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Executive Summary

The current guidelines governing drug industry sponsorship of continuing medical education (CME) symposia will be considered for possible revisions by a recently formed industry-medical community steering committee. The group's first meeting, a closed session, is scheduled for Sept. 26 in Kansas City. Guidelines on commercial support for continuing medical education programs were issued by the Accreditation Council for Continuing Medical Education in 1984. Those guidelines will serve as the point of departure for the committee's work. Drug industry representatives on the steering committee include: Upjohn Medical Sciences Liaison Education Representative David Lichtenauer; Ciba-Geigy Medical and Professional Communications Executive Director Robert Orsetti and Marion Merrell Dow Professional Education and Scientific Communication Director Lee Yerkes. The 13-member committee is also made up of representatives from universities and medical societies, including the American Medical Association and the Association of American Medical Colleges. The group has not yet chosen a chairman. PMA will also participate on the committee. The association has not yet announced its representative. Although the association is participating in the process, it has no current plans to alter its marketing code with respect to symposia. PMA's marketing code includes a set of principles regarding industry sponsorship of symposia. The association has been reviewing its position regarding promotional activities in the face of potential Capitol Hill criticism. At a May meeting, for example, the association's board adopted the guidelines on industry-physician relations developed by the American College of Physicians ("The Pink Sheet" June 4, T&G-3). The new steering committee will look at the American College of Physicians' guidelines and other pertinent standards as it considers its revisions. The committee recommendations will ultimately be presented to the ACCME for adoption. The committee's current plan is to have a final document by early 1991. The steering committee was established following an Aug. 8-9 conference on industry-sponsored symposia held in Chicago by the American Medical Association and the Association of American Medical Colleges. PMA and individual drug firms participated in the meeting. Upjohn Chairman Theodore Cooper suggested at the August meeting that new guidelines are not needed as much as a renewed commitment to existing standards. A consensus on appropriate industry sponsorship of symposia need not result in new regulations, the Upjohn exec said. "I would hope that...we can reach consensus on the most appropriate way for the medical community and the pharmaceutical industry to continue" working together for patient care. "We need more of the spirit of the enterprise and less of the letter," he said. "Inherent" in calls for more standards "is the idea that industry can't be trusted, charges too much money, and likewise that doctors and the whole health care enterprise cost too much," Cooper continued. "Those of us in the business of continuing medical education need to get together and agree on what guidelines should be implemented and how they should be monitored," he said. "Restraint is required in the continuing education area," Cooper asserted. "Unusual or expensive settings, accompanied by lavish entertainment and expensive gifts, destroy the credibility of the educational effort, irrespective of how good the professional presentations are." While symposia should not become dominated by commercial interests, "it's not the commercial element that's dangerous," Cooper maintained. "Commerce is a fundamental part of everyday life," he said. What is potentially dangerous is "the degree to which CME providers, physicians and institutions allow the educational effort to be based solely on marketing -- not therapeutic or diagnostic considerations."

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