Separating Continuing Medical Education From Pharmaceutical Marketing http://jama.jamanetwork.com/article.aspx?articleid=193743

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.” 

Article published in BMJ, one of the top five English medical Journals, expose that CME (continuing medical education) is in reality a sales pitch.  This point has been repeatedly made by top professors who have gone public exposing the corruption worked by industry upon the medical field.  Another of Ray Moynihan that refers to the insider Kimberly Elliot’s in the  BMJ is at file:///C:/Users/My%20Computer/Desktop/Bad-Pharma-RC/Key%20opinion%20leaders%20-%20%20independent%20experts%20or%20drug%20%20%20representatives%20in%20disguise.pdf

Feature Drug marketing

Key opinion leaders: independent experts or drug representatives in disguise?

http://www.bmj.com/content/336/7658/1402

Ray Moynihan examines the role of the influential experts paid by industry to help “educate” the profession and the public.

In the world of medicine, “key opinion leader” is the somewhat Orwellian term used to describe the senior doctors who help drug companies sell drugs.  These influential doctors are engaged by industry to advise on marketing and help boost sales of new medicines. Across all specialties, in hospitals and universities everywhere, many leading specialists are being paid generous fees to peddle influence on behalf of the world’s biggest drug companies.

Kimberly Elliott, who was a drug company sales representative for almost two decades in the United States, puts it directly. “Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations,” she said. “If that speaker didn’t make the impact the company was looking for, then you wouldn’t invite them back.”

From the age of 23, Ms. Elliott worked for several global drug companies, including Westwood Squibb, SmithKline Beecham, and Novartis, leaving the industry 18 years later, only last year. Many times a top national salesperson, part of her job was developing relationships with local and national opinion leaders, also described as “thought leaders.” Ms Elliott says she would pay these respected doctors $2500 (£1280; €1610) for a single lecture, which was largely based on slides supplied by the company. Sometimes the company would pay the fee to an academic centre, which would then pay the doctor. “These people are paid a …

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 http://healthfully.org/index/id9.html, or http://content.nejm.org/cgi/content/short/358/3/252