Is UW's Smoking Cessation CME Course Effective Promotion of Chantix?

I generally believe that, on balance, the drug industry gets pretty good press. That is, there are more favorable stories about Rx drugs (especially new drugs) than unfavorable stories. Unfortunately -- as most PR people will tell you -- it takes an average of seven favorable stories to counteract one unfavorable story.

An unfavorable story about Chantix appeared in yesterday's Milwaukee-Wisconsin Journal Sentinel. The story, entitled "Ads, class ignore drug's downside," was about Pfizer's support for a smoking cessation continuing medical education (CME) course offered through the University of Wisconsin-Madison.

The article claims "None of the side effects are mentioned in the UW continuing education online course, which is paid for by Pfizer. The course directly mentions only Chantix as a first-line treatment, even though the drug is one of seven first-line treatments, according to national guidelines."

There are several problems with this. First of all, I found it difficult to believe that a CME course would mention any drug by brand name as this article implied was done in the UW course. Luckily, I was able to pose as a doctor and register to take the course. The relevant section of the course that mentioned drug treatment options is shown below (please click on it for an enlarged view).

As I suspected, only the generic or scientific names of drugs are used. There is no mention of "Chantix," only "Varenicline," which is the scientific name.

It is true that none of the other first-line drugs approved for smoking cessation was mentioned and the course did not mention side effects. The Clinical Practice Guideline, which the course suggested time and again that I review, does include extensive information about side effects.

The article starts out with "A Pfizer promotional campaign for the controversial drug Chantix - which includes financing a course for doctors through the University of Wisconsin-Madison - has helped the drug dominate the prescription smoking-treatment market while burying mention of its serious side effects."

I suppose the CME course could be part of Pfizer's plan to make physicians more aware of Chantix, and perhaps the ads do not mention the serious side effects that the journalist who wrote this article wished they would mention: "such as suicidal behavior and blackouts." Unfortunately, the FDA does not require Chantix ads to mention these "unproven" side effects, which are "under investigation."

The article also focuses on the amount of money Pfizer has donated for CME at UW: "UW's smoking cessation course is being paid for as part of a $3.5 million grant from Pfizer."

At first, I thought this meant that the entire $3.5 million was spent on this one course, which so far has been taken by 100 physicians plus me. That would mean $35,000 to promote Chantix to each of the 100 physicians who have taken the course to date! Of course, that is ridiculous. Especially when any Tom, Dick, or John (Mack) can register for the course. It would be a lot less expensive to send a sales rep to see each of the 100 doctors 10 times!

But how much of that $3.5 million grant was used for this course?

According to the article, "At UW, drug companies spend about $13 million a year to fund its doctor education courses..." I looked at the CME course catalog (here) and found about 24 courses listed. If each course received an equal slice of the pharma funding pie, then the smoking cessation course would have gotten about $550,000. That means Pfizer has paid ONLY $5,500 per "doctor" taking the course so far. That's still a lot more money than would be needed to send sales reps to each physician ten times!

It seems to me that this kind of CME is not as effective a promotional tool as this article would like us to believe. If every pharma company spent its promotional resources like this, they would all be bankrupt!