Pfizer multinational is awarding a huge $ 3 million grant to the reputed Stanford University towards continuing education programme.
Both parties maintain it is a no-strings aid, but many are skeptical. The corporate-doctor nexus could become stronger with such projects, ultimately compromising medical ethics and patient interests, they apprehend.
Stanford said the curriculum would focus on areas that needed improvement, like diabetes, cardiovascular disease, smoking cessation and infections. The university plans to use advanced technologies, including a simulated hospital, rather than lecturing.
"The Pfizer grant comes with no conditions, and the company will not be involved in developing the curriculum," according to a medical school press release.
Dr. Philip Pizzo, dean of the Stanford medical school, says Pfizer will have no say on how the three-year grant will be spent. The university plans to set up unbiased programs of postgraduate education on the Stanford campus rather than the industry-selected topics of the past that have been presented to rooms full of doctors at hotels and resorts.
"It's a fundamental change," Dr. Pizzo said Sunday, criticizing the drug industry for poisoning educational programs with marketing messages and doctors for "complicity" in taking speaker fees and expenses-paid trips. He called the grant "a novel rebooting."
Pfizer, in a statement, said it wanted to help redefine how continuing medical education was financed to ensure the independence and patient benefit of the programs, which most doctors are required to take to maintain their state medical licenses.
It may be noted that drug and medical device companies have paid more than $1 billion a year for continuing medical education through universities, disease associations and private vendors, about half the total cost of the programs.
Last December, the Institute of Medicine, in its report titled Redesigning Continuing Education in the Health Professions
, regretted that pharmaceutical and medical device companies had taken a lead role in financing the provision of and research on CE, raising questions about conflicts of interest.
"Such commercial funding has raised and continues to raise concerns about conflicts of interest and whether some companies are using CE to influence health professionals so as to increase market share," the report said.
Pfizer itself has a checkered history of using such education courses to promote off-label use of its drugs. For instance Pfizer paid $2.3 billion last year to settle government fraud charges of deceptive marketing, including sponsoring supposedly independent programs promoting off-label uses for the pain drug Bextra
, wrote Duff Wilson in New York Times.
In 2008, it became the first drug company to say it would no longer provide such money directly to profit-making medical education companies, but only to universities and other nonprofits. But a $780,000 grant from Pfizer to the Canadian Medical Association for educational programs drew criticism because the company was given two seats on a six-member supervisory board. And a $3.4 million grant last year for the California Academy of Family Physicians to sponsor stop-smoking
educational programs was questioned because Pfizer makes Chantix, a smoking cessation drug.
Still, some saw inherent conflicts in the Pfizer conection.
Dr. Adriane Fugh-Berman, a Georgetown University
medical professor who has researched and written about industry influence in continuing medical education, dubbed the grant announcement as self-satirizing and noted, "Pfizer's interest in better ways to manipulate physicians is well-known."
He also pointed out that Pfizer has major products in two of the four areas that Stanford proposes to pursue - smoking cessation and heart disease.