Saturday, March 17, 2012

Medical societies fight CMS efforts to make CME funding more transparent

On February 9, 2012, I wrote about how Merck manages to evade FDA regulations on advertising by funneling money through third party intermediaries: educational institutions and education/PR companies.  These third parties then pay doctors to provide advertising to other professionals in the form of continuing medical education.  Merck can then have the doctors speak about off-label uses of its drugs and vaccines, a discussion which is prohibited by FDA if conducted by (direct) employees of Merck.

Doctors are required to obtain at least 50 hours of continuing medical education yearly in order to maintain their licenses.  A common way to do so is to attend professional meetings, which have individual talks or even whole sessions sponsored by pharmaceutical companies.  This is said to keep the cost of attending down, and additionally funnels money to the professional organizations that put on the meetings. Professional organization can earn huge fees from this type of sponsorship.

The Centers for Mericare and Medicaid Services (CMS) have proposed regulations that would make the process of using third parties to obscure who is funding educational programs for medical professionals more transparent.  Speaking fees and other "transfers of value" from industry would be published on the internet for all medical practitioners.  Using third parties would not exempt the information from publication.

The information provided would come from the pharmaceutical companies.

But the professional societies are balking.

According to Medscape,
CMS proposes requiring drug and device makers to report not only direct transfers of value to physicians but also indirect transfers through a third party when the manufacturer knows whom the ultimate recipients are. An example would be a grant given to CME faculty by an industry-funded CME provider. Organized medicine has cried foul about this, saying that CMS is going beyond the intent of Congress.
In their letter to CMS, the AMA and its allies contended that accredited CME does not need to be policed for influence peddling, as it is structured to prevent industry funders from controlling its content, speakers, or attendees. [Give me a break--Nass]  According to organized medicine, following these dollars would further burden CME providers, manufacturers, and physicians, who would have to track "any activity that could conceivably have any indirect transfer of value." That task contributes greatly to the 80 hours of annual paperwork that the regulation would impose on physicians, stated the medical societies. Accordingly, they urged CMS to exclude CME from the reporting requirements.
The ACC also asked CMS to exempt CME. Otherwise, drug and device makers would be less likely to fund CME events, and physicians would be less likely to attend.
"Better educated physicians furnish higher quality care," the ACC stated. "Reducing available CME activities certainly does not assist in achieving that goal."  [The problem is that our CME are currently so tainted, they can often not be believed.--Nass]

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