Medical education and independence from industry control in Europe
The gCMEp started with
an open letter
In 2011, members of the gCMEp penned an Open Letter to European Union of Medical Specialist (UEMS) and European Federation of Pharmaceutical Industries and Associations (EFPIA) calling on the two organisations to clarify the issue of independent (i.e. arms length) funding of CME. Although over a decade old it is still relevant today, highlighting crucially unresolved challenges around the independence of accredited CME where funding from pharma is involved.
Pharma funding of CME in Europe
Developments in recent years have provided some clarity on the funding of IME and CME. At #9ECF in 2016 (Workshop 4c), a group of US and European-based industry representatives came together and gave a presentation, the first of its kind in Europe, clarifying the role of industry in medical education and promotion. In 2018, some of these presenters and other European members of the newly-created EFPIA Working Group on Medical Education published a paper explaining how Pharma can engage with various types of medical education and promotion with respect to quality standards and funding models. It is the “Type D” funding described in the paper, the only acceptable form of funding in US CME, that is still not a requirement as standard practice by the medical regulators and accreditors in Europe (regionally or nationally).
In late 2018, the International Federation of Pharmaceutical Manufacturers (IFPMA) issued further guidance about how industry can support CME. The current EFPIA Code of Practice was published in July 2019. The code introduced a new Article (Article 16) dedicated to medical education; however, it fell short of providing detail on Pharma support of IME/CME discussed in 2016 at #9ECF.
In response, the gCMEp co-authored a Position Paper led by Mental Health Europe, with the Standing Committee of European Doctors (CPME), Continuing Medical Education-European Accreditors (CME-EA) and other organisations. The Position Paper “Regulating for Bias in Medical Education – Reaction to the Pharmaceutical Industry Updated EFPIA Code of Practice“ called on clearer guidance for Pharma.
In December 2021, EFPIA published further guidance in a guideline for Article 16, “Aligning the European Pharmaceutical Industry on a quality approach for industry funded and led Lifelong Learning in Healthcare activities” (subsequently incorporated as “Annex 3” to the EFPIA Code of Practice), and in May 2022, a Letter to the Editor in the Journal of CME, providing the European CME community further explanation.
European accreditor requirements
There is still little development from the European accreditors. For example, UEMS-EACCME, as well as most other accreditation bodies in Europe, still accredit CME activities run by “medical communications agencies” (i.e. “agents” of their industry “clients”) and some even accredit education from industry itself. “EACCME 3.0” was launched in June 2023 and continues to confuse processes and definitions around industry-controlled and independent education. Despite this, we are finally starting to see some developments in Europe. The European Board for Accreditation of Continuing Education for Health Professionals (EBAC) and the national CME system in Germany are making these distinctions in Europe by adopting the standards for commercial support, as defined by the International Academy for CPD Accreditation, as well as attaining Substantial Equivalency status with the ACCME. However, accreditors and industry must now take action if we are to achieve the much-needed clarity on the difference between funding routes and maintain the independence of the organisations planning and implementing accredited CME activities in Europe.
​gCMEp identifies challenges in Europe
In 2023, the gCMEp published a consensus statement outlining of their concerns with some of the above issues. The ongoing challenges faced by providers of CME-CPD in Europe was published in Journal of CME. In 2024, we expect that UEMS-EACCME will significantly revise the EACCME 3.0 accreditation standards, and in the UK, the PMCPA will be updating the ABPI Code of Practice following a consultation process. We await further news and detailed discussions of these topics at CME meetings during the year, particularly at #17ECF this November.
Guiding principles
The gCMEp operates on collaborative principles, discussing and addressing key challenges and developments in the European CME arena. From the very first meetings two key issues were identified as challenges in Europe: quality of medical education and transparency and independence. This initial publication is still valid today and the touchstone of much of the work of the group:
Farrow S, Gillgrass D, Pearlstone A, Torr J, Pozniak E. Setting CME standards in Europe: guiding principles for medical education. Curr Med Res Opin. 2012;28(11):1861–1871