This weekly column offers opinions on the latest pharmaceutical industry news.
To keep doctors current on medical issues, drug makers help pay for continuing education. Until now, though, industry has not had to report the value of these sessions to a federal database created in response to mounting concerns that such payments may unduly influence medical research or practice.
That is expected to change next year, however, when a new reporting requirement kicks in. And many physicians are pushing back.
Already sensitive about financial disclosures about meals and research grants, many doctors are backing a Senate bill to exempt drug and device makers from reporting the value of continuing education, journal reprints, and textbooks provided to physicians. They argue that patients will lose out if companies choose to curtail their financial support when the reporting requirement goes into effect next year.
More than 100 national and state medical societies recently wrote Senator John Barrasso (R-Wyo.), a physician who introduced the bill, to cheer him on. His legislation, they wrote, would ensure any moves to “promote transparency do not undermine efforts to provide the most up-to-date independent medical knowledge, which improves the quality of care patients receive.”
Their valentine is misguided, though, and the bill should be dismissed.
To be sure, patients certainly do benefit when doctors learn more about new diseases and new treatments. After all, who wouldn’t want their physician to have the latest information about a new drug or device?
But continuing education, which physicians are required to pursue to maintain their licenses, has a checkered past. These programs have been controversial over concerns that drug and device makers not only fund the courses, but have also tightly controlled the educational curriculum to favor their products. In response to such criticism, the Accreditation Council for Continuing Medical Education, which regulates educational activities, has been taking steps to tighten oversight.
As a result, the companies that industry pays to organize continuing educational sessions are supposed to be free to choose the speakers and have an opportunity to influence the curriculum.
“The idea that companies are actually orchestrating big commercial advertising plans for their products really doesn’t pan out,” said John Kamp, who heads the Coalition for Healthcare Communication, a group of ad agencies and medical publishers that supports an exemption for the reporting requirement.
Nonetheless, these educational sessions can still serve as a convenient conduit for marketing medicines, because continuing education remains an important avenue for conveying information about new drugs and new uses for existing drugs, not just new health topics or regulatory policies. This helps explain why industry support for continuing education amounted to $693 million last year, a 2 percent rise over the year before, according to the ACCME. Registration fees paid by physicians funded slightly more than half of these programs.
“This bill will move us backwards, not forwards in seeking greater transparency in science,” said Paul Thacker, a former US Senate Finance Committee investigator who probed financial ties between industry and physicians and helped craft the law that created the database. “This initiative smells of money coming from industry to prop up biased continuing medical education and industry-supported studies that serve to market drugs to doctors.”
As it so happens, health professionals were the largest financial contributors to Barrasso over the last five years, while the pharmaceutical industry was his third-largest financial supporter, according to the Center for Responsive Politics.
A Barrasso spokeswoman did not address the financial backing, but sent us a note saying that he “believes federal policy should encourage the free exchange of medical information, not increase reporting requirements.”
Will companies cut back on such support because of another reporting requirement? It’s true drug makers and continuing education providers will have more paperwork, because industry support for continuing education is not paid directly to doctors. Instead, values will have to be assigned.
But drug and device makers continue to pay for meals and research, and the value of these payments appear in the database. Industry has learned to live with those reporting requirements and likely can adjust to still more.
The reality is that doctors benefit just as much, if not more than, patients. Beyond the licensing requirement, industry support for continuing education, as well as journal reprints and textbooks, help doctors avoid spending more of their own money on such things.
The purpose of the database is to provide transparency. Carving out exceptions only keeps information behind a curtain.