Healthy Skepticism Library item: 13914

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Publication type: news

Loftus P.
Pfizer To End Direct Support For Commercial Doctor Courses
CNN Money.com 2008 Jul 2
http://money.cnn.com/news/newsfeeds/articles/djf500/200807020937DOWJONESDJONLINE000389_FORTUNE5.htm

Full text:

Pfizer Inc. hoping to temper criticism that it’s improperly influencing doctors, is eliminating direct financial support for medical-education courses that are offered by third-party companies.

The New York drug giant will continue to fund so-called continuing medical education, or CME, courses at academic institutions, teaching hospitals and those supported by medical societies. But it will no longer directly support CME courses offered by for-profit medical-education and communication companies.

Pfizer said it’s ending the payments to avoid the appearance of any conflicts of interest. Critics have charged that industry-supported CME courses for doctors aren’t purely educational but rather designed to promote use of specific medicines.

A report by the Senate Finance Committee last year concluded the drug industry used educational grants totaling $1 billion annually to increase the market for their products, including the promotion of drugs for uses not approved by regulators.

“The reason we’re not going to directly support them has to do with mitigating the perception of a conflict of interest, if a direct payment is going from a company like Pfizer to them,” Cathryn Clary, vice president of U.S. external medical affairs, told Dow Jones Newswires Tuesday. The company will honor its existing commitments to CME companies.

Pfizer spent a total of about $80 million last year on CME courses offered by companies and non-profit organizations alike, Clary said, with less than half going to for-profit companies. Pfizer began disclosing details of its educational grants on its Website in May. Rival Eli Lilly & Co. began making similar disclosures last year.

The drug industry has taken a series of steps recently to become more transparent about how it does business — often under political pressure. Companies have begun posting details about clinical trials and political contributions on their Websites. Merck & Co. and AstraZeneca PLC in May expressed support for Senate legislation that would require the public disclosure of certain financial relationships between industry and doctors.

Commercial CME courses have become a niche industry. Doctors need to attend these courses in order to keep their medical licenses. Dozens of companies including PDI Inc. offer the courses to doctors.

Pfizer’s rationale for supporting CME has been that physician education will improve patient care, and will “be aligned, in some cases, with our business interests.”

Clary said Pfizer supports medical education in therapeutic areas in which the company has some sort of business interest. But it doesn’t require that the content of courses be about Pfizer products. Recently, some drug makers and CME organizations have taken steps to ensure course content is more insulated from the business interests of the companies funding it.

Pfizer will continue to support academic and medical-society CME because “ their primary mission is patient care,” Clary said.

Pfizer may continue indirect support for commercial CME companies as well. That’s because the academic centers and medical associations that it supports may contract with CME companies, Clary said. “The distinction we’re making is we’re not directly paying them,” she said.

One large grant Pfizer recently made was a $3.4 million contribution to the California Academy of Family Physicians to support a three-year, national medical education campaign aimed at reducing the number of U.S. smokers. Pfizer markets Chantix, a smoking-cessation drug. Participants in the campaign include a medical-education company.

This may be the first time a major drug company has ended direct support for third-party CME companies, said David Davis, senior director of continuing education and improvement at the Association of American Medical Colleges. Other drug companies’ policies couldn’t immediately be verified.

Pfizer is making other changes in its CME procedures, including: initiating a competitive grant review period for grant applicants; supporting financial caps on grant support to ensure more balanced funding; and requiring all grant applicants to meet criteria equivalent to the highest level of accreditation by the Accreditation Council for Continuing Medical Education.

Clary said Pfizer also has hired a new staff of CME grant reviewers, including experts in adult education.

Asked to comment on Pfizer’s move, Sen. Chuck Grassley, ranking member of the Senate Finance Committee, said in a written statement: “My goal is to strengthen the system by shedding light on the financial relationships that exist between industry and medical doctors, medical education programs, medical journals, and medical research…. Public scrutiny can do a lot to bring about necessary reforms.”

Spokespeople for CME trade and accreditation groups couldn’t immediately be reached.