Media: USA Today Editorial Board Ignores the Facts on Gardasil CME

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An editorial in USA Today issued opinions on conflicts of interests and ethical considerations for doctors when pharmaceutical companies underwrite courses. Although we previously covered issues relating to HPV funding and research through a comprehensive approach of the literature, this article offers a mostly biased opinion without researching all the facts.

The article tries to sway readers into their perspective by asserting that “patients don't know that many doctors learn about drugs at courses … paid for by the very pharmaceutical companies that stand to make millions, even billions, from selling them.” If patients wanted to know, they would ask their doctors, and can do so anytime they want.

While the relevance of Continuing Medical Education (CME) is essential to better patient outcomes and future research and collaboration between industry and academia, the location of where these courses are being taught is irrelevant, besides I hate to break the news to the paper but CME meetings supported by industry are not held in vacation destinations.

These courses provide the newest breakthroughs and clinical data on devices and drugs that will save the lives of patients.

Like most media sources who abuse numbers, the opinion states that “in 2007, the pharmaceutical industry spent more than $1 billion to cover half the cost of doctors' continuing education in the USA.” They also tie this point to the fact that “industry-supported programs gave more favorable treatment to sponsors' products than independent programs,” according to an American Medical Association ethics panel found.

It is important to note that the AMA Ethics panel (CEJA) did not state that industry supported programs gave more favorable treatment to sponsors, and this article failed to consider is that physicians who choose a supporters’ products are doing so because the research and clinical data support their use, the outcomes are better, and they are cost effective. This leads the story to focus on the JAMA article we covered last month.

While it was publicly disclosed that Merck, maker of a new HPV vaccine, gave three major groups concerned with adolescent and women's health sizable grants to teach doctors, nurses and others about their drug, this disclosure does not constitute a conflict of interest, plain and simple.

While USA today believes the CME courses were inadequate because of Merck's marketing message and lack of focus on the vaccine's limitations and potential risks, this assertion is problematic all together. These courses are attempting to save lives through a new breakthrough that will help prevent cervical cancer, one of the largest diseases that kill women each year. Any perception of conflict based on funding of education alone should be outweighed entirely by the benefits such research and education will provide to patients lives. 

The article notes the vaccine’s limitations such as women still needing to get annual Pap smears to detect cervical cancer. How is that a limitation? No science is 100%, and these procedures for women have other significance to women’s health. The article also cites that “the vaccine is so new that scientists don't know how effective it will be over the long haul.” According to one of the JAMA article’s authors, the Society of Gynecologic Oncologists, which got $250,000 from Merck, failed to address those critical points in its "Frequently Asked Questions." That’s why we need these courses to start discuss ways to measure the long term effects through research and clinical studies. 

What is interesting is the USA Today Editorial board failed to even mention that an FDA/CDC study showed that GardAsil was both safe and effective and was published in the same issue of JAMA.  (Who needs facts when you have hype)

Other critics of Merck’s funding of education assert that “the American Society for Colposcopy and Cervical Pathology, which received $300,000 from Merck, advised doctors "to downplay the sexually transmitted infection issues surrounding HPV."

In response, all organizations that have received funding from Merck firmly acknowledged that all of the courses they offered are balanced and independent. In fact, many of the policies governing such funding for CME say that sponsors can have no part whatsoever in choosing any material presented or shown.

In the end, USA Today has it all wrong when they claim that “education bought and paid for by drug companies is a blatant conflict of interest, no matter what its content.” Critics like these who confuse patients with selective information will lose trust of patients and consumers faster than any patient would lose the trust of a doctor. What sort of specialized training does the editorial board at USA Today have to be telling patients when and when not to trust their doctors?

Patients and consumers who are concerned about conflicts of interest need to ask their doctors about medicines they receive, if they even feel justified in doing so.

With the limited time patients have to see doctors today, if they can even see a doctor, should patients worry more about their health and questions related to livelihood, or what education and training their physician continues to receive?

In the end, physicians get continuing medical education for exactly what the name suggests: medical education is constantly and continuously evolving. Nothing is free in this world, and education certainly is not, especially in such a highly professional field as medicine. Companies that put patients first by supporting such courses to physicians should be recognized for their focus on getting better results for patients through new research and development.

Whether it’s happens at the Hospital, Days Inn or a Marriot, in Florida or Alabama, continuing medical education is needed in America.

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