CONTINUING MEDICAL EDUCATION
commercial medical firms, insurers, medical facilities, and possibly even
physicians.171 A federal authority would then allocate the funds raised from
the tax to government certified not-for-profits that would distribute the
funds to independent CME providers.172 Drug and device companies would
be prohibited from donating funds to CME providers, even indirectly.173
The tax would earn enough revenue for CME activities, eliminating the
demand for Industry support.174
This novel proposal calls for a fundamental shift in the way CME is
funded, created, and monitored.175 It would place much of the burden of
funding CME on drug and device manufacturers, which would either absorb
the cost or pass the cost onto payors ( i.e., insurers and individuals).176 The
overall cost to the public, however, would likely be relatively small.177 On
the other hand, increasing taxes in this political climate is arguably less
feasible. The public-private committee discussed above could be charged
with locating more consistent and reliable sources of alternative funding.
Still, the CME tax is a viable option Congress should consider
The current state of CME regulation is complex and inefficient. The
entity in the best position to eliminate industry bias – the ACCME – has
relatively weak accreditation standards that still allow commercial sponsors
to influence CME content. Moreover, the ACCME does not strictly enforce
its own standards. Other guidelines that go further than the ACCME
Standards for Commercial Support are only voluntary or limited in scope.
Although the medical community is hesitant to reduce or eliminate industry
support because of concern over how CME providers would make up the
lost funding, other funding mechanisms exist.
If the medical community and the federal and state government wish to
eliminate commercial bias from CME, thereby improving the overall
171. Rodwin, supra note 10, at 812.
174. Id. at 813.
175. For additional reading on the CME tax, see MARC A. RODWIN, CONFLICTS OF
INTEREST AND THE FUTURE OF MEDICINE: THE UNITED STATES, FRANCE, AND JAPAN (Feb.
176. Rodwin, supra note 10, at 813.
177. Id. (estimating that, based on country’s health care spending in 2008 and annual
industry support for CME of $2 million, the cost to the public would be approximately $6.58