Last week I posted a tweet about Pfizer’s announcement that it is going to change the way it funds continuing medical education in the United States. I put the news out in a tweet, because I didn’t have time for a full posting at the time, but I think it merits some thought.
According to the press release issued by the company:
Pfizer will continue to support CME programs at many of the world’s leading academic medical centers and teaching hospitals, as well as programs sponsored by associations, medical societies and community hospitals, in keeping with the shared goal of improving public health.
Effective immediately, Pfizer is eliminating all direct funding for physician continuing medical education (CME) programs provided by medical education and communication companies (MECCs).
A Fleishman-Hillard colleague, Steve Walker, and I were talking about this and agreed that it signals a game change. Especially, given the mood on Capitol Hill, as noted many times here on Eye on FDA, things are about to change – dramatically (I am working on a White Paper on this very topic). I have said that, anticipating reform, pharma companies need to begin to move ahead of the curve. It is a corporate reputation issue and this move is but the latest example of Pfizer anticipating the curve and moving ahead of it.
For example, from a press release outlining major policy decisions by the company that I quoted in a previous posting:
Pfizer is committed to increasing transparency and disclosure of activities that relate to the public interest.
- In 2002, Pfizer began to register its clinical trials on the public database at http://www.clinicaltrials.gov/. The company now registers all trials in patients and has more than 800 trials registered.
- Also in 2002, Pfizer began publicly reporting U.S. political contributions.
- In 2004, Pfizer began publicly posting the results of its clinical trials at http://www.clinicalstudyresults.org/.
- Starting in December 2006, the company launched a regularly updated public website, describing all compounds in its drug development pipeline and detailing their progress.
- And in April 2007, Pfizer began reporting its FDA post-marketing commitments relating to safety, efficacy or the use of Pfizer medicines.
- This latest transparency initiative follows a commitment Pfizer made in June 2007 to provide more information about the support it provides for groups that work to promote public health."
I bring it up again because I think that Pfizer gets it – each of these bullet points represents potential reform in the coming months. It’s not that I’m a Pfizer rah-rah, but they are moving in the right direction and that deserves some credit.
But back to the point at hand, Steve makes the point that the Accreditation Council for Continuing Medical Education (AACME) has stated its commitment "to improving the organization’s ability to ensure that CME is independent of commercial interests and free of commercial bias in all CME topic selection, planning decision and presentation content. " While a vote on the issue to end commercial support for professional education by the American Medical Association failed, chances are the issue will return.
That means in a few years, there won’t be any company supporting CME in this way, and perhaps no company supporting CMEs at all. In fact, it may be the harbinger of a day when pharmaceutical funding of medical and professional societies to disappear. You can decide if that is a good, or a bad thing but you can probably bet that day is coming.
You did a great job of outlining Pfizer’s proactive role in creating transparency and disclosure. They are to be commended for this. This latest move, however, is something else entirely.
By excluding medical education companies from funding they are instituting a policy- albeit their own- that runs contrary to existing ACCME practice. ACCME does not distinguish among providers based on their entity type. With regard to any organization’s worthiness to offer CME ACCME regards a medical education company to be on equal footing with a hospital, university or professional association. The ACCME accreditation process only distinguishes providers based on whether they do or do not meet the criteria for accreditation.
Pfizer certainly has the right to choose how they award grants and to whom. And their outreach has been of demonstrable benefit to many thousands of physicians. But, while probably unintended, this new plan actually has the effect of interfering with the current CME system.
Institute for Advanced Medical Education