Big Pharma feeds controversy by routing big bucks to private CME

While pharma's gifts to physicians have dropped off thanks to the Sunshine Act, Big Pharma's undisclosed funding of continuing education for physicians remains a source of contention.

A recent investigation by The Boston Globe found that the largest chunk of money is spent on independent companies who provide physician training. The funding of those companies, which pay doctors to speak at events and conferences, has increased 25% since 2011, from $248 million to $311 million last year, the newspaper reported, citing Accreditation Council for Continuing Medical Education annual reports.

Pharma also gave $157 million to medical schools, $128 million to professional physician societies and $34 million to hospitals for continuing education efforts--a total of more than $630 million. However, both medical schools and hospitals numbers declined since 2011. In total, more than 40% of the 1,900-plus accredited continuing education providers "rely on drug company money to defray the cost of their courses," the article reports.

Opinions on whether the payments are ethical is split, with opposing sides each taking a strong stance.

University of Michigan's Dr. Paul Lichter

"To be blunt, this is just government-sanctioned money laundering," said Dr. Paul Lichter, a University of Michigan ophthalmologist who heads the medical school's conflict of interest committee. "Companies are making it appear charitable, but it's clearly to influence physicians to prescribe expensive drugs and order expensive tests."

A hotel workers union agrees, in an odd sort of bite-the-hand-that-feeds-you move, given that most live CME events are held at hotels. Unite Here, which represents 270,000 workers, has started a campaign to stop Big Pharma funding of CME courses, dubbed "No More Drug Money." The union says the payments unduly influence doctors and contribute to rising healthcare costs.

On the other side, Dr. Graham McMahon, the president and chief executive of the Accreditation Council for Continuing Medical Education and former continuing ed dean at Harvard Medical School, said, "Investment by industry is safe, and commercial bias is minimized to as close to zero as we can possibly get it. The intended purpose of accreditation is to give attendees the reassurance that they are not being subjected to promotion and marketing."

Continuing ed money to physicians has also been the subject of controversy in the 21st Century Cures Act, recently passed by the House of Representatives and moved on to the Senate, with different groups coming down on opposing sides over an amendment in the act that exempts continuing medical education expenses, including speaker fees, travel expenses, tuition and medical books. The non-profit group Public Citizen called the exemptions "irrational" and wrote in a May letter to Congress that "exempting them from reporting would seriously undermine the intended benefits of the Physician Payment Sunshine Act."

- read the Globe article

Special Report: Top 10 drug brands by payments to doctors