Occasionally, a piece of investigative journalism sets into motion processes that strike corrupt business practices at their core. Such an article was published yesterday in the Milwaukee Journal Sentinel, written by John Fauber and Suzanne Rust.
The article is entitled “Drug firms' cash skews doctor classes: Company-funded UW courses often favor medicine, leave out side effects.” It is such a devastating indictment of the corruption inherent in drug company funding of CME that it will become required reading for all those involved in health care policy.
The University of Wisconsin has a huge program of industry funded CME. Why? This is fueled largely by George Mejicano , UW’s associate dean for continuing education. Mejicano, who was profiled by Medical Meetings magazine in 2008, was the driving force behind winning $12.3 million from Pfizer for a CME program on smoking cessation, $3.5 million of which went to UW. Pfizer, of course, markets Chantix, the new smoking cessation drug which is effective but laden with side effects, such as nausea and insomnia, and, potentially, suicidal ideation. These side effects should not necessarily dissuade doctors from prescribing a drug which may ultimately save many lives, but they should be made aware of these risks.
Unfortunately, Fauber and Rust found that the smoking cessation course produced by UW does not even mention Chantix’s side effects. The reporters asked Dr. Mejicano to comment on this and on the fact that the course did not disclose that clinical trials of Chantix excluded patients with common comorbid conditions, such as mental illness and heart disease. Here’s how he responded: “UW's Mejicano said he did not think the side effects or the people excluded from the clinical trials should have been included in the course. He said such courses are rarely comprehensive and are designed to meet selected learning objectives.”
Indeed—and this is precisely the problem with industry funding of CME. The drug companies, via the proxy of various third parties, set the agenda for medical education. That agenda does not include saying bad things about the funder's product. I commend Mejicano’s honesty for essentially admitting this, thought it was apparently an unwitting confession.
The article goes on to profile other UW CME courses, in each case showing how the content is biased in favor of the supporter’s drug. This rogues' gallery includes a course pushing Boehringer Ingelheim's Mirapex for restless leg syndrome and one hawking Bayer’s Yaz and Pfizer’s Xanax XR for premenstrual dysphoric disorder.
I wonder if the American Medical Association, that great defender of industry sponsorship of CME, will respond to this article. Perhaps they can reference it in their new and embarrassing “fact sheets” on CME, which I reviewed here.