Senate Committee Asks: CME – Higher Learning or Higher Earning?

August 2, 2009

By Carrie S. Martin

Last Wednesday, the Senate Special Committee on Aging held a hearing to discuss the conflicts of interest presented by the funding of continuing medical education (“CME”) by pharmaceutical and medical device companies.  Lewis Morris, Chief Counsel to the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”), testified that industry funding of CME  has increased by more than 300 percent in the last decade and that the pharmaceutical industry spent over a billion dollars on CME-related events in 2007, nearly half of all CME costs.  He said that this funding, however, is not entirely philanthropy:  according to one study, every dollar spent on physician events, like CME, results in over three dollars in increased revenue. 

In order to prevent industry from “co-opting” CME as a marketing tool, Mr. Morris recommended creating an independent CME grant organization, through which funding from industry would be pooled and then distributed by an independent board of experts.  Most panelists on the Aging Committee endorsed the recommendation.  Mr. Morris also recommended that pharmaceutical and medical device companies:

  • Separate grant making functions from sales and marketing;

  • Establish objective criteria for making educational grants to CME providers; and
  • Eliminate any control over the speakers or content of the educational activity.

He acknowledged that the Pharmaceutical Research and Manufacturers of America (“PhRMA”) has already incorporated the first two recommendations into its PhRMA Code and that the Advanced Medical Technology Associates ("AdvaMed") has incorporated some restrictions on CME into its Code of Ethics as well.

The Chairman of the Committee on Aging, Herb Kohl (D-WI), is also a cosponsor of the Physician Payments Sunshine Act (S. 301), which requires industry to report payments and gifts to doctors.  Similar provisions are included in the House tri-committee health reform bill, which also requires disclosure of payments to medical schools and sponsors of continuing medical education programs.  It is conceivable, therefore, that Mr. Morris’s recommended CME “firewall” could make its way into health reform legislation as well.