Pfizer Eliminating Some–Not All–Financial Support for Physician Courses

Amid ongoing criticism and hoping to quell accusations that it is improperly influencing doctors, New York <"">drug maker Pfizer, is eliminating direct financial support for medical education courses offered by for-profit third-party companies such as medical education and communication companies.

Pfizer said it is ending such payments to avoid the appearance of any conflicts of interest but will continue to fund courses in continuing medical education, or CME, at academic institutions, teaching hospitals, and organizations supported by medical societies. Critics have long argued that industry-supported CME courses for doctors are not purely educational but rather are designed as marketing tools to promote the use of specific medicines developed by the drug makers funding the education.

A 2007 report by the Senate Finance Committee concluded the drug industry used educational grants totaling $1 billion annually to increase the market for their products, including the promotion of drugs for uses not approved by regulators, also known as off-label uses. Off-label drug use is perfectly legal when prescribed at the physician’s discretion. What is illegal is the marketing of drugs by drug makers for drug uses that are not approved by the US Food and Drug Administration (FDA).

“The reason we’re not going to directly support them has to do with mitigating the perception of a conflict of interest, if a direct payment is going from a company like Pfizer to them,” said Cathryn Clary, Pfizer’s vice president of US external medical affairs. The company will honor its existing commitments to CME companies. In 2007, Pfizer spent about $80 million on CME courses offered by companies and nonprofit organizations alike, Clary said. Pfizer began disclosing details of its educational grants on its Web site in May. Eli Lilly and Company began making similar disclosures last year.

Doctors need to attend these courses to keep their medical licenses and a plethora of companies offer such courses to doctors. Drug makers such as Pfizer claim that physician education improves patient care and will “be aligned, in some cases, with our business interests,” Clary said adding that Pfizer supports medical education in therapeutic areas in which Pfizer has some sort of business interest.

Some organizations have worked to ensure course content is “more insulated” from the business interests of those companies funding the education. For instance, Rockpointe Corporation, a for-profit CME provider in Columbia, Maryland has taken steps to minimize drug company bias in its physician courses, according to President Thomas Sullivan. Rockpointe received funding from Pfizer but will not be eligible under the new criteria. Sullivan brought up a good point and questioned whether Pfizer’s recent move would make much of a difference in reducing CME bias, especially in light of the fact that Pfizer will continue to fund nonprofit CME.

Pfizer may continue indirect support for commercial CME companies, as well as through a bit of a loophole: The academic centers and medical associations Pfizer supports may contract with CME companies, which will not receive direct payment from Pfizer. According to Ms. Clary, “The distinction we’re making is we’re not directly paying them.”

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