I hope that Roy Moynihnan's editorial is part of a chain of awareness
of the pharmaceutical industry's use of Key Opinion Leaders (KOL).
There are a couple of arguments commonly put forward to defend the KOL
practice: the most prominent, seen again in the discussion of these
articles, is that disclosure is imperative and mitigates the impact of
potential conflict. I don't think that there is any research to support
this statement and fear that physicians have become culturally inured to
industry-driven CME without critically examining the potential effects of
conflict. In other words, it is the perception of conflict that matters
not the action of declaring it. Indeed, there is a risk that 'disclosure'
allows the audience to justify or feel more comfortable about their
attendance at marketing-driven CME events rather than provoking critical
evaluation of the material presented.
The second argument, that I've heard espoused by KOL themselves , is that
their participation in events and receipt of remuneration from several
pharma companies is a measure of their neutrality. This is strikingly
naive and misses much of the argument against these practices.
The tide may be turning - Pfizer (US) have recently announced that
they will henceforth only provide support to accredited CME performed by
medical schools and national organizations: this will make it far more
palatable for those KOL, like Dr McAllister-Williams, who feel their role
all along has been to disseminate evidence and promote excellence in
clinical care.
A more subtle, unchecked and dubious use of KOL is the hearsay
reporting of their statements by marketing representatives when visiting
physicians in the community. Again it may be a matter of education in our
medical schools to enhance sensitivity to marketing techniques. Other
health professionals also need awareness, especially as nurse
practitioners, special clinic nurses and pharmacists assume greater
influence in prescription of medications.
Airing this matter will achieve more by improving the sophistication
of the target audience than appealing to industry or those who earn
significant sums from them.
Rapid Response:
KOL and disclosure
I hope that Roy Moynihnan's editorial is part of a chain of awareness of the pharmaceutical industry's use of Key Opinion Leaders (KOL). There are a couple of arguments commonly put forward to defend the KOL practice: the most prominent, seen again in the discussion of these articles, is that disclosure is imperative and mitigates the impact of potential conflict. I don't think that there is any research to support this statement and fear that physicians have become culturally inured to industry-driven CME without critically examining the potential effects of conflict. In other words, it is the perception of conflict that matters not the action of declaring it. Indeed, there is a risk that 'disclosure' allows the audience to justify or feel more comfortable about their attendance at marketing-driven CME events rather than provoking critical evaluation of the material presented. The second argument, that I've heard espoused by KOL themselves , is that their participation in events and receipt of remuneration from several pharma companies is a measure of their neutrality. This is strikingly naive and misses much of the argument against these practices.
The tide may be turning - Pfizer (US) have recently announced that they will henceforth only provide support to accredited CME performed by medical schools and national organizations: this will make it far more palatable for those KOL, like Dr McAllister-Williams, who feel their role all along has been to disseminate evidence and promote excellence in clinical care.
A more subtle, unchecked and dubious use of KOL is the hearsay reporting of their statements by marketing representatives when visiting physicians in the community. Again it may be a matter of education in our medical schools to enhance sensitivity to marketing techniques. Other health professionals also need awareness, especially as nurse practitioners, special clinic nurses and pharmacists assume greater influence in prescription of medications.
Airing this matter will achieve more by improving the sophistication of the target audience than appealing to industry or those who earn significant sums from them.
Competing interests: None declared
Competing interests: No competing interests