ACCME Poses Four Conditions For Acceptable Industry-Supported CME

The Accreditation Council for Continuing Medical Education is seeking comments on stronger measures to define when industry can help fund physician CME without compromising its independence.

ACCME has been working to restrict industry influence on classes that update health care professionals on medical advances and provide continuing education credits. In July 2007, its board adopted several measures to prevent conflict of interest in CME development, including a directive to providers to devise their own education programs without "advice or guidance, either nuanced or direct," from commercial supporters (¹ (Also see "As Drug Marketing Laws Proliferate In States, PhRMA Rejects Federal Option" - Pink Sheet, 24 Sep, 2007.), p. 8).

Despite those efforts, concerns linger that industry still unduly influences the content and presentation of CME. Thus, the group, which accredits classes that allows professionals to meet their CME requirements, has recently released policy clarifications including what it calls a new "paradigm" for evaluating commercial CME support. It seeks comments on the ideas by Aug. 11.

One approach is to ban industry support of CME altogether, ACCME notes. That option should be debated but "nothing would be worse than the deconstruction of a system without the identification of alternatives."

Accordingly, ACCME proposes a new paradigm in which the key element is that independent organizations, such as government agencies, set the agenda for educational activities.

Under this scenario, industry could continue to support CME, but only if:

The CME is based on educational needs that are identified and verified by organizations, such as government agencies, that do not receive commercial support and are free of financial relationships with industry.

The CME addresses a particular group's professional practice gaps (physician performance, competences and patient outcomes), which are corroborated by bona fide performance measurements of the learners' practice.

CME content is from a curriculum specified by a bona fide organization or entity, such as the American Medical Association or the HHS Agency for Healthcare Research and Quality.

The CME is verified as free of commercial bias.

If these four conditions are met, a company could support an individual CME program or provide funds to a pool that is then distributed to a variety of CME programs, under the proposal.

While ACCME had previously directed that CMS providers design their programs without guidance from commercial sponsors, it now proposes that sponsors be barred from communicating the kind of content they prefer or their internal criteria for providing support.

ACCME also has launched an initiative to increase screening of "high risk" CME firms. These are firms that receive a large percentage of commercial support, whose CME content may need further validation, and that only offer CME with non-accredited organizations.

The 90 providers in this category will be asked to provide additional information about their compliance with ACCME standards.

ACCME also is setting up a database of CME activities and participants. Phase one will provide a description for each meeting provider's activities. Phase two will add data from ACCME monitors' reports on these activities, including input from meeting participants. Phase three will add self-assessment data. Information about provider compliance will be made publicly available.

The Prescription Project released a survey June 18 showing that 52 percent of Americans believe industry gifts have a large or extremely large influence on how physicians make prescribing decisions. Another 26 percent feel such gifts exert a moderate influence. Sixty-eight percent support a requirement for pharmaceutical companies to disclose gifts to physicians.

The figures are based on a survey of 1,009 adults conducted between June 4 and June 8 by ICR. The Prescription Project was formed in early 2007 with a $6 million two-year grant from the Pew Charitable Trust (² (Also see "Sales Reps’ Rx Sampling Could Be Limited Under The “Prescription Project”" - Pink Sheet, 19 Feb, 2007.), p. 25).

- Cathy Dombrowski ([email protected])