Health professionals appear concerned about bias in commercially funded CME

**Tabas JA. Arch Intern Med. 2011;171:840-846.**

Issue: June 2011

Commercial funding of continuing medical education and the potential for bias concern many health care practitioners, according to a report in the Archives of Internal Medicine, but many reported being unwilling to pay higher fees to eliminate or offset commercial funding sources.

Although the role of pharmaceutical and medical device manufacturers in directing continuing medical education (CME) has been reduced, the entities “still fund a substantial proportion of costs,” according to the press release.

This has been met with urging from the Institute of Medicine, American Association of Medical Colleges and American Medical Association to further decrease — or even eliminate — commercial support for educational activities, according to the release. However, that could potentially mean the funding costs get shifted to attendees.

“Our two main outcome variables were dichotomized as follows: (1) agreed or strongly agreed that raising the registration fees is an effective way to decrease commercial support vs. not, and (2) agreed or strongly agreed that commercial support for live CME should be eliminated vs. not,” the researchers wrote.

Unwillingness to pay

The researchers surveyed 1,347 participants at a series of five live CME activities. The survey included questions regarding the impact of commercial support on bias, as well as the participants’ willingness to make up for the lack in funding if commercial support were to be eliminated.

With a reported 57% response rate, the researchers found 88% of the 770 respondents believed commercial support introduces bias. More support, these respondents added, would indicate a greater risk of bias. However, the researchers also found that only 15% of respondents supported the elimination of CME activity commercial support. Furthermore, 42% of respondents were willing to pay increased registration fees in the interest of helping eliminate or decrease commercial support.

“Participants who perceived bias from commercial support more frequently agreed to increase registration fees to decrease such support,” the researchers noted. “Participants greatly underestimated the costs of ancillary activities, such as food, as well as the degree of support actually provided by commercial funding. These results highlight the complexities of eliminating or decreasing commercial support for CME at this time.”

“Given the reality that CME learners underestimate the actual costs of live CME activities, the impact of decreases or changes in funding sources needs to be further clarified, and an understanding of the perceptions of these learners and efforts to better inform these clinicians of the true costs of CME needs to be taken into account in the implementation of any policy change,” they added.

Disclosure: No relevant financial disclosures were reported.

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