Often times, when something is banned, unintended consequences ensue.
And when it comes to industry sponsorship, including free drug samples and pharmaceutical sponsorship of CME, it’s no exception.
In a recent piece, it’s no secret that I’ve thought that doctors continue to be influenced by industry sponsorship. To combat this, there are various forces that advocate banning drug company sponsorship of continuing medical education courses, eliminating free samples, and removing industry presence from medical schools.
But, what are the consequences of doing so? As the ACP’s Bob Doherty writes, “If industry support for CME was to be prohibited, I wonder where the money would come from to allow internists to continue to have access to CME at a price they can afford.” Indeed, it’s likely that patients will be the ultimate ones that will end up paying.
Mr. Doherty also touches upon the issues of free drug samples. Yes, it’s universally recognized as a marketing tool, but many of the poor and uninsured rely on samples to manage their chronic diseases. Although a vast majority of drug classes are available generically, or at Wal-Mart for $4, some aren’t. And as this family physician writes, “doctors and other health care providers [have] to be put in a position where you’re damned if you do – and patients die if you don’t.”
As always, the issue isn’t always clear. Banning drug company involvement appears to be a moral ideal, but at what cost?
Related posts:
- Has the ban on doctors accepting drug company gifts gone too far?
- My take: Bribing patients, Dr. Naturopaths, drug samples
- Do free sample medications really save patients money?
- Will banning drug reps bankrupt caterers?
- Death of the drug rep, and who will take their place?
- Do drug company logos influence medical students?
- Op-ed: Pads, pens, prescriptions
{ 8 comments }
I’m always amazed at this argument made by CME companies that want pharma to sponsor, or drug companies looking for marketing opps.
We demand school teachers do continuing education, but nobody subsidizes them. They pay for it themselves, and they don’t command nearly the income doctors do.
Samples? Just a set up for patients. Free drug samples end up being much more expensive than no samples, and a generic prescription.
Sorry, but whenever I hear doctors complaining about not being able to afford CME without drug companies subsidizing courses, I hear the strains of the smallest violin in the world.
Bad economics, Kevin. Patients and/or insurers pay for CME, either through higher drug/device prices or higher physician fees. Why not get rid of the middleman? I prefer my doctor-patient relationship straight up.
This argument that if drug companies don’t sponsor CME doctors won’t be able to afford or access it is ridiculous. There are innumerable opportunities to earn CME credits without going to conferences sponsored by pharma or going through modules designed by them. The majority of physicians live near an academic medical center. Grand rounds are free and provide CME credits. Journals usually have the opportunity to earn CME. Although they are partially sponsored by pharma, since they are peer-reviewed the influence is likely to be less. Conferences also offer such opportunities.
Did you watch the Super Bowl on TV? Did you do it for free or did you pay your fair share of $billion tab?
If you watched for free, did any ad influence you so much, you lost control and bought a product you did not want?
Most of the critics have irremediable conflicts of interest. So, academics want all CME money to pass through their med school bureaucracy, where the lion share will not end up in CME, but in bureaucrat pockets.
Professional societies know that if CME money is cut off, it will have to go through their journal print advertising.
Some of the opponents provide inferior, non-competitive CME themselves, and would personally profit from a ban on sponsored CME. Their CME often has the bias of anti-medication extremists, and is worthless or misleading.
I suppose I don’t mind the ban on industry-sponsored CME, although I personally think the fears that their will be undue influence on physicians is overblown. Then again, studies do indicate that physicians are influenced by pharma company spending, so there may be something to it.
What bothers me more is the blatant hypocrisy. Doctors are apparently not trusted to keep their patients’ best interests in the forefront in the face of industry CME. At the same time, politicians who ultimately will have more say in the healthcare system have no restrictions on how much money they can take from lobbyists. They can go to all the dinners and trips they want. There sure isn’t any Hippocratic oath either for politicians. I’m no anti-government libertarian, (in fact I would describe myself as a liberal) but this still bothers the hell out of me.
The costs of running an educational seminar are so different for teachers and physicians that the it’s not apples and oranges but apples and watermelons. Additionally, the prerequisite forms for a medical cme are essentially the staten island phone book. Finally, teachers salaries are fixed and cme’s are often funded by the school systems. Teachers’ courses, moreover, lead to advanced degrees which lead to higher salaries. Physicians costs are rising while payments are shrinking for a variety of reasons. The days of the “rich doctor” are over. Perhaps the trial lawyers might subsidize physicians’ cme. After all, they’ve been making a great living off the backs of physicians for years.
It will help patients greatly, and certainly not harm them. It’s ridiculous to suggest this question.
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