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Continuing Medical Education is Marketing

Separating Continuing Medical Education From Pharmaceutical Marketing

Arnold S. Relman, MD     JAMA. 2001;285(15):2009-2012. doi:10.1001/jama.285.15.2009.

The pharmaceutical industry has gone too far. It is assuming a role in continuing medical education (CME) that is inappropriate for an industry with a vested interest in selling prescription drugs. Worse, many medical educational institutions not only allow the industry's encroachments but also welcome and even solicit pharmaceutical company participation in programs that should be the profession's sole responsibility. As a result, CME is now so closely linked with the marketing of pharmaceuticals that its integrity and credibility are being questioned. The problem is not new, but it has recently grown to alarming proportions.

From first page:  “Consider these pharmaceutical industry practices now common in accredited CME programs, which have the effect of linking financial support of the programs to the marketing objectives of the companies that provide the funding. They may prepare teaching slides and curriculum materials, and they compile lists of possible speakers and indirectly pay for them.  They also subsidize practitioners, medical students, residents, and fellows to attend…. At, or adjacent to, virtually all educational sessions subsidized by industry, sales representatives are allowed to display and promote the company’s products, particularly the products related to the topic of the program…. The true purpose of pharmaceutical support of CME is perhaps most clearly revealed by the growing new industry called Medical Education and Communication Companies (MECC).  These for profit companies now number more than 100 put together educational programs to be presented in hospital grand rounds and in freestanding CME presentations, and they prepare various other teaching materials for physicians.  The MECCs are paid mainly by pharmaceutical companies….“ 

Top article first page:  “The most widely recognized bias is financial.  Guidelines often have become marketing tools for device and pharmaceutical manufacturers… Financial ties between guidelines panel members and the industry is common…. Tricoci et al found that in ACC/AHA guidelines with at least I revision, the number of recommendations increased 48% from the first guidelines to the most recent version.  Most guidelines have one size fits all mentality, and do not hold flexibility or contextualization not the recommendation.  Moreover guidelines are often out of date.” 


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Disclaimer:  The information, facts, and opinions provided here is not a substitute for professional advice.  It only indicates what JK believes, does, or would do.  Always consult your primary care physician for medical advice, diagnosis, and treatment. 

Positive bias averaged 32% (range 11 to 69%) in a NEJM article, 2008.  The study of neuroleptic drugs made a comparison of 74 journal articles to the raw data which was obtained by FOIA (Freedom of Information Act) from the FDA. See, or