Industry spending on continuing medical education in US falls further

BMJ 2012; 345 doi: (Published 07 August 2012) Cite this as: BMJ 2012;345:e5336
  1. Bob Roehr
  1. 1Washington, DC

The drug and medical devices industries’ spending on continuing medical education (CME) activities in the United States has fallen for the fourth consecutive year, shows the latest annual report from the Accreditation Council for Continuing Medical Education.1

The report found that overall industry support for CME was $736m (£470m; €590m) in 2011, a decrease of $94m (11.4%) from 2010. At its peak in 2006 the industry’s contribution to CME spending was a half, but that is down to a third today.

Despite the decline of industry support, the number of CME activities and hours of instruction rose last year, while the number of participants stayed much the same.

Total CME spending peaked in 2007 at $2.69bn then fell with the economic recession. It inched back up to $2.37bn in 2010.

At first glance the $2.35bn spent in 2011 seems to represent a fall in spending from the previous year. But the council report attributes the reduction to a change in the way that contributions in kind, such as use of facilities or equipment, are handled. Rather than estimating the dollar value of those contributions, they must now be described.

CME revenue rose in two areas: advertisement and exhibition fees (7.2%) and fees paid by participants (4.4%), reflecting a trend for doctors to take on more of the direct costs of CME activities.

The report is a compilation of data generated by CME providers accredited by the council and by individual states. A web based data collection system introduced in 2010 has expanded the amount of information and streamlined the process by which it is gathered, as well as allowing for more detailed analysis.

This is the first time in its 14 year history that the report has aggregated state and national statistics. It found that more than 23 million people participated in 132 768 activities provided by 2079 accredited CME providers across the country in 2011.

Hospitals and healthcare delivery systems were the only category of CME providers where the majority were accredited by state agencies rather than the council (39 101 versus 10 872).

The council conducted a more detailed analysis of activities by the providers it directly accredited. It found that 79% of those activities, covering 80% of physician participants, did not receive commercial support. Non-physician participants were slightly more likely (25%) to participate in commercially supported CME.

Medical schools were most dependent on industry for CME funding, receiving “about half of their income from commercial support,” the report said. It added, “About 20% of their activities are commercially supported, and they produce the most overall hours of instruction.”

“Nonprofit physician membership organizations receive the smallest percentage of their revenue from commercial support and produce the smallest percentage of commercially supported activities,” the report said.

But government or military providers were the least likely to receive industry support, with less than 1% of their CME activities receiving commercial funding.


Cite this as: BMJ 2012;345:e5336