Starting in 2018 European device companies will no longer be allowed to directly sponsor physician attendance at medical meetings. In response, three prominent European interventional cardiologists warn that the change could have dire consequences, stifling education and potentially reducing attendance at European medical meetings by 30-50%.
In the US physicians can still enjoy free meals. But, following revelations many years ago that drug and device companies were footing the bill for US physicians to go to medical meetings– often at fancy resorts– direct sponsorship from industry to simply attend medical meetings has not been allowed. (Physicians who are speakers and consultants are another story.)
In Europe, however, industry sponsorship of physician attendance at medical meetings is still quite common. At medical meetings large and small you can easily find desks in hotel lobbies decorated with the logos of the major drug and device companies. These desks are manned by friendly company representatives who take care of the company sponsored “delegates.” It’s a big business. The sponsorship often covers travel, food, and entertainment as well as payment of the conference fee.
In October MedTech Europe, the alliance of European medical technology industry associations, first proposed to its members that they “phase out” direct industry sponsorship of healthcare professionals (HCPs) to third-party organised conferences.” On December 2 MedTech Europe announced that it had formally adopted the new ethics code.
It should be noted that the new code does nothing to alter other existing forms of support from medical device companies for medical meetings. This includes financial support for the medical organizations putting on the conferences, satellite symposia, and other forms of CME and promotional activities.
In response to the plan three prominent European interventional cardiologists, Patrick Serruys, William Wijns, and Stephan Windecker, penned a fiery editorial in EuroIntervention expressing their extreme distaste for the sponsorship ban. They predict that attendance at medical meetings could drop by 30-50%. They write that
“attendance at conferences and meetings will become more complicated: individual attendance will become more difficult with new finance models emerging through third parties such as teaching hospitals, scientific societies, congress organisers and other institutions. Costs for projects will be questioned in greater depth, with the need to prove fair market value for all services from catering through to speaker fees.”
I think this may represent an important new step in the torturous tango of industry and doctors. I don’t think it’s generally appreciated how big a role this type of sponsorship plays in European medicine. I am convinced, for instance, that it is the single biggest reason why the annual ESC meeting is now much larger than the corresponding AHA and ACC meetings. (It used to be exactly the opposite.)
We should think carefully about the editorialists prediction that meeting attendance could decline by 30-50%. This may in fact be a real consequence of the new policy. But it’s by no means clear whether this is a good or a bad thing. The authors of the editorial don’t appear to consider that this possible decline might be a sign that industry funding for the routine activities of medical education might be unseemly and even unhealthy. If the industry stranglehold on European doctors is the only thing propping up medical meetings then it might be a good idea to reconsider the entire underlying relationship of industry and medicine, not just the direct sponsorship of physicians to attend medical meetings.
One additional thought: Direct industry support for physicians to attend conferences is the proverbial tip of the iceberg. It’s big, it’s visible, and it’s dangerous. But the part that’s not immediately visible is actually much bigger and far more dangerous.
From James Stein (University of Wisconsin):
“That attendance at conference may decrease is not necessarily a bad thing. It might be a good thing, esp. if sponsored attendance had the collateral or primary effect of mainly promoting industry relationships and their agendae. Indeed, the nature of medical meetings may change, possibly for the better if the content is less industry-driven. In the US, attendance at large meetings declined for many reasons but there is no evidence that not going to national meetings is bad in any way. There are many other ways to obtain medical knowledge than large meetings. Also, recent data suggest that patients do better when cardiologists are off at major meetings – we need to figure out why, so all these docs that are predicted not to go to meetings don’t stay home and hurt people instead (wink).”