Sunday, June 17, 2007

Throwing the baby out with the bathwater

An OP-ED writer in the New York Times wants to eliminate all pharmaceutical industry support for accredited CME. I guess he wants to criminalize it---he calls it money laundering. He writes:

The solution could hardly be simpler: any continuing medical education that is paid for by the drug industry should not be accredited. Drug companies could still pay for any educational event, article or pamphlet they choose, but their courses and materials would no longer bear the imprimatur and implied credibility of accreditation.

Doctors, in turn, would be encouraged to seek medical education from sources that are not financed by drug companies. A renewed commitment to unbiased education would allow doctors to learn about drug risks sooner.

So, we are to believe that drug company support for accredited CME keeps doctors from learning about the risks of drugs. I wish Daniel Carlat, the author of the piece and a professor at Tufts Medical School, would provide evidence to back that incredible claim. The adverse lipid effects of Avandia, for example, were well known for several years. (Some time ago I linked to this review which cited Avandia’s well known adverse effects).

Carlat seems to believe, as implied by the title of his OP-ED piece, that drug companies have a conflict of interest concerning information about adverse drug effects. But common sense and history suggest the opposite: that it’s very much in industry’s interest for doctors to be informed about the hazards of drugs. It would certainly have been in the interest of American Home Products for doctors to know the hazards of Fen-phen. Johnson and Johnson is still paying for doctors’ failures to heed their package information and repeated letters about the hazards of cisapride. Pharmaceutical companies know all too well that if the message about drug hazards could be communicated effectively and responsibly they would not have to pay, in money and reputation, for so many doctors’ mistakes.

There must be a reasonable middle ground. Drug companies should not become the primary educators of doctors. But with appropriate safeguards industry support for CME can be beneficial.

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