The Dark Money of Medicine
Written by Editor   
Thursday, November 26, 2015 01:02 PM

In 45 states and the District of Columbia, doctors are required to take continuing medical education courses to keep their license.  The courses typically cover cutting-edge procedures, disease awareness, new treatments or other important topics.  While doctors are required to report income provided by drug manufacturers, the drug companies have discovered that money paid for teaching an accredited course doesn’t have to be disclosed, and today, CME funding is again on the rise.  In 2014, course providers reported a near-record $2.7 billion in income.  A quarter of that came from drug companies and medical device makers.  The US Government found, however, that drug companies have used such courses to market unapproved uses for their products.  This report outlines the “dark money” of pharmaceutical medicine.

Drug companies have long been associated with CME courses, but their funding of such courses dropped following congressional investigations showing they had misused the programs to market unapproved uses for their products. From 1998 to 2003 the total income for providers of the courses doubled from $890 million to $1.8 billion as they were viewed as a great way to promote their products to doctors.  Industry spending on the courses more than tripled, from $300 million to more than $970 million.

From 2004 to 2007 Industry-funded courses went from making up a third of total income to around half in each of those years.  Unlike payments doctors receive for speaking or consulting, money paid for teaching an accredited course doesn’t have to be disclosed.  Total income increased by an average of 7% a year.

From 2007 to 2010 the federal government investigated course providers’ practices.  Total income dropped more than $400 million in three years from a peak in 2007.  After the Senate investigations, which found drug companies had used such courses to market unapproved uses for their products, industry funding of the courses dropped significantly.  Overall income dropped as well, reaching a recent low of $2.32 billion in 2009.

Since that time, however, total income from the courses have again increased every year.  Since 2010 they had grown by $426 million, and industry funding grew by $16 million last year alone.  Yet where hospitals and medical schools used to earn a large portion of that income, more of it now went to for-profit publishing and education companies. In 2014 those companies received $63 million more money than in 2011 while medical schools and hospitals received $64 million less from the industry.