Healthy Skepticism Library item: 18751

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Electronic Source

Kellner T
Value of CME to public health and business value to commercial supporters: Can there be an appropriate match?
Email from NetworkPharma 2010 Oct 19

Full text:

This question creates a lot of controversy. Policies stating education
must be without financial interest have to be strictly followed by
industry whilst other providers of education use CME as a component of
their fund raising tactics. Both under the flag of contributing to
public health maintenance via improved patient care. Beyond all the
controversy there is an increasing demand for post graduate education:
flat healthcare budgets driven by an ageing population and continuing
innovation require more effective resource allocation. Medical
education, respectively CME, is increasingly becoming a key component
to manage these challenges. Pharma and device companies still have an
obligation of educating those who purchase and use their products. On
top of that education is becoming an element of product labels and
associated risk mitigation strategies.

The question is, if and how an appropriate match between the business
interest of a commercial supporter and the value to public health
maintenance can be defined. Analyzing existing care gaps in
professional performance and disease management and identifying those
being in synergy with business might be an appropriate option for the
engagement of commercial supporters. The focus of support needs to be
on the primary goals of medical education: improving knowledge,
competence and skills of healthcare professionals and respective
healthcare teams. This requires an appropriate definition and a better
differentiation of education versus promotion. Defining education is
currently almost not recognized by national and regional (EFPIA)
policies and codes of conduct. In the absence of a clear understanding
of professional medical education these policies become barriers for
evolving educational standards rather than giving guidance to
supporters and providers. In order to reduce the risk of increased
public scrutiny these gaps need to be closed as soon as possible.

For avoiding inappropriate influence several components can help
ensuring fair balance by increasing quality and efficiency:

• Involvement of independent 3rd parties (CME providers)
• Educational needs assessment involving the target group
• Appropriately defined learning objectives
• The right scope of a program
• Program faculty and speaker selection by the provider
• Peer review of program content
• Outcome measurement (at least level 3 based on the model suggested
by Moore et al.)

The delegation of some responsibilities to 3rd parties does not imply
Pharma shall be completely firewalled from education or that it will
have to support any type of program without any decision rights. A
component to ensure this collaboration is maintained appropriately is
the recruitment of education managers. Education teams should be in
charge of decisions related to medical education and manage the
collaboration with providers. Moving budget ownership for medical
education out of marketing departments, as often practiced in the US,
will not necessarily guarantee programs will be of higher quality or
less biased.

If the collaboration between supporter and provider is well
maintained, kept transparent and controls to avoid abuse are in place,
there is a benefit to all stakeholders: patients, medical professional
associations, payers and industry.

Conflict of interest: Thomas Kellner has no interest in selling a
service that is related to medical education.