Jacob Goldstein and the Wall Street Journal Blog ran the story on Sloan-Kettering's decision to ban industry funding of CME and generated an entertaining debate in the comments section. I recommend that interested readers take a peek. You'll find the usual polarities in this contentious topic, including both those who cheer on Sloan-Kettering for its ethical stand, and those who warn that this is a dangerous trend and will lead to poorly educated doctors.
But my favorite comment was posted by "Get Real CME Companies," a person who has worked in the CME system for 20 years. The writer's description of how porous the so-called firewall is between drug companies and the "independent" medical education companies that produce the CME is so accurate and trenchant that I can't resist reprinting it below in its entirety:
"I love all the comments by the CME vendors about how great the system is and how the rules require independence. I have never read such a load of crap in my life. Yes, the rules require independence. Who enforces it? If you work in CME you know the answer very well NO ONE. As the recent investigation by the Senate Finance Committee found the ACCME has no teeth whatsover. But more importantly, the rules are loosely structured and basically an entire approach has developed that works around the rules. And it’s not very sophisticated but certainly very devious. Marketing teams will generate a list of medical topics they think are important, things that they supposedly get questions about. Inevitably, certain off-label uses of their product will be on the list because as I said of course they get lots of questions about that. That list of questions or topics will be used by the companies grants department to award grants. Now the CME vendors are very smart folks, it’s an incredibly profitable business. They will submit grants and they will note in the request who the chairperson of the event will be and inevitably it will be the lead investigator from a hot off-label study. It’s a shocker but that grant request will be awarded while hundreds of others will be rejected. So the CME vendors learn over time what exactly they need to do to get the money. Pharma companies don’t need to exercise any control. All the control they need happens right up from when the grant decision is made. It’s a giant game incredibly profitable for pharma and the CME vendors alike. And there is no one minding the store. I have worked in this area for 20 years and what I have seen happen in that time frame makes me sick. CME has become just another marketing tool. Many of the CME vendors are the same companies who do the marketing programs, they just have a CME arm! I applaud Sloan-Kettering. And I applaud this blog for picking it up. I frequently look at about 4 or 5 different pharma related blogs and did not see this anywhere. It’s a great development and I hope it sets a trend. Pharma and CME have had too many years to clean up their act. It’s time for more dramatic change. Please keep focused on this story, it’s huge."