Significant players in the for-profit medical communications industry include WebMD's Medscape business unit, the Postgraduate Institute for Medicine, and Research to Practice. They each received at least $10 million in grants from industry for CME in 2010, according to a study published last year in JAMA. WebMD declined to comment for this article.
The number of accredited CME providers in the U.S. fell 13% from 2,300 in 2008 to 2,000 in 2012, and the number of accredited CME events dropped about 11% from 150,000 in 2008 to 133,000 in 2012, according to the ACCME.
But the amount of money spent on CME remains very significant for manufacturers, CME providers, and physicians. A total of $2.47 billion was spent on accredited CME in 2012, according to ACCME data, and one-quarter of that revenue came from industry support. The share of CME costs paid by manufacturers is down from previous years, when drug company spending made up half of all CME grants.
The JAMA study found that 14 drug and device companies paid $657 million in grants to CME providers in 2010. For-profit medical communication firms received about 77% of that total, with the rest going to academic medical centers and disease-targeted organizations.
In total, the pharmaceutical industry spent about $27 billion on drug promotion in 2012, with nearly all of that spending going toward marketing to physicians, according to Pew data. This figure does not include CME, which Pew considers indirect marketing.
CME traditionally has been viewed as one of the industry's primary marketing tools when launching or promoting a drug, said Eric Campbell, director of research for the Mongan Institute of Health Policy at Massachusetts General Hospital.
Some for-profit medical communication companies provide accredited CME and unaccredited promotional and marketing programs. In the latter types of programs, drug and device companies have control over the content and the speakers, and payments to physicians who speak must be disclosed under the Sunshine Act. But accreditation standards prohibit employees at these companies from working on both sides of the business, and the accredited CME and promotional arms must be organized as separate corporations.