, the university-based accredited continuing medical education courses received funding from multiple companies through a MECC to the university. University faculty determined the content of their courses, and the MECC handled marketing and meeting logistics. During meal breaks at these courses, symposia funded by industry were
also offered.

Orlowski, J. P., and L. Wateska. 1992. The effects of pharmaceutical firm enticements on physician prescribing patterns. There’s no such thing as a free lunch. Chest 102(1):270-273.)

This study focused on a kind of industry-sponsored activity that provoked considerable criticism and that now is not permitted for accredited education, that is, a program held at a resort with all expenses paid for attendees and with limited time actually devoted to the educational content. The authors found, using actual prescribing data obtained before and after the activity, that this “elaborate promotional technique . . . was associated with a significant increase in the prescribing of the promoted drugs at one institution” (p. 273). The investigators also found that the physicians involved did not believe that the activity would affect their practices.

Bowman, M. A. 1986. The impact of drug company funding on the content of continuing medical education. Journal of Continuing Education in the Health Professions 6(1):66-69.

This study, published before the adoption of the first ACCME standards for commercial support, compared programs funded by rival pharmaceutical companies and found that the programs favored the products of their funders.