The eagerly awaited (by me, anyway) ACCME 2005 Annual Report Data is available online (pdf). I haven’t had a chance to look at it yet, and am very curious about the most recent data. Depending on who I talk with, commercial support has either dried up completely or is going great guns. This should be interesting.

You’ve probably heard about the flap in JAMA over an article it published on the use of antidepressants in pregnant women, where many of the researchers had ties to antidepressant makers. Today I ran across this editorial, which says the researchers also took their show on the road:

It wasn’t enough for Dr. Cohen and his friends to author the study while covering up payments that may have clouded the authors’ view of the facts, however. They took their show on the road. One of my favorites was titled “Continuing Medical Education You Can Trust,” sponsored by Harvard.

That’s the gist of this article from MedAdNews. Through social networking tools like blogs, people are already talking about healthcare issues, but the pharmaceutical industry’s voice is curiously absent from the conversation. I agree wholeheartedly with this statement:

The use of social and interactive technology has put the customer in control of the message. Online communities and blogs allow the public to discuss and debate health concerns and the medicines that treat them. The industry must stop hiding behind its fear of regulatory hurdles and begin thinking about how to get involved in the interactive space.

I doubt it will happen, though. There’s too much fear involved to allow unfettered speech on pharma’s part, which I think is a darn shame.

From Anne Taylor-Vaisey:

An article by Dr. Jerome Kassirer was just published in the July 2006 supplement of the Journal of Pediatrics:

 

Kassirer JP. J Pediatr. When physician-industry interactions go awry. J Pediatr 2006 Jul;149(1S):S43-S46.

 

This article is based on Dr. Kassirer’s testimony before the Subcommittee on Health of the House Committee on Ways and Means, July 2005. Link to his full testimony and the abstract of the current article here.

Here’s an interesting editorial exploring the other side of conflicts of interest among researchers with ties to companies. A snip:

Over the past two decades, private biotechnology firms and other drug companies have increasingly played a major role in cutting-edge medical research. These companies have built relationships with many of the best and brightest academic scientists, helping to bring about huge advances in medical treatment, including powerful new hormones and anti-cancer drugs as well as new devices that repair heart damage.



But they have also drawn scrutiny from those who believe that, with so much money at stake, corruption must surely be present. Instead of assuming that scientists would want, above all, to protect their reputations and their research, critics have assumed the worst — and have underestimated the positive impact of relationships between university researchers and companies.

You know all those cute direct-to-consumer ads (the toe fungus one makes my skin crawl every time I see it)? According to this article, docs are fighting back, saying that they don’t have enough time to “learn about the benefits and risks of a new drug before patients start requesting prescriptions.” The American Medical Association last month asked the FDA to put a moratorium on advertising new drugs to consumers until a certain time period has passed, which would probably help. As the article says,

“Doctors just want to make sure they have a chance to get up to speed on new drugs before the patients are being urged to seek these medications because of heavy advertising,” said Dr. Ron Davis, the association’s president-elect.

The American Medical Association is looking for a few good case studies to include in this year’s case-based session at the Annual Conference of the National Task Force on CME

Provider/ Industry Conference. This session is called “Working Together within the Guidelines:

Interactive Case Studies.”  From an AMA e-mail alert:

As in previous years, featured panelists in this session will represent the perspectives of the ACCME, AMA, FDA, PhRMA and OIG

and will address specific cases related to compliance, and will interact   with conference participants through the use of an audience response system.

 

In order to  develop the most current and relevant case studies, we would like to invite you to submit any challenges and/or interesting situations  that you have encountered as you navigate the guidelines and requirements in CME provider/industry collaboration.  If you are interested in submitting a case, or a situation that may be developed into a case,  please e-mail it to kevin.heffernan@ama-assn.org no later than July 31, 2006.

 

This year’s conference will be held October 16-18 in Baltimore.  To register, or obtain more information, click here.

That’s what the recent issue of Pharma Marketing News (link to pdf download) explores. While it doesn’t come up with a whole lot of new answers—I think we’re all waiting for the latest ACCME data report—it does have this to say:

Although the total amount of pharma spending on CME increased in 2004 as compared to 2003, the percentage of CME income attributable to pharma has decreased and shifted away from MECCs to schools of medicine. The2005 ACCME data—due to be released soon—is expected to reveal that the absolute dollar amount of pharma CME dollars has decreased somewhat.

Well, let’s wait and see. From what I hear, some CME providers are doing better than ever with commercial support, while others are struggling, so I guess your perception of how the market is doing really is what counts. Still, I’ll be curious to see what shakes out in the ACCME data.

As one might expect they would. This article in PLoS Medicine ends with this conclusion:

The primary obligation of industry is to make money for its stockholders. The primary obligation of journals should be to physicians and their patients, who depend on the accuracy of information within these publications. Medical journals should not accept advertisements from pharmaceutical companies, medical device companies, or other industries “relevant to medicine.”

Not surprisingly, journal publishers are not too keen on this idea. In this article:

John Kamp, executive director of the Coalition for Healthcare Communication, called the study‘s proposed ban on advertising a “goofy” idea, stating the study‘s authors should instead thank drug companies for supporting robust medical journal independence.

“PLoS Medicine needs to take a basic course in the First Amendment and the history of American journalism,” he said. “Journals advance the science of medicine and play a critical role in the diffusion of innovation in clinical treatment, mostly at the expense of the drug industry. What the drug industry gets in the bargain is access to prescribers and the opportunity to be kicked around routinely by fiercely independent journal editors. For all its perceived faults, it’s a great system that benefits doctors and their patients.”

Check this one out: Big Pharma’s Nurse Will See You Now. The subtitle is: Drug companies are hiring RNs to educate patients — and boost marketing. Interesting:

the nursing programs are attractive to the drugmakers because they help hold patients to the recommended drug regimen. Patients with progressive illnesses such as MS and diabetes are supposed to stay on medicines for their whole lives, but many quit because they feel no symptoms, or because the therapy adds to their discomfort. Jaideep Bajaj, a Princeton (N.J.) managing director at medical marketing consultant ZS Associates, estimates that this sort of patient noncompliance may deprive the drug industry of $30 billion in sales each year. The nurses, in short, serve companies and patients alike. “In principle, this sounds like a win-win situation,” says George J. Annas, a professor of health law and bioethics at Boston University’s School of Public Health.

Of course, the fact that they get paid a lot more to do this than they would at a regular nursing job won’t help with the growing nursing shortage, and probably adds to the cost of the drugs. Where does this fit on the conflict of interest scale?