Thursday, June 22, 2006

CME: Promotion vs Education

Pharmaceutical companies provide over half the financial support and funding for continuing medical education (CME) programs. In 2004, the industry spent over $1 Billion to support CME. This does not include the $200 Million or so in advertising and exhibit income that CME providers receive primarily from drug and device manufacturers.

Recently, this largesse has come under scrutiny from numerous sources, including the Senate Finance Committee, which sent a letter to many pharmaceutical companies requesting

"additional information about certain practices. Most notably, as Chairman and Ranking member of the Committee we seek to better understand the role(s) of sales and marketing personnel [emphasis added] in initiating and/or evaluating grants, and the use of grants to provide funding to professional societies or associations and patient advocacy organizations. With respect to the role of sales and marketing personnel in the grant approval process, we are concerned that sales and marketing personnel may influence the awarding of grants in a way that favors those individuals or organizations that are known to advocate use of specific product(s). [emphasis added] With respect to the use of educational grants to fund professional and patient advocacy organizations, we are concerned that such organizations, many of which develop treatment or practice guidelines, may come to rely on such funding to an extent that may compromise their independence. The Committee is also interested in funding provided to academic institutions or state agencies to support the development of practice guidelines or treatment algorithms." (see letters)
In the June issue of Pharma Marketing News, John Kamp, Executive Director, Coalition for Healthcare Communication calls this "regulation by raised eyebrows." Kamp claims that "Virtually everything he's been asking about is clearly illegal and not done by companies -- at least not anymore..."

In other words, the ploy by Grassley reminds some industry supporters of the trick question often asked to entrap unwitting suspects: "So, when did you stop beating your dog?"

"We stopped last year. I mean, yes, we did it [used marketing dollars to fund favorable CME programs] before, but we don't do it any more. [awkward pause] Can I call my lawyers?"
Now, we are supposed to believe that all the CME funding from pharma is handled by research or medical affairs people inside pharmaceutical companies and hence pharma has a purely educational motive for supporting CME.

Although $1 Billion is only a small fraction of the total promotional spend of the industry, it is still a sizeable chunk of dough to shell out with no expectation of return on investment (ie, new scripts for product) and with no involvement by sales and marketing.


Kamp claims that, like pornography, if you look for sales and marketing control of CME funding in enough places, you are likely to find it. Personally, I'm OK with pornography, but what about pedophilia? Where's the line? Anyway, I digress...


You Say ROE, I Say ROI

The industry now talks of "return on education" or ROE rather than return on investment or ROI whenever the measurement of the effectiveness of CME funding comes up. I don't believe they are serious, but let's suppose that they are.


CME is supposed to help physicians provide better medical care. Obviously, part of that is knowing more about new treatments. Another part of providing good medical care is communicating well with patients.

"The ability of physicians to communicate well with patients is one of best skills they could have for treating patients. They are taught much science, but very little communicative skills. A lot of times physicians donĂ‚’t treat as well as they could because they are not listening or communicating as well as they could be." -- Neil Gray, Managing Director, Healthcare Trends & Strategies, LLC and member of the Pharma Marketing Roundtable.
If pharmaceutical companies were really interested in educating physicians to provide better healthcare, then they should support CME that is designed to improve the bedside manner of physicians.

According to Harry Sweeney,
member of the Pharma Marketing Roundtable and CEO/Chief Creative Officer, Dorland Global Health Communications, "there's an awareness in the academic medical community that their graduates'’ bedside manner is terrible! Several of them have inaugurated bedside manner courses."

So, will pharma companies pay attention to this "unmet medical need?" Sounds like Kamp doesn't think so: "It's important, but I don'’t know if pharmaceutical companies will be paying a lot of attention to it."




You can read more about this topic in the article "
Trends in Commercial Support of CME", which appears in this month's Pharma Marketing News. Also see more blog posts related to Physician Sales and Marketing.

2 comments:

  1. Doctors do need more help with their bedside manners, especially with the way medicine has become too technology- and business-driven.

    As for the senate finance committee request - they're simply rehashing what the OIG guidance said in its 2004 documentation for pharma manufacturer's compliance. Companies that have responded to the risk areas and "suspect activities" should not be surprised at this request and should in fact be prepared to prove that they have complied and are complying to remove promotional pressures from funding of both education and research activities.

    Using your beating of the dog analogy, what we're seeing with Grassley etal is just another way of beating a dead horse to make companies "get it."

    As for ROI v. ROE, I see this as "a word by any other name still means the same, although it seems to make people feel and look less guilty." Remember, we're now regulated by perception.

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  2. Its been a 150 years since the synthesis of urea, that propelled the use of hypnotic marketing as an alternative means to interpreting "symptoms". Marketeers have enforced belief in in the purification of "active components", of herbal cures since the 1800's. Their purpose is clear, to sell manufactured "drugs", promote the synthetic chemistry industry, and deny validity to herbal, exercise and meditation approaches to healing. Most important is the denial of percpetion and conversation as key practices in healing. It is sad that medical lobbies (top physicians) continue to deny the role of the psyche (both local and non local) in the perception and diagnosis of symptoms. It is clear that almost all "Pharma selling" MD's are incapable in explaining the interpretive basis for their prescription logic.
    This is also why specific small molecule approaches are denied proper "POSITIONING" in Pharma-influenced clinical trials.

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