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April 12, 2021

Industry-Sponsored Speaker Programs—End of the Line?

Author Affiliations
  • 1Brown University, Providence, Rhode Island
  • 2Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Harvard University, Cambridge, Massachusetts
JAMA. 2021;325(18):1835-1836. doi:10.1001/jama.2020.26580
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    3 Comments for this article
    The experience of my nonprofit research center in developing CMEs
    Diana Zuckerman, PhD | National Center for Health Research
    Adashi and Cohen's excellent article shows how difficult it has been to effectively address the problems raised by industry-funded speakers and CMEs. We have personal experience that supports that unfortunate finding. A decade ago our nonprofit research center developed an article for healthcare professionals intended as CME, which was aimed at reducing over-treatment of very early stage breast cancer. That's when we realized that offering a CME costs thousands of dollars and pays nothing to the entity that does all the work. It was obvious that no nonprofit could afford to develop CMEs unless they had a grant to pay the fees demanded by the medical societies or medical schools that were needed to distribute the CME. Fortunately, Medscape agreed to distribute our CME for free, and it was widely used by health professionals. We subsequently went back to Medscape with a proposed CME providing a comprehensive analysis of antibiotics, which they expressed interest in, but when we submitted it to them it was apparently too controversial to offer as a CME, so Medscape published it as an article, but not as a CME. It is apparently not currently available on Medscape.com but you can judge it for yourself by checking it out on our website at http://www.center4research.org/antibiotic-uses-review/ (Just keep in mind that it is now 10 years old).

    The bottom line is that the only entities that can afford to offer written CME are likely to be industry-funded, directly or indirectly. If there are foundations funding unbiased written CMEs, we haven't found them. And as long as that is true, CMEs are rarely going to be a source of unbiased educational information.
    Paul Nelson, MS, MD | Family Health Care, PC retired
    Reigning in industry's manipulation of CME, although significantly important, will only prompt the use of alternate tactics. As Chair of one hospital's and health system's Formulary Committee for 20 years, these tactics required a continuing vigilance as a basis to maintain our credibility. As a reminder, 40% of revenue is allocated to promotion and profit.

    But we should acknowledge its advantages, as demonstrated by a Covid vaccine that is 90%+ effective (appropriately achieving a level of almost all of our commonly used vaccines) that was developed, tested, and distributed in less than 1 year. Remember
    also, we have never had a flu vaccine that was more than 60% effective (viz 50,000-70,000 influenza deaths annually). The national health spending for pharmaceuticals has not increased any faster than health spending generally, 10%. Health Spending was 5.0% of our national economy in 1960, and in 2019 it was 18.0%. We cannot blame industry for our nation's health spending problems.
    Industry-Sponsored Speaker Programs - End of the Line Soon In Sight?
    Pandiyan Natarajan, MBBS, DGO, M.D., M.N.A.M.S. | Professor and Head of the Department of Andrology and Reproductive Medicine, Chettinad Super Specialty Hospital, Rajiv Gandhi Salai, Kelambakkam, Chennai, Tamil Nadu, India- 603103.
    I read with considerable interest the excellent timely article by Adashi and Cohen. I fully endorse their view. However I fail to see the end of the line now. The line seems to be endless at the moment.

    In the COVID era, even webinars which cost much less than conventional CME are often industry-funded or sponsored.

    Industry and academia need each other. Any basic research for transfer to clinical application needs industry support. However this need for each other should be purely professional with checks and balances and not lead to co-mingling of both with conflicts of interest.

    Industry and academia should be like the rails of the train. They need to work together for the train to travel, but they should not meet. If they meet, that will be a disaster. That is what we see now.

    I have run several national and international conferences in the past. Most conferences are profitable ventures for the professional associations. Industry participates in the trade exhibition, exhibits their wares, and contributes to the revenue of the conference. When they start sponsoring academic programs bringing their own speakers, they have crossed the rubicon. There is bound to be dilution of standards.

    To see the end of the line of industry-sponsored speaker programs, professional associations should be proactive and take the first step:

    1. They should not let industry sponsor sessions or bring speakers in to the conferences.
    2. CME programming can be held at universities and colleges instead of in 5-star hotels. This will considerably reduce the cost.
    3. Online webinars which cost much less to organize should be the order of the day. Socializing should be after the conference.

    If we follow these suggestions we will be able to see the end of the line of industry-sponsored speaker programs.