CONTINUING MEDICAL EDUCATION
provider asks Pharm Inc., along with several other drug manufacturers, to
fund the CME event. Knowing that the CME program concerns a topic for
which one of the company’s drugs is an effective treatment, Pharm Inc.
gladly funds the program. It does not, however, plan any CME content.
Under the ACCME Standards for Commercial Support, this interaction is
acceptable. 100 At the topic selection phase, the CME provider approached
Pharm Inc., and Pharm Inc. provided its thoughts without requiring the
CME provider to pursue the topic it suggested. At the CME planning
phases, the CME provider approached Pharm Inc. about funding and Pharm
Inc. provided funding knowing that Cholesteran, or at least Cholesteran’s
class of drugs, would likely be mentioned without requiring the CME
provider to mention such information.
Even though Pharm Inc. did not require the CME provider to do
anything, the company influenced the CME provider by providing input and
financial support. The CME provider planned the CME event about
treatments for childhood obesity knowing that Pharm Inc. would likely fund
the program. This exemplifies how CME programs cover topics that
support drug and device-based treatments without explicit direction from
drug and device companies. Moreover, the CME provider is more likely to
include information about its commercial supporters’ products, including
Pharm Inc.’s Cholesteran, knowing that Pharm Inc. otherwise might not
support the CME provider’s next CME activity. CME providers, whether
not-for-profit medical organizations or for-profit commercial companies,
depend on the funding they receive from industry for their continued
success. CME providers instead seek to develop long-term relationships
with commercial supporters. 101
Conflicts of interest are particularly problematic at the topic selection
and funding solicitation stages with medical education and communications
companies (MECCs). MECCs are for-profit companies that advertise their
programming to the drug industry to obtain commercial support. 102 Drug
and device companies often hire MECCs to organize meetings, find
speakers for conferences or lectures, and develop enduring materials. 103
Often located in close proximity to the headquarters of major
pharmaceutical and device companies, MECCs solicit funds from the
pharmaceutical industry to put on various educational activities. 104 As
Steven E. Nissen, M. D., Chairman of the Department of Cardiovascular
100. See ACCME STANDARDS FOR COMMERCIAL SUPPORT, supra note 10, at 3.
101. See id.
102. BRODY, supra note 26, at 209.
103. INST. OF MED., supra note 1, at 67.
104. See Nissen Testimony, supra note 11.