Why Did Pfizer Cut Off MECCs?

However, this explanation ignores the fact that pharma income of other CME-producing organizations, like medical societies, is not inconsequential, despite what Dr. Carlat alleges. For instance, by examining the ACCME's 2006 Annual Report (the same report that Dr. Carlat references), it is apparent that the collective, net commercial income (total commercial support – total expense) for nonprofit organizations (eg, a physician membership organization) was actually higher than that for publishing/education companies in 2006: $247,782,325 vs $210,811,540. And the average net income per nonprofit organization (n = 267) was not that far behind the net income per publishing/education company (n = 154): $928,024 vs $1,368,906.

So while Dr. Carlat argues that loss of pharma CME income for a big-budget academic medical center would "cause barely a hiccup," this is not likely the case for a medical society operating on much smaller revenues. For instance, the 2006 expenses of the American Academy of Neurology, the flagship organization of practicing neurologists, totaled approximately $3.5 million.

Pfizer's move to cut off MECCs, I would argue, is primarily (if not solely) based on the perception of bias in MECC-generated CME, not actual bias.* Otherwise, according to Dr. Carlat's argument, Pfizer would have considered cutting off direct CME grants to medical societies as well―a questionable PR move.

ACCME = Accreditation Council for Continuing Medical Education; MECC = medical education communications company.

* And if bias did exist in Pfizer-funded CME, it's only because Pfizer expected (even demanded) bias.