GSK, Like Pfizer, Cuts off MECCs

GlaxoSmithKline announced today that it will no longer provide continuing medical education (CME) grants to MECCs, according to Reuters. The drug company's decision, which is part of a new grant policy, is effective immediately. GSK joins Pfizer, which announced its decision to cut off educational grants to MECCs more than a year ago.

GSK also reports that it will fund fewer CME programs and "invite grant applications from approximately 20 medical education providers with a documented track record of developing and delivering high quality medical education programs that have a measurable impact on improved patient health." Invited applicants are limited to unnamed, accredited academic medical centers and national physicians' organizations.

It's been argued here that the move by drug firms to deny grants to MECCs is based on the perception of bias, not actual bias, in MECC-generated CME. In any event, it's bad news for companies like CE Alliance ($225,000), Discovery Communications* ($426,500), Physicians' Education Resource Group ($363,700), Pri-Med Institute ($1,024,773), Research to Practice ($530,000), and Vindico Medical Education ($225,338), which received a total of nearly $2.8 million in grants from GSK in the first half of this year. (Values in parentheses indicate GSK funds to the individual company for the first 2 quarters of 2009.)

According to data from the ACCME, total income for "publishing and education companies" (in other words, MECCs) dropped 20% from 2007 to 2008. The income drop is largely due to the loss of grant support from pharma.

Whether CME leads to positive changes in healthcare delivery remains up for debate. A recent Cochrane review concluded that professional educational meetings, particularly when combining didactic and interactive formats, can improve healthcare delivery and patient outcomes. However, the effect is typically small and similar to that of other types of CME activities, like audit and feeback programs. The effectiveness of CME increases when serious outcomes or less complex behaviors are considered.

* Suspected to be the Discovery Institute of Medical Education.

09/23/09 addendum: According to Daniel Carlat, blanket critic of all pharma-supported CME, GSK will still provide CME grants to invited applicants that partner with MECCs. Carlat ignorantly describes the MECC-cosponsor arrangement as adding another layer to a "money laundering operation." The description, which Carlat appears to be in love with, is simply wrong.

Money laundering refers to methods by which illegally obtained income (eg, from drug trafficking, prostitution) is moved around to disguise its source. There are at least 2 very important ways in which "money laundering" fails to describe pharma-funded CME. First and foremost: Providing educational grants to MECCs or any other organization is not illegal (although on Planet Carlat, it would be). Second: The source of the funding is not hidden; the pharma grantor must be disclosed on CME materials to the program participant. This requirement is stipulated by the ACCME.