Continuing medical education (CME) programs are largely funded and controlled by pharmaceutical companies. They function as marketing vehicles disguised as education, systematically biasing physician prescribing toward promoted drugs.

The CME Problem

Continuing medical education is required for physician licensure in the United States. Physicians must complete a certain number of CME hours per year to maintain their licenses. This creates a captive audience for pharmaceutical marketing.

Approximately 60% of CME in the United States is funded by pharmaceutical companies. This funding comes with strings attached: companies fund CME on topics relevant to their products, and they influence the content of the programs.

How Industry Influences CME

Speaker selection: Companies fund CME programs featuring speakers who are favorable to their products. Speakers who are critical of company products are not invited.

Content control: Companies provide "educational grants" to CME providers, with the understanding that the content will be favorable to their products.

Symposia at conferences: Companies fund symposia at major medical conferences. These symposia are often indistinguishable from regular conference sessions but are controlled by the company.

Physicians who attend industry-funded CME are significantly more likely to prescribe the promoted drug — even when the drug is inferior to alternatives. The influence is real and measurable.

Online CME: Companies fund online CME modules that promote their products. These modules are often presented as independent education but are designed to increase prescribing.

The Evidence of Influence

Multiple studies have demonstrated that industry-funded CME influences physician prescribing:

  • A 2010 study found that physicians who attended industry-funded CME were significantly more likely to prescribe the promoted drug
  • A 2011 study found that restricting industry funding of CME reduced prescribing of promoted drugs
  • A systematic review found consistent evidence that industry-funded CME increases prescribing of promoted drugs

What Independent CME Looks Like

Independent CME — funded by government, universities, or professional societies without industry support — is available but less common. The Therapeutics Letter (University of British Columbia) and the NPS MedicineWise (Australia) are examples of independent prescribing information.

What Physicians Can Do

Physicians who want to prescribe based on evidence should:

  • Prefer CME funded by independent sources
  • Be skeptical of CME funded by pharmaceutical companies
  • Use independent prescribing information (Cochrane reviews, Therapeutics Letter)
  • Disclose and minimize financial relationships with industry