Pharma Free: Oregon Docs Ban CME Funding
9 CommentsBy Ed Silverman // March 13th, 2008 // 7:58 am
Two months ago, the Oregon Academy of Family Physicians became only the second state chapter in the national Academy of Family Physicians to adopt a policy of eschewing financial support from pharma. As a result, the 1,300-member group no longer accepts any grants - restricted or unrestricted - for its continuing ed seminars or allows drugmakers to take booths in its exhibit hall during conferences. And there are no pharma ads in its publication. Of course, this may prove to be a financial risk. Who wants their dues to rise, after all? So we asked executive director Kelly Gonzales to tell us how the move has, so far, been received…
Pharmalot: Why did your organization take this step?
Gonzales: It was a little bit of wanting the academy to walk our own talk. We’d like our members to make decisions on medications based on facts and evidence, not on marketing. So it just seemed like we couldn’t have a straight face if we were giving that message to our memberes while, at the same time, we’re taking unrestricted grants. Also, the national organization relies on pharmaceutical support, but a lot of state academies would like to know how much support they get. There are resolutions introduced every year questioning the amount and we’re among the states pushing them on that. So we felt we needed a clean house ourselves. Now, we feel we’re in a better position to confront them.
Pharmalot: Why not reject unrestricted grants instead of all grants?
Gonzales: The affiliation still connotes we’re working with the pharmaceutical industry. If we’re putting on a course that includes a seminar on, say, immunization, and we apply for an unrestricted grant and send out 10 applications, we’re likely to get responses from companies with some interest in immunization. They may not have applied to support the program the year before and may not apply next year. But the implication is that they wanted to support this program, because they have a vested interest.
Pharmalot: Is your group taking a big hit by rejecting financial support?
Gonzales: We’re going to find out. We’re still putting on CME seminars, of course, but as I mentioned, not taking any unrestricted grants, so we’re looking for other financial support. But being pharma-free has actually proven to be a good selling point. We’re attracting interest from some health plans and hospital systems, people we’ve not traditionally approached in the past. It’s more work to get those sources, but there are also electronic medical records companies and insurance companies. So it’s possible.
Pharmalot: So how is it being received so far?
Gonzales: We have our annual conference this coming May (look here for the brochure boasting a pharma-free environment) and I think we’ll do alright. We have just three big continued ed conferences each year. And in the past, maybe a fifth of our exhibitors were pharmaceutical companies. So I don’t think it will have a detrimental affect.
And it’s turning out to be really popular with our members. We haven’t had a huge meeting where a lot of people have shown up yet, so we’ll get a broader view (in May). I have heard our members won’t be unhappy that we won’t have pharmaceutical companies in our exhibit hall this year. But for instance, the med school here puts on week-long course on family medicine and invited us on the first day to address the group about what we’re doing. And when our speaker mentioned that we were now pharma free, the audience broke into spontaneous applause. That was a good indicator.
Hat tip to The Carlat Psychiatry Blog
Former pharma Marketing Exec
This is a brilliant step forward and a great opportunity to shift the focus back to evidenced based decision making. I really hope that they can take the next obvious step and critically review the studies on the drugs they may prescribe for their patient base.
Ed, is there any way you can keep an eye on this? I am particularly interested if after a year or so, prescription writing/habits change in any way. Would be interesting also to poll the patients and see if they notice anything different.
Great piece, thanks,
John
It will be a brilliant step forward when the Academy forces its membership to underwrite the entire cost of the event without seeking outside support…then it it will truly be free of bias…oh, I forgot medical records companies and insurance companies don’t have skin in the healthcare game.
Ed, I would be particularly interested in to know why the OAFP does not seek grants from non-healthcare related foundations, is it too much work?
The thought that accepting unrestricted grants from industry given through a CME provider serves as a “firewall” is ludicrous and former pharma Marketing Exec should know this.
Dan
Over 20 years ago, science, academia, and objectivity became altered due to commercialism. Happened about the same time as the savings and loan scandal.
You know, acts approved by lawmakers can be reversed or discontinued. If that were to occur, it would benefit many more instead of the microscopic pockets in medical communities taking a stance such as this one in this post, which I admire greatly for the stance they have chosen to take for all the right reasons.
Jack2
QUOTE: We’re attracting interest from some health plans and hospital systems, people we’ve not traditionally approached in the past.
Right, so let’s take the most negative view of everyone involved, since that’s what creationg of this restriction implies. Would you rather have doctors learning from pharma companies trying to sell overpriced medications with only modest improvement over existing medicines…or would you rather have doctors learning from insurance companies who profit by denying patients healthcare access (doc visits, procedures, hospital stays, and drugs)? If Oregon want to take the high road and deny all external pharma influence, they should deny ALL external influence, so I hope they don’t take any financial support from insurance companies.
Plus, doesn’t it make sense that CE focuses on new treatments? Pre-existing drugs already got highly detailed coverage, in a little place I like to call medical school.
Jeff
Unrestricted means free from corporate influence which can be blinded by having a neutral Grant Committee. Recently a major pharma company put on a program with aEuropean Expert who trashed their drug. If its unrestricted you pay your money and take your chances.
Former pharma Marketing Exec
John:
I do not see where they are saying that they are still taking pharma money through a third party CME organization. If that is happening then of course it defeats the purpose…
Additionally, we do not know here if in fact they will not take money from “outside interest” or other un related industry.
Yes, there is a bias anywhere you go. That being said, this is still a step in the right direction.
However, I am aware of the concern that Hospital and health care plans can have some influence. But what can they really influence? Will they influence the CME programs to slant towards denying and with holding drugs until it is really really necessary? What benefit would that be? If treatment is withheld or denied (and of course I do understand the obstacles we all face today with our health care providers) than invariably it will be more costly to manage the patient - net result no savings at all.
So, I think we need to be mindful of the slippery slope mentality.
Jack2
Because people don’t have the same health plan their whole life.
Let’s say you have high cholesterol, and you’re 50. Should you’re insurance pay for cholesterol lowering medicines - to save the expense of heart disease later on? Yes. But what if you probably won’t get heart disease until you’re 67ish? This insurance company no longer deals with you and handed you off to medicare? From a purely financial standpoint your insurance company only needs to care about problems that could develop while they insure you - not all problems that will affect you at any point in your life.
I think it’s easy to criticize health insurance companies (probably easier than pharma-companies), and I don’t want to insinuate that this behavior is common. Just that it is possible. If Oregon wants to take the high road, then take the highest road and don’t accept any financial support from anyone. It looks like at this point they’re only considering support from other sources.
Keith
Why did you ask about rejecting unrestricted grants instead of all grants? (question #2)
I was interested in the example of immunization sessions being funded only by companies with a vested interest. The link to their May “pharma free” program shows no sessions on vaccines. In such a dynamic field hopefully future meetings will have updates in this area for the OAFP membership
Ed Silverman
Hi Keith,
I asked that question simply to hear what kind of answer would come back, and because I already knew why they chose to eschew restricted grants.
As to vaccines, I don’t know the answer to that question, which is a good one. Sorry about that.
Thanks for stopping by,
ed