Amid increased scrutiny of commercial support for continuing medical education, support from drug and device makers fell 30 percent since 2007 last year, marking the third consecutive annual decline and the lowest level since 2002, according to data from the Accreditation Council for Continuing Medical Education.

Specifically, industry support declined to $830.8 million, considerably below the $1.2 billion reached in 2007, reflecting concerns that CME companies relying on commercial funding are more likely than medical schools and professional physician groups to tolerate industry bias in programming. In June, for instance, delegates to the American Medical Association annual meeting voted to restrict support from entities or individuals that have financial interests in the subject matter (read this).

In general, commercial support generated 37 percent of the $2.2 billion in overall CME funding last year down from 47 percent in 2007. Revenue from advertising and exhibits fell 2 percent, to $276.7 million, although overall CME revenue rose 3 percent due to increased registration fees, which can range up to $50 a credit hour, and allocations from a provider’s parent organization, according to the ACCME (see table 7).

Besides criticism industry funding may unduly influence commercial CME, other factors played a role in the decline, including the economy, stricter rules instituted by the ACCME and fewer new medicines to promote. But CME companies say industry critics deserve the blame. “Some of the restrictions and the criticism have caused money to leave the marketplace,” Tom Sullivan, who runs a CME known as Rockpointe, tells American Medical News. “Big (pharmaceutica)] companies don’t like to get criticized.”

Among those scaling back is the University of Wisconsin School of Medicine and Public Health, where less than 30 percent of proposals for CME industry grants won approval last year, down from 80 percent five years ago. “Commercial support has dropped precipitously. At the high point, it was around $9 million, and now we’re down to $2 million,” associate for continuing professional development George Mejicano tells AmMed News. “We made a policy decision to try to wean ourselves away from commercial support, and we have a strategic goal of further diversifying by 2015.”

For CME companies, generating replacement revenue may be difficult. As AmMed News reminds us, nine in 10 doctors and other health professionals say industry funding raises the risk of biased CME, but only 42 percent are willing to pay higher registration fees to eliminate commercial support. This finding was reported last May in the Archives of Internal Medicine (look here).

Consequently, Danny Carlat, a Massachusetts psychiatrist who runs an accredited CME company that does not take industry funding predicts that commercial support for CME this year and next is likely to decline by 5 percent annually. “The bottom line is that we are in the midst of an overdue correction in the funding structure for CME,” he tells AmMed News. “Doctors are once again taking over funding for their own education.”

pic thx to Jerome Kassirer