Healthy Skepticism Library item: 16161

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Publication type: news

Gever J.
ACCME to Broaden Firewall Between Industry and Medical Education
MedPage Today 2009 Jul 30
http://www.medpagetoday.com/PublicHealthPolicy/Ethics/15323

Full text:

CME in the U.S. is not influenced by industry, the head of the Accreditation Council for Continuing Medical Education (ACCME) told senators at a Capitol Hill hearing.
But the organization is nevertheless considering a range of proposals to put more distance between commercial interests and CME, said Murray Kopelow, MD, ACCME’s chief executive.

Dr. Kopelow was the last witness to appear yesterday before the Senate Committee on Aging. Earlier in the hearing, several prominent physicians were strongly critical of industry funding of CME.

Departing from his prepared remarks, Dr. Kopelow responded to one critic directly, saying, “ACCME is the firewall between industry and medical education. Accredited CME is free of influence from commercial interests.”

Although industry funding for CME totaled more than $1 billion in 2008, as stated by committee chairman Herbert Kohl (D-Wis.), the total was $200 million less than the previous year, Dr. Kopelow noted.

He provided data showing that industry’s share of total CME funding has increased only modestly since 1998.

That year, commercial support accounted for 34% of total CME income by providers accredited by ACCME. By 2008, the percentage had risen to 44%.

Dr. Kopelow also outlined steps that the organization has taken and is considering to prevent commercial interests from biasing CME.

He said ACCME has stepped up its enforcement activities, putting greater scrutiny on providers that receive large amounts of commercial support.

He noted that about 80% of industry funding goes to just 15% of CME providers.

Dr. Kopelow also reported that the group is starting a surveillance and monitoring system under which ACCME staff will personally observe CME activities in the field.

The organization is boosting staff by 50% and expenditures by 60% over 2007 levels, he said — funded by new fees levied within the CME system.

Providers that are found not in compliance with standards, he added, must now submit an improvement plan within weeks of notification, and must demonstrate compliance within six or 12 months.

The 47 state medical societies that accredit more than two-thirds of CME providers nationally are now applying the same ACCME-set standards, “creating equivalency of enforcement,” Dr. Kopelow said.

In the coming months, he added, the ACCME will begin making public the accreditation status of providers, whether they take commercial support, and the findings on which accreditation decisions were made.

The ACCME is also set to “exclude from accreditation any entity that markets, resells, or distributes healthcare products or services,” he said.

Dr. Kopelow also ticked off several proposals for additional restrictions on commercial support for CME now under consideration.

One would ban commercial support from accredited CME unless it meets all of the following criteria:

Educational need is verified by an independent entity free of commercial support
The activity addresses a gap in professional practice
Content is from a specified curriculum
The activity is verified as free from commercial bias
Another proposal would block people from controlling CME content if they have been paid to create or present promotional materials.

Still another would create a new organization to collect and pool unrestricted educational donations from industry to be disbursed to CME providers.

The ACCME may also issue formal designations such as “Commercial Support Free” to identify CME activities that do not have industry funding.

“We have not yet acted on these proposals,” Dr. Kopelow stressed.

“They remain on the table while a nationwide discussion about the impact of industry relationships continues within many other organizations, including the ACCME’s member organizations,” Dr. Kopelow said.

He did not indicate how long he expected that process to take.