Pharmaguy's Insights Into Drug Industry News
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Pharmaguy curates and provides insights into selected drug industry news and issues.
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Pharma Commercial Support of Accredited CME Programs Rose About 3% in 2016

Pharma Commercial Support of Accredited CME Programs Rose About 3% in 2016 | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The pharmaceutical industry spent more on accredited continuing medical education in 2016 than it did in 2015, with spending hitting $704 million last year, up from $693 million in 2015 — a 1.5% increase.

 

[Note: If you include advertising and exhibit income - almost all of which is paid by pharma - then the year-over-year increase is more like 2.9%.]

 

In 2016, about one-quarter — 28% — of all CME investment came from the phama industry, according to an annual report from the Accreditation Council for Continuing Medical Education (ACCME).

 

Investment in CME from advertising and exhibits also increased modestly, by 3% over the same year-over-year period, CME providers reported.

 

Overall investment in CME programs increased slightly to $2.5 billion in 2016, up from $2.4 billion in 2015, and the number of CME events also rose in 2016 by 7%. More than half, or 54%, of all revenue generated by CME programs came from registration fees.

 

CME providers increasingly took their programming to live online formats this year, with 17% more of those kind of activities reported in 2016 compared to 2015.

 

Further Reading:

  • “Industry-funded Testosterone CME Courses Downplay Risks, Lead to Overuse in Older Men”; http://sco.lt/5eex9t
Pharma Guy's insight:

At its height in 2003, pharma support of CME totaled $971 million. Today, pharma's support is only 73% of what it was back then. Unless the increase in support picks up dramatically, it may be a very long time before we see numbers like those in 2003.

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21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act

21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Tucked into the 21st Century Cures legislation that was negotiated by the House and Senate late last week is a controversial provision to exempt companies from reporting payments made to doctors for receiving continuing medical education sessions, medical journals, or textbooks.

 

The move — which has sparked objections from Senator Chuck Grassley (R-Iowa) — is the latest in a long-running attempt to roll back requirements for reporting such payments to a federal database that tracks financial relationships between companies and physicians.

 

Known as OpenPayments, the database was launched in 2014 in response to concerns that financial ties between drug and device makers and doctors may unduly influence medical practice and research. It was included in the Sunshine Act provision in the Affordable Care Act. As we noted previously, an analysis earlier this year found that payments can affect prescription rates.

 

Grassley, who was instrumental in pushing legislation that led to the database, may try to place a hold on the bill “unless this provision is removed,” he said in a statement. “The Sunshine Act brings transparency to a big part of the health care system for public benefit. Transparency brings accountability wherever it’s applied. With taxpayers and patients paying billions of dollars for prescription drugs and medical devices, and prices exploding, disclosure of company payments to doctors makes more sense than ever.”

 

Drug company payments have effect on prescription rates, analysis finds

Consumer groups are echoing this sentiment. “In a time of increasing concern about drug prices and spending, it would be unwise to reduce transparency about the financial relationships associated with drug promotion,” said Allan Coukell, senior director for health programs at the Pew Charitable Trusts (the language can be found in section 4009).

Pharma Guy's insight:

Massachusetts Senator Elizabeth Warren also objected to a provision that would allow drug companies to avoid disclosing fees paid to doctors for continuing medical education, medical journals, or textbooks. Warren tore into the package late yesterday on the Senate floor, saying “I will fight it because I know the difference between compromise and extortion.”

 

Related article: “21st Century Cures Bill Hides CME Payments & Allows Off-Label Promotion”; http://sco.lt/62vgQr

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AMA & Many Other Physician Groups Lobby to Keep CME Payments Out of the Sunshine

AMA & Many Other Physician Groups Lobby to Keep CME Payments Out of the Sunshine | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Nearly 100 national and state medical societies from around the United States are backing a Senate bill (see “21st Century Cures: Hide CME Payments & Allow Off-Label Promotion”; http://sco.lt/62vgQr) that would exempt drug and device makers from reporting payments made to doctors for receiving continuing medical education, or CME, sessions, medical journals, or textbooks. Among them are the American Medical Association and the American College of Cardiology.

 

The move is the latest push in a long-running effort to roll back requirements for reporting such payments to a federal database, which tracks financial relationships between companies and physicians. Known as OpenPayments, the database was launched in 2014 in response to concerns that financial ties between drug firms and device makers and doctors may unduly influence medical practice and research. It was included in the Sunshine Act provision in the Affordable Care Act. A recent analysis found that payments can affect prescription rates.

 

But more than once over the past few years, the Centers for Medicare and Medicaid Services, which maintains the database, appeared to change its mind on reporting requirements for CME payments, in particular. These payments are made by manufacturers or group purchasing organizations to CME providers, which are either commercial firms or nonprofits that organize courses for physicians.

 

CME has been a particularly controversial issue, with accusations that drug and device companies not only fund the courses but they also tightly control the educational curriculum. Last year, industry support for CME totaled $693 million, a 2 percent rise, from the previous year, according to the latest report from the Accreditation Council for Continuing Medical Education, which regulates CME activities.

 

In late 2014, CMS ultimately decided that reporting CME payments would be required. As far as the agency is concerned, medical information — whether in the form of courses, journals, or textbooks — has value that physicians would otherwise have to pay for themselves. However, the CMS decision prompted a lobbying push by industry and medical societies to eliminate the reporting requirement.

 

The support from the medical societies for the bill, which is called the Protect Continuing Physician Education and Patient Care Act, is hardly surprising. In a letter to US Senator John Barrasso, a Wyoming Republican and a physician who introduced the bill, the medical groups argue, however, that Congress initially intended to create such exemptions and CMS may hurt medical practice.

 

“Passage of this bill is urgently needed to remedy onerous and burdensome reporting obligations imposed by CMS that have already chilled the dissemination of medical textbooks and peer-reviewed medical reprints and journals, and to avert a similar negative impact on access to independent” CME, they wrote to Barrasso in a June 30 letter.

 

“When a company gives a grant to an accredited CME provider, it’s pretty hands off. They’re not supposed to suggest speakers or influence the curriculum, for instance,” said Thomas Sullivan, president of Rockpointe. “So if a company that supports commercial CE has no control (over the use of its grant dollars), I don’t see why that should be reported. Doctors don’t have the direct relationship with the company.”

 

“It’s a stretch to view free textbook and free medical education as being anything other than a benefit to physicians,” said Daniel Carlat, who runs a company that publishes CME newsletters for mental health practitioners. “These are not direct benefits to patients. The only way these would benefit patients is if a drug company gave free books or courses to patients themselves.”

Pharma Guy's insight:

For a closer look at CME funding data, read "For First Time in Seven Years, Pharma Support of CME Increases"; http://bit.ly/1Ctqf8D 

 

As you can see from the charts, most of the increase in CME funding comes from for-profit CME providers - those so-called "hands-off" 3rd parties. With regards to pharma grants to such groups, it's widely understood that pharma's hands remain "off" perhaps the first time, but if the pharma sponsor is not satisfied with the MECC's CME program, then there may not be a second round of funding via that "independent" CME provider.

 

A Pharma Marketing News survey asked respondents if CME activities that accept commercial support from pharmaceutical companies have more bias that activities that don't and what should be done to limit any potential bias. About one third of respondents said that pharma/device companies should cease funding CME courses provided directly by for-profit, third-party companies (eg, medical education and communication companies), but continue paying for courses offered by medical schools, teaching hospitals and medical societies. Another third disagreed and the rest weren't sure. For more, see http://www.surveys.pharma-mkting.com/PharmaCME.htm

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ACCME versus PharmedOut: #Pharma Influence Over CME

ACCME versus PharmedOut: #Pharma Influence Over CME | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Dr. Adriane Fugh-Berman, director of PharmedOut (left): Dr. Graham McMahon, president and CEO of the Accreditation Council for Continuing Medical Education (right)


A long-standing critic of pharmaceutical marketing practices is calling for beefing up accredited continuing medical education standards, after she traded sharply worded commentaries with Dr. Graham McMahon, the Accreditation Council for Continuing Medical Education's president and CEO, in recent issues of a BMJ ethics publication. 


The critic, Dr. Adriane Fugh-Berman, director of PharmedOut, a Georgetown University project that studies how marketing affects pharmaceutical prescribing practices, in December published a letter referring to CME as “commercial medical education,” arguing that the ACCME doesn't track reporting of in-kind support, such as the costs of equipment, hotel rooms or meeting spaces, or advertising and exhibits income.


Calling PharmedOut's accusations “wholly inaccurate,” McMahon countered that, “Despite the authors' rhetoric, they provide no evidence for their claims to suggest that our work to create and maintain independence in CME has been corrupted or maligned,” he said in a statement. 


The dustup followed a viewpoint co-authored by Fugh-Berman that appeared in the June 29 edition of the BMJ's Journal of Medical Ethics. Titled “Hypoactive sexual desire disorder: inventing a disease to sell low libido,” the piece examined what the authors said is one of the latest instances of “disease branding,” whereby drugmakers develop a condition while they are developing a drug for that condition.


In this case, researchers identified multiple industry-funded, accredited CME modules on hypoactive sexual desire disorder in women that took place in advance of the FDA approval in mid-2015 of the drug Addyi (flibanserin), the first prescription medication sanctioned for that condition.


Of the 14 accredited CME modules about hypoactive sexual desire disorder researchers studied, all disclosed funding from BI, the drug's owner at that time, and 12 out of 14 modules had at least one author who had financial ties to BI. 


“There are certainly women who are troubled by low libido, but there is no reliable scientific evidence that hypoactive sexual desire disorder is a real medical condition,” the researchers contended. “Invented diagnoses may outlive the drugs for which they were invented. Although Boehringer Ingelheim did not create hypoactive sexual desire disorder, the company apparently attempted to brand the condition through CME modules available years before the expected launch of flibanserin.”


They concluded their research by calling for serious consideration of banning industry sponsorship of CME.

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AMA Lobbies to Keep CME Payments to Docs Out of the Sunshine

AMA Lobbies to Keep CME Payments to Docs Out of the Sunshine | Pharmaguy's Insights Into Drug Industry News | Scoop.it
A big stream of money from drug industry to doctors remains hidden, despite efforts to increase disclosure of industry influence. The American Medical Association, the biggest Washington lobby for doctors, wants to keep it that way.


Federal law allows pharmaceutical and medical device companies to funnel millions of dollars a year, without disclosure, to doctors who teach continuing education programs. The conduits for the money are independent companies that sponsor medical lectures for doctors. Since 2011, drug industry payments to these outside companies have risen 25 percent, to $311 million in 2014, according to a Boston Globe analysis.


Doctors who deliver the lectures typically receive between $2,000 and $3,000 per appearance.


The biggest lobbying organization for doctors is fighting in Congress to keep those payments out of public view, backing a bill to derail an Obama administration push for more transparency. The lobbying group, the American Medical Association, says disclosure would unfairly stigmatize doctors who are leaders in their fields and deliver lectures on breakthroughs in medicine.


But some physicians say payments to provide medical education have been transformed into a bigger channel to conceal drug company cash.


“To be blunt, this is just government-sanctioned money laundering,” said Dr. Paul Lichter, a University of Michigan ophthalmologist who heads the medical school’s conflict of interest committee. “Companies are making it appear charitable, but it’s clearly to influence physicians to prescribe expensive drugs and order expensive tests.”


Continuing education for doctors has long been underwritten by drug manufacturers who have a direct financial stake in medical decision-making. Industry subsidies help pay speaking stipends for top doctors in their specialties while also keeping costs low for rank-and-file doctors who attend the lectures to maintain professional certification.


Defenders of the system say medical education companies have already pledged, when they get accreditation, that their lectures and classes “were made free of the control of a commercial interest.”

Pharma Guy's insight:

For a closer look at CME funding data, read "For First Time in Seven Years, Pharma Support of CME Increases"; http://bit.ly/1Ctqf8D 


A 2004 Pharma Marketing News survey asked respondents if CME activities that accept commercial support from pharmaceutical companies have more bias that activities that don't and what should be done to limit any potential bias. About one third of respondents said that pharma/device companies should cease funding CME courses provided directly by for-profit, third-party companies (eg, medical education and communication companies), but continue paying for courses offered by medical schools, teaching hospitals and medical societies. Another third disagreed and the rest weren't sure. For more, see http://www.surveys.pharma-mkting.com/PharmaCME.htm 

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christopher cyril's curator insight, August 7, 2015 7:34 AM

For a closer look at CME funding data, read "For First Time in Seven Years, Pharma Support of CME Increases"; http://bit.ly/1Ctqf8D ;

 

A 2004 Pharma Marketing News survey asked respondents if CME activities that accept commercial support from pharmaceutical companies have more bias that activities that don't and what should be done to limit any potential bias. About one third of respondents said that pharma/device companies should cease funding CME courses provided directly by for-profit, third-party companies (eg, medical education and communication companies), but continue paying for courses offered by medical schools, teaching hospitals and medical societies. Another third disagreed and the rest weren't sure. For more, see http://www.surveys.pharma-mkting.com/PharmaCME.htm ;

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21st Century Cures: Hide CME Payments & Allow Off-Label Promotion

21st Century Cures: Hide CME Payments & Allow Off-Label Promotion | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Pharmas efforts to evolve restrictions about offlabel marketing move forward.


Although communication policy about medicines often moves slowly in Washington, two events last week portend advances not seen in decades.


You've no doubt heard about the overwhelming vote in favor of the 21st Century Cures bill, but you may have missed the drama in a New York federal courthouse early in the week. In Washington, the House of Representatives passed a historic medicines bill. In New York, the FDA weakly defended its off-label marketing policies and set up the judge to issue a likely order limiting the FDA's off-label enforcement.  


Taking the Cures bill first, the House voted 344-77 in favor of measures that promise faster cures to American patients by spurring research at the National Institutes of Health, speedier drug and device approvals at the FDA and more robust communication with industry and providers. The next step is the Senate, where the companion bill has thus far languished but will likely be taken up this fall in time for enactment later this year or early next.


Although largely ignored by the popular press, the bill's three communication provisions could well open the door to much more robust communication and marketing by our industries.  


First, the Physician Payment Sunshine Act provision sheds new light on shady interpretations by the Center for Medicare and Medicaid Services on education issues. The amendment, backed primarily by a coalition of medical societies, publishers and others coordinated by the Coalition for Healthcare Communication, was co-sponsored by Reps. Michael Burgess (R-TX) and Peter DeFazio (D-OR). Clarifying the original intent of the Sunshine Act, the provision would exempt from Sunshine-reporting certified CME events and the acceptance by doctors of medical reference texts and journal reprints.


Second, the payer-communication provision would significantly expand long-standing provisions that enable drug sponsors to talk openly with payers about some off-label issues, especially economic and comparative-effectiveness studies. This provision expands both the audience and the scope of the discussion, enabling discussion with “payers and similar entities” and increasing the range of studies that can be discussed.

Pharma Guy's insight:


A prior version of the bill included specific direction for FDA to issue clear guidance with respect to the use of the Internet and social media by industry, recognizing the heavy patient use – and even FDA’s use – of social media and its role in healthcare communications today. But that was dropped from the bill. No worries, Senator Long introduced a stand-alone bill that would force FDA to reverse it's stance and allow the "one-click rule" (if passed). For more on that, go here: http://sco.lt/5Jog8f 


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Medical Meetings Face #Pharma Sponsorship Crisis

Medical Meetings Face #Pharma Sponsorship Crisis | Pharmaguy's Insights Into Drug Industry News | Scoop.it
The medical meetings industry could face 'drastic changes' if pharmaceutical companies clamp down on their sponsorship of doctors.


More stringent regulations in the future could see pharma firms further discouraged from sponsoring doctors and other healthcare professionals to attend conferences.


And Richard Evans, director of NexGen Healthcare Communications, has warned that the industry needs to be prepared to change.


"If pharma stops spending money on sending people to meetings, then those meetings will change drastically," he told the Healthcare Meetings Forum at Park Inn by Radisson.


"If pharma does decide not to support physicians to attend those congresses then they will slowly wither on the vine."


The two-day forum aimed to consider the challenges facing the industry as it is faced with an increasing focus on compliance and financial transparency.


One doctor who addressed the 100 delegates admitted that without support from pharmaceutical companies, lower- and middle-grade healthcare professionals would struggle to afford to attend congresses.


"It is not obvious where else the money can come from - it is not going to come from my training budget," he said.


A representative from a pharmaceutical company told the conference it would depend on the circumstances.


"The budgets aren't changing per se, but we are using them differently. As long as we have a commercial benefit of having an exhibition, we will have an exhibition," he said. "We will sponsor physicians where we can, but if we don't have any products to promote or we don't see any value, we will of course not be sponsoring."


In 2013 Sir Andrew Witty, GlaxoSmithKline's chief executive, announced the company would no longer pay doctors to attend medical conferences or give lectures promoting its drugs.
Pharma Guy's insight:


The pharmaceutical industry supports CME through grants to accredited providers such as medical societies, medical schools and for-profit Medical Education Communications Companies (MECC's). It also helps finance CME through advertising and exhibiting at CME events. I include the latter in my analysis of total pharma support, which decreased slightly (0.6%) in 2013 compared to 2012 (dropping from $1,006,327,936 in 2012 to $999,791,328 in 2013). Advertising and exhibit income, however, increased from $331.6 million in 2012 to $339.8 million in 2013. For more, read Total CME Revenue is Up, But Pharma Support is Down (Again)

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Congress Will Scrap Reporting Exemption for #Pharma Payments for CME/Textbooks from 21st Century Cures Act

Congress Will Scrap Reporting Exemption for #Pharma Payments for CME/Textbooks from 21st Century Cures Act | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Amid intense criticism, lawmakers have removed a controversial provision in the 21st Century Cures Act that would have exempted companies from reporting payments made to doctors for receiving continuing medical education sessions, medical journals, or textbooks (read “21st Century Cures Bill Would Weaken the Sunshine Act Provision in the Affordable Care Act”; http://sco.lt/6655If).

The provision “is not going to be in the bill when it gets to the House floor” on Wednesday for a vote, a spokeswoman for Rep. Diana DeGette, a Democrat from Colorado, wrote us. The change came one day after Sen. Chuck Grassley (R-Iowa) threatened to put a hold on the entire bill unless the language was removed. We asked the House Energy and Commerce Committee for comment and will pass along any reply.

The exemption — which was widely supported by drug and device makers, as well as physicians — was an attempt to roll back requirements for reporting such payments to a federal database that tracks financial relationships between companies and physicians.

Pharma Guy's insight:

Statement of Dr. Michael Carome, Director, Public Citizen’s Health Research Group

 

Nov. 30, 2016

 

Note: Today, the U.S. House of Representatives passed the 21st Century Cures Act. View Public Citizen’s updated summary (PDF) of the dangerous provisions in the legislation.

 

The U.S. House of Representatives, after weeks of secret deliberations, today passed the dangerous 21st Century Cures Act. The bill has been sold erroneously as a commonsense, bipartisan compromise that enables scientific innovation and medical breakthroughs for America. But in reality, the legislation includes a grab bag of goodies for Big Pharma and medical device companies that would undermine requirements for ensuring safe and effective drugs and medical devices.

 

Moreover, many House members were persuaded to support the bill, despite the many harmful provisions, in exchange for promises of increased funding for the National Institutes of Health (NIH). But there is no guarantee that this funding will be appropriated by Congress in future years. Permanently weakening the U.S. Food and Drug Administration in exchange for tenuous promises of increased NIH funding is a bad deal for patients.

 

We urge the Senate to reject this legislation.

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Don’t Keep Pharma Payments in Support of CME Behind a Curtain, Says @Pharmalot

Don’t Keep Pharma Payments in Support of CME Behind a Curtain, Says @Pharmalot | Pharmaguy's Insights Into Drug Industry News | Scoop.it

To keep doctors current on medical issues, drug makers help pay for continuing education. Until now, though, industry has not had to report the value of these sessions to a federal database created in response to mounting concerns that such payments may unduly influence medical research or practice.

 

That is expected to change next year, however, when a new reporting requirement kicks in. And many physicians are pushing back.

 

Already sensitive about financial disclosures about meals and research grants, many doctors are backing a Senate bill to exempt drug and device makers from reporting the value of continuing education, journal reprints, and textbooks provided to physicians. They argue that patients will lose out if companies choose to curtail their financial support when the reporting requirement goes into effect next year. [Fore more on that, read “AMA & Many Other Physician Groups Lobby to Keep CME Payments Out of the Sunshine”; http://sco.lt/9KptUv]

 

“This bill will move us backwards, not forwards in seeking greater transparency in science,” said Paul Thacker, a former US Senate Finance Committee investigator who probed financial ties between industry and physicians and helped craft the law that created the database. “This initiative smells of money coming from industry to prop up biased continuing medical education and industry-supported studies that serve to market drugs to doctors.”

 

As it so happens, health professionals were the largest financial contributors to Barrasso over the last five years, while the pharmaceutical industry was his third-largest financial supporter, according to the Center for Responsive Politics.

 

Will companies cut back on such support because of another reporting requirement? It’s true drug makers and continuing education providers will have more paperwork, because industry support for continuing education is not paid directly to doctors. Instead, values will have to be assigned.

 

The purpose of the database is to provide transparency. Carving out exceptions only keeps information behind a curtain.

Pharma Guy's insight:

Recent data from ACCME (see chart in this post) shows that pharma is increasing it support of CME, which may indicate that the industry believes CME payments will be carved out of the sunshine law.

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ACCME versus PharmedOut: #Pharma Influence Over CME

ACCME versus PharmedOut: #Pharma Influence Over CME | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Dr. Adriane Fugh-Berman, director of PharmedOut (left): Dr. Graham McMahon, president and CEO of the Accreditation Council for Continuing Medical Education (right)

A long-standing critic of pharmaceutical marketing practices is calling for beefing up accredited continuing medical education standards, after she traded sharply worded commentaries with Dr. Graham McMahon, the Accreditation Council for Continuing Medical Education's president and CEO, in recent issues of a BMJ ethics publication. 


The critic, Dr. Adriane Fugh-Berman, director of PharmedOut, a Georgetown University project that studies how marketing affects pharmaceutical prescribing practices, in December published a letter referring to CME as “commercial medical education,” arguing that the ACCME doesn't track reporting of in-kind support, such as the costs of equipment, hotel rooms or meeting spaces, or advertising and exhibits income.


Calling PharmedOut's accusations “wholly inaccurate,” McMahon countered that, “Despite the authors' rhetoric, they provide no evidence for their claims to suggest that our work to create and maintain independence in CME has been corrupted or maligned,” he said in a statement. 


The dustup followed a viewpoint co-authored by Fugh-Berman that appeared in the June 29 edition of the BMJ's Journal of Medical Ethics. Titled “Hypoactive sexual desire disorder: inventing a disease to sell low libido,” the piece examined what the authors said is one of the latest instances of “disease branding,” whereby drugmakers develop a condition while they are developing a drug for that condition.


In this case, researchers identified multiple industry-funded, accredited CME modules on hypoactive sexual desire disorder in women that took place in advance of the FDA approval in mid-2015 of the drug Addyi (flibanserin), the first prescription medication sanctioned for that condition.

Of the 14 accredited CME modules about hypoactive sexual desire disorder researchers studied, all disclosed funding from BI, the drug's owner at that time, and 12 out of 14 modules had at least one author who had financial ties to BI. 

“There are certainly women who are troubled by low libido, but there is no reliable scientific evidence that hypoactive sexual desire disorder is a real medical condition,” the researchers contended. “Invented diagnoses may outlive the drugs for which they were invented. Although Boehringer Ingelheim did not create hypoactive sexual desire disorder, the company apparently attempted to brand the condition through CME modules available years before the expected launch of flibanserin.”


They concluded their research by calling for serious consideration of banning industry sponsorship of CME.

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Industry-funded Testosterone CME Courses Downplay Risks, Lead to Overuse in Older Men

Industry-funded Testosterone CME Courses Downplay Risks, Lead to Overuse in Older Men | Pharmaguy's Insights Into Drug Industry News | Scoop.it
With many universities turning their backs on the funding, and new federal requirements to disclose payments made directly to doctors, drug companies found a way to elude transparency reforms and continue to influence the courses:

Payments increasingly are made to third-party organizations — often for-profit firms — that help create the materials, hire the faculty and put on the courses. Those payments don't have to be disclosed.

Consider it the dark money of medicine.
Pharma Guy's insight:


Even though ACCME data suggest that pharma's support of CME took a nose dive from 2008 through 2012, CME income from "other" sources took up the slack and then some beginning around 2010-2011. Total CME income increased 13.6% from 2011 through 2014, whereas drug industry support dropped about 3% during that time.


Where did this extra money from "other" sources come from?


http://bit.ly/cme7yritch 


According to grant funding reports on drugmaker Eli Lilly’s website, the company sponsored more than 25 testosterone courses from 2011 and 2014, spending more than $1.8 million. Rosenberg maintains that the funding is important for the healthcare system to continue to educate its professionals.


“We should be careful to criticize such a powerful tool in our healthcare arsenal, or to be one-sided in attacking its source of funds without acknowledging the important anti-bias protections that are in place,” Rosenberg wrote.


Men who suffered serious side effects from testosterone prescriptions have a different view of the manufacturers.


http://bit.ly/1WhBRoh 

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Pharma's Hidden CME Payments

Pharma's Hidden CME Payments | Pharmaguy's Insights Into Drug Industry News | Scoop.it
New rules will require manufacturers to report some indirect payments made to physicians for CME activities.


But...


The Centers for Medicare and Medicaid Services updated reporting requirements for continuing medical education, pushing back the deadline for manufacturers to start reporting indirect payments to the Open Payments database by one year.


Drug and medical device manufacturers that pay third-party CME providers to hire physicians for education events are required to report those payments to the CMS if they find out the identify of the doctors who spoke or attended the event within one year.


CME advocates believe that this will mean the majority of CME payments will still remain unreported. Others have said they expect more reporting because manufacturers tend to find out the identify of the speakers.


The indirect payments that meet the new reporting threshold now have to be reported to the CMS starting in 2017 and will eventually be published in the Open Payments database, according to guidance issued by the CMS on Friday. The CMS defines direct payments as transfers of value made directly by the manufacturer to the physician or teaching hospital.


In 2014 the CMS revised reporting requirements for CME payments, removing a carve-out that it had created in the rulemaking process that exempted reporting of CME activities that fit certain categories, such as activities conducted by companies that are accredited by the ACCME, one of the nation's largest accrediting bodies. The revision was criticized by organizations that represent CME providers and drugmakers.


Those groups have advocated in Washington for legislation that would again provide an exemption. The sweeping 21st Century Cures Act that passed 344-77 in the House of Representatives in mid-July would exempt CME payments from reporting.

Pharma Guy's insight:

Also, ACCME's annual report does not break down income from "other" sources, but I suspect that at least some of that income originates from the drug industry through grants made to medical societies and private medical education communication companies (MECCs). These grants may not be included in the  "commercial" support category. For more on that, go here: http://bit.ly/1Ctqf8D 

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Pharma's Seven Year CME Support Itch Is Over!

Pharma's Seven Year CME Support Itch Is Over! | Pharmaguy's Insights Into Drug Industry News | Scoop.it

According to data compiled by the Accreditation Council for Continuing Medical Education (ACCME), the pharmaceutical industry has increased its financial support of CME in 2014 compared to 2013. This is the first time in seven years that Pharma's support has increased.

In the chart below, I plotted the Growth vs. Decline of Pharma CME Support from 1999 through 2014. I include monies paid for advertising and exhibits at CME events and assume 100% of this activity comes from manufacturers (drugs and devices). Based on this, the drug and device industry support for CME has increased by about 3% in 2014 vs. 2013 ($1.031 Bn vs. $1.00 Bn).


Even though the data suggest that pharma's support of CME took a nose dive from 2008 through 2012, CME income from "other" sources took up the slack and then some beginning around 2012. Total CME income increased 13.6% from 2011 through 2014, whereas drug industry support dropped about 3% during that time.

Where did this extra money from "other" sources come from?


Read more here: http://bit.ly/1Ctqf8D 

Pharma Guy's insight:


See the Trends in Pharma Support of CME info graphic here: http://bit.ly/1NTIdS8 

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Las Vegas Chefs Against Pharma Funding of Continuing Medical Education

Las Vegas Chefs Against Pharma Funding of Continuing Medical Education | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Pharmaceutical companies have too much influence on continuing medical education (CME) courses. So argues the national hospitality workers' union, Unite Here, which this week launched a new campaign against the funding of CME courses by "Big Pharma." That funding, it argues, unfairly influences what prescriptions doctors write their patients, which in turn, it says, has increased health care costs for its members, including hotel, casino, and foodservice workers.

"Medical meetings are important to our hospitality industry in Las Vegas and nationally," said Unite Here member Chad Neanover, prep cook at the Margaritaville on the Las Vegas Strip. "We negotiate with our employers to have affordable health care. Unfortunately, this is constantly under attack as health care costs continue to skyrocket and pharmaceutical companies are influencing the medical industry."

According to Unite Here, which cites data from the new Open Payments database -- a federal program that collects and makes public information about financial relationships between the health care industry, physicians, and teaching hospitals -- doctors accepted $4 billion in gifts, cash, and other compensation between 2009 and 2014. Meanwhile, it said, as recently as 2011 pharmaceutical companies spent $736 million on CME courses.

In response to its concerns, Unite Here will spend the summer seeking petition signatures across the United States, encouraging the Accrediting Council for Continuing Medical Education (ACCME) to end CME funding by the pharmaceutical industry.

"ACCME has acknowledged in their own report that 'CME activities funded by commercial interests can be effective in changing physicians' prescribing practices,'" said Levi Pine, medical industry researcher for Unite Here. "The fact that Big Pharma and their drug money have so much influence on our doctors is unethical and problematic."

ACCME Responds

In a response to Unite Here's objections, ACCME said that only 11 percent of CME events receive pharmaceutical funding.

Pharma Guy's insight:


ACCME's response is disingenuous. Even though pharma support for CME has been waning -- according to data through 3013 - About 39% of CME funding comes from the pharmaceutical industry in the form of grants and advertising at CME events. Read "Total CME Revenue is Up, But Pharma Support is Down (Again) in 2013": http://bit.ly/pharmaCME 

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Total CME Revenue is Up, But Pharma Support is Down (Again) in 2013

Total CME Revenue is Up, But Pharma Support is Down (Again) in 2013 | Pharmaguy's Insights Into Drug Industry News | Scoop.it

The Accreditation Council for Continuing Medical Education (ACCME) 2013 Annual Report is out. Here's the data regarding total CME income and breakdown according to source of income.


The pharmaceutical industry supports CME through grants to accredited providers such as medical societies, medical schools and for-profit Medical Education Communications Companies (MECC's). It also helps finance CME through advertising and exhibiting at CME events. I include the latter in my analysis of total pharma support, which decreased slightly (0.6%) in 2013 compared to 2012 (dropping from $1,006,327,936 in 2012 to $999,791,328 in 2013). Advertising and exhibit income increased from #331.6 million in 2012 to $339.8 million in 2013.

Pharma Guy's insight:


Note: the data analyzed in this post include income received by BOTH ACCME-Accredited and ACCME-recognized State-Accredited CME providers.

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