BMJ  2003;326:1163 (31 May), doi:10.1136/bmj.326.7400.1163

News

Drug company sponsorship of education could be replaced at a fraction of its cost

Washington, DC

The head of the main medical education accrediting body in the United States says that many commercially sponsored educational events could be run at a fraction of their cost, without unnecessary extras such as expensive lunches and entertainment.

The chief executive officer of the Accreditation Council for Continuing Medical Education, Dr Murray Kopelow, said, "It's possible that a significant reduction in the amount spent on an educational event would not result in a significant loss in educational opportunity."

More than half of the $1.4bn (£0.9bn; €1.2bn) spent on accredited continuing medical education in the United States is now funded from commercial sources, including drug companies and device manufacturers, and concerns are growing that the boundaries between education and promotion have become blurred.

The powerful accreditation body is currently reviewing the national rules on commercial support, to try to manage the growing entanglement between sponsors and educators and to provide unbiased curricula. The review has made it clear that much commercial support for education is not actually spent on education.

Dr Kopelow, a paediatrician before he became an education executive, cited a recent example of more than $100 000 of commercial support being directed at a two hour long "educational opportunity" for 100 people. "Maybe only $20 000 was spent bringing speakers, hiring the space, and advertising it," he said. "A lot of other funds were spent on amenities, visual aids, more promotion, meals, and entertainment."

He continued: "The quality of the educational opportunity is dependent on how well designed the education is and how well matched it is to the needs of the learners. The quality of the amenities and the meal are not critical to that."

Some institutions have already reduced their dependence on commercial support. At the Chicago Medical School of Finch University of Health Sciences, psychiatrist Frederick Sierles replaced company sponsorship with internal departmental funding when he took over responsibility for education four years ago. "Now we have an annual budget of just on $8000 to cover payments to invited lecturers and speakers," said Dr Sierles, a member of the reform group No Free Lunch, which advocates greater reliance among doctors on unbiased sources of information that are free from commercial influence.

Dr Kopelow contends that commercially supported education can be unbiased, but he welcomes the move to funding that is more independent: "Anything that enhances independence is a valuable development, and that strategy is fulfilled by making an event free of commercial support."

Responding to calls from organisations such as No Free Lunch to move away from drug company funding of education altogether, Dr Kopelow floated the possibility of a "blind trust," whereby companies could contribute to a national pool of funds that are then distributed to educational providers.

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