Johns Hopkins in Pharma Funding Flap

Is Johns Hopkins University Medical School offering to endorse drug company "educational" materials for money? That was the allegation made last week by Daniel Carlat, a blogger and psychiatrist in private practice.

Johns Hopkins, naturally, denies the claim.

Carlat says Johns Hopkins is offering "certification" to anyone with a checkbook. If a pharma company pays Johns Hopkins $85,000, it can get "Certification through Johns Hopkins University School of Medicine" for its drug seminar. If a company pays $103,000, John Hopkins will give "certification" to a special report, Carlat says.

Carlat labels his description of the event a "guided tour of greed."

A Johns Hopkins spokesperson said Carlat had it wrong. "This is a standard CME function that is accredited by the ACCME," said Joann Ellison Rodgers, Johns Hopkins' director of media relations, referring to the Accreditation Council for Continuing Medical Education. "They are unrestricted grants. Pharmaceutical companies have no say on the program at all. They don't see any plans for the programs, they cannot make recommendations as to who should be in the program."

Rodgers did say that there would likely be drug company signage at the events and that the companies' grants would be acknowledged in the program notes.

Carlat did not return an email requesting comment.

CME has become controversial in the last few years as more doctors have questioned Big Pharma's role in funding it. The dispute between Carlat and Johns Hopkins reveal just how murky and misinderstood CME funding can be.

Peter Hurwitz, the managing director of the Institute of Applied Science and Medicine (the CME agency that organized the event), said that his shop merely handled logistics for Johns Hopkins. "We're not responsible for the content ... fair balance is on these programs, it's the key to make sure there is no bias."

So why do companies sponsor these programs if they don't get anything out of them? "It raises awareness of a therapeutic condition or disease state. Do pharmaceutical companies want to raise awareness of therapeutic condition or disease state? I'd say absolutely," Hurwitz said.

CME events are run through the ACCME, the body that monitors CME. But CME events are mostly funded by drug companies, not educational institutions. You can see that on table 6 of the ACCME's annual report.

Note that $2.1 billion $1.4 billion of ACCME's $2.4 billion in total funding -- that's 87 percent 60 percent -- came from "commercial support" and "advertising and exhibits."

The drug-industry trade group PhRMA recently unveiled a new code for drug sales reps, in hopes of curbing some of the excesses of the business that have annoyed doctors and politicians over the last few years.

The code places restrictions on CME, and stops companies from directly funding CME so that educational seminars don't devolve into bald drug pitches. Nonetheless, companies can still fund CME by funneling it through agencies like IAMS that run CME programs, the code states.