Healthy Skepticism Library item: 13004

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: news

Smith P.
Sponsored education: the debate rages on
Australian Doctor 2008 Mar 5
http://www.australiandoctor.com.au/articles/F8/0C0548F8.asp

Full text:

GP education is under fire. The allegations: drug companies are paying for sponsorship deals that allow them to suggest specialist speakers and even topics at CPD events sold as independent.

Here we get views from both sides. NSW GP Dr Ian Arthur explains his reluctance to attend drug-company-sponsored CPD events. And sexual health physician Dr Terri Foran discusses her experience speaking at education events sponsored by drug companies.

The RACGP says its CPD program is robust — untainted by undue influence. Specialists taking part in GP educational eventsare also angry, claiming the recent media storm has left the impression they take drug company payola, tailoring their presentations in the commercial interests of their backers.

On a slightly different note, the New York Timeshas run an interesting essay on whether prescription drugs should be advertised at all (NB: you may need to register to read the article).

——-

We should pay our own way 5-Mar-2008

NSW GP Dr Ian Arthur discusses his experience of drug – company – sponsored education activities. He ’ s not a fan and argues that GPs should pay for their own education.

I rarely attend drug company sponsored events — about one a year at most. The most recent event I attended was a Saturday afternoon/Sunday morning event organised by Sanofi-Aventis and three out of the four sessions were excellent with very little bias.

But one session was essentially a promotion for the new Karvezide 25.

I rarely attend drug company sponsored events because they are generally thinly veiled marketing exercises of little educational value. I understand that many GPs do attend these events and I’ve been told by some drug reps that they are known as “knife and fork” doctors, as they just stay for dinner and leave.

I actually paid to attend three out of the past educational activities I attended. One excellent event was organised by our local division of general practice but only about eight local GPs turned up; the numbers were boosted by students and registrars. The cost was $100 and it was a Saturday afternoon event with no free dinner.

I think doctors should pay their own way. We are among the best paid people in Australia, with the average GP earning over $200,000 after expenses. We can afford to pay for our own education. If drug companies want to be involved they should support GP divisions as corporate sponsors for education and have no say how the money is spent as long as it is spent on GP education and audited.

There is also excellent online education available now, put together by the RACGP and universities. I recently did a six-hour online interactive program on palliative care in rural Australia — no drug promotion and it earned me 40 CPD points.

In our practice we have a one-hour clinical meeting at lunchtime every two weeks. One meeting is case discussions and the next meeting we invite a guest speaker, such as a physiotherapist, diabetes dietician or wound care specialist, or one of our doctors presents an update on asthma diabetes or similar. Our practice nurses attend the talks as well.

I find these far more useful than an evening function where alcohol is served with blatant drug promotion. I went to one meeting on glitazones and the speaker used a Powerpoint presentation that was little more than a promotion for Avandia.

I would like to see pharmaceutical company promotion of education banned unless it is arm’s length corporate sponsorship of division-based education with no mention of pharmaceutical products.

Dr Arthur is a GP in Coffs Harbour, NSW .

——-

Throwing the educational baby out with the bathwater 5-Mar-2008

Dr Terri Foran is appalled by the implication that presenters at conference s are somehow “ bought off ” by pharmaceutical companies in an attempt to dupe the presumably non-discriminating attendees.

I am writing regarding the issues raised by Mr Ray Moynihan on the Background Briefing program on ABC National last weekend. I must say that I thought it somewhat ironic that what I think was such a biased presentation came from someone who purports to despise potential bias.

I was one of the invited speakers at the most recent Women’s Health Conference on 16 February and have spoken at several of these conferences over the past four years. I was particularly appalled by the implication that presenters at this conference had somehow been “boughtoff” by pharmaceutical companies in a thinly veiled attempt to dupe the presumably non-discriminating attendees.

I want to set the record straight—at least from a personal perspective.

I was asked in late 2007 by the organising committee to address the audience on ‘Modern Contraception— New Developments’. I was not surprised at this invitation since I have a long-standing affiliation with the Research Centre at the RoyalHospital for Women in Randwick and have presented at previous HealthEd Conferences on topics ranging from thrush to PID to contraception. On NONE of these occasions was a particular sponsor mentioned and at no time was I asked to tailor my presentation in any way by either the organising committee or any pharmaceutical company. Of course I was aware that there was sponsorship of the conference generally by a number of different companies since these were displayed by the side of the stage and there were trade displays in the foyeras there have been at every single medical conference I have ever attended both here and overseas

My own presentation was drawn largely from those I have given to previous groups — most recently a pre-examination presentation to RANZCOG registrars. I certainly used trade names in my presentation but would point to the fact that if this was promotion it was certainly equalopportunity! The presentation included discussion of a wide range of different contraceptive methods marketed by various companies— including several which are not yet marketed here at all. My presentation represented, I feel, a balanced discussion of the pros and cons of each method and I would be happy to hold it up for independent scrutiny for obvious bias in favour of any product in particular.

I have never received any payment from HealthEd for any of the presentations I have made at the HealthEd conferences. However, I am involved regularly with several pharmaceutical companies for whom I present at educational sessions and for which I normally receive a small honorarium. With the rare exception of presentations specifically designed to inform clinicians at the launch of a new product, in which case the focus is, I believe, apparent to all, these generally cover broader women’s health topics and I always include discussion of a wide range of treatment options. No company has ever sought to change or influence my presentations — I suspect this is because they would be aware of the response they would get if they did.

I first became aware of this issue when I was contacted by the program’s producer on 29January, who questioned me about my attitude to sponsorship at medical conferences and then asked me about payment and sponsorship of my particular presentation. I truthfully gave her the information above and stated that I felt doctors were discriminating enough to be able to differentiate a sales pitch from a balanced presentation. I also made the point that even when an honorarium was paid to a speaker this was an amount that in most cases did not even cover the research and preparation time required and was certainly not sufficient to buy one’s integrity. Following this conversation I contacted the conference organiser to find out what was going on. He informed me that my session was indeed sponsored but that there was no question as to any influence on the content of the presentation and reiterated the committee’s desire for a balanced approach.

I not only presented at this particular conference but attended a number of other sessions on the day. I have always been impressed as to the high quality of the speakers involved and can only assume that the other 750-odd attendees who regularly attend these conferences are similarly impressed. I honestly did not feel any of the other speakers displayed any particular bias. In fact, in the case of Dr Terry Diamond’s presentation, he specifically addressed the issue of bisphosphonate-induced osteonecrosis of the jaw — an issue I suspect any pharmaceutical company marketing these medications would rather have downplayed. Coincidentally, this issue represents yet another recent media beat-up.

As a practising clinician I depend on my own attendances at various conferences and educational sessions to maintain my clinical currency. Throughout the world these meetings are only made possible through grants from the pharma companies, because of the high organisational costs involved. Without such involvement it would be impossible, for instance, to make international experts available to most Australian clinicians. To suggest the same outcome could be achieved by the colleges or, even more ludicrously, government, is disingenuous. Even on a smaller scale I regularly take off for the evening to present to rural clinicians who are not spoiled by the overabundance of educational opportunities available in the major centres. These are usually organised by the local division but are often pharma-sponsored. I suspect without some degree of sponsorship they would occur much less often — a case of throwing the educational baby out with the bathwater.

Perhaps I am naïve, but I still believe it is possible for pharmaceutical companies to have an ethical relationship with doctors and it has certainly been my experience that this is what they are generally seeking. I resent the constant insinuations from the media that such relationships are by their nature suspect.

Dr Terri Foran is a sexual health physician.