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Who will pay for CME if industry doesn’t?

Reducing industry support for CME — it’s now supplies about half of the $3 billion spent every year on re-educating doctors — is now on everyone radar’s screen as part of the general movement to reduce conflicts of interest in medicine. Merrill Goozner says that whether drug companies finance CME or physicians pay out of their own pockets, the cost gets passed along to patients, taxpayers and employers in the form of the higher insurance premiums and co-pays, which in turn finance the higher drug prices and higher office fees needed to pay for CME.

Merrill Goozner is an award-winning journalist and author of “The $800 Million Pill: The Truth Behind the Cost of New Drugs” who writes regularly at Gooznews.com.

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The answer to that question is the same people who always have — you and me and everyone else who picks up the health care tab.

Reducing industry support for CME — it’s now supplies about half of the $3 billion spent every year on re-educating doctors — is now on everyone radar’s screen as part of the general movement to reduce conflicts of interest in medicine. The American Medical Association’s ethics committee will present a scaled-back resolution at the group’s next convention that will call for bolstering the wall that separates industry CME financing from its content. But it won’t go as far as a resolution floated last year that called for drastically scaling back that support.

The Institute for Medicine as a Profession last week called for CME providers to gather all industry contributions in a centralized pool — rather than allow companies to earmark their contributions for specific programs — and create panels of physicians without conflicts of interest to develop the programs. The most likely institutions to adopt such a proposal would be the nation’s 130 or so medical schools, many of which have already begun scaling back their financial involvement with drug, device and other health care provider firms.

That approach drew fire over the weekend from the KevinMD blog (Dr. Kevin Pho, a young Nashua, NH internist with a regular USA Today column), who suggested if medical schools take the step the AMA will not, i.e., banning industry support, then the cost will likely rise and the cost will “fall on individual physicians.”

Too bad they don’t teach economics in medical school. Whether drug companies finance CME or physicians pay out of their own pockets, the cost gets passed along to patients, taxpayers and employers in the form of the higher insurance premiums and co-pays, which in turn finance the higher drug prices and higher office fees needed to pay for CME.

As I testified before Institute of Medicine in March 2008, it would be better for the independence of CME if the profession cuts out the middleman and patients and insurers reimbursed doctors directly for their CME expenses.

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