Industry Support for Partners Educational Activities Office for Interactions with Industry Kaley Klanica and Erin Stewart October 20, 2010 Office for Interactions with Industry Office for Interactions with Industry Industry-support education Why are we so worried? “A new system for funding accredited continuing medical education should be developed that is free of industry influence.” IOM Report on Conflict of Interest in Research, Medical Education and Practice, April 2009 “Commercial sponsorship could be maintained if the appropriate safeguards are implemented to prevent undue commercial influence and preserve the integrity and independence of CME.” Lewis Morris Chief Counsel OIG, US Department of Health and Human Services Testimony to the Senate Special Committee on Aging, July 29, 2009 2 Office for Interactions with Industry Industry-support education What is being done to address the issues? •Physician Payments Sunshine Act and Health Reform •Massachusetts Pharmaceutical & Medical Device Manufacturer Code of Conduct •Pharma/Device Companies’ Transparency Sites •Partners HealthCare •Harvard •Peer Institutions •Stanford •Michigan •Memorial Sloan Kettering Cancer Center 3 Office for Interactions with Industry OII/ERB OII •Provides staffing support to Committee on Conflicts of Interest (CCOI) and Education Review Board (ERB). •Implements policies regarding interactions with industry •Processes all educational grants ERB •Chaired by: •Jonathan Borus, MD (BWH) •Lawrence Friedman, MD (NWH) •17 Members •Broad representation •BWH, MGH, Faulkner, NWH •Surgery, Psychiatry, Orthopaedics, Palliative Care, Nursing, and other PHS entity departments •Many members have a broad background in medical education •External members 4 Office for Interactions with Industry Education Activity Approval Flow Chart HMS/ Accredited Provider OII/ERB Approves and Finalizes Support Required Paperwork: 1. Intake Form 2. Budget 3. Letter of Agreement Proposal for Support Submitted to Company 5 Company OII Processes Support Department Notifies OII & Submits Required Paperwork Company Awards Support (financial or in-kind) ERB Educational Activity Upon Request, Dept Provides Financial Reconciliation to Company and/or OII/ERB Office for Interactions with Industry Industry and Educational Activity What is Industry? Pharma/Device Companies Examples: Pfizer, AstraZeneca, Medtronic Continuing Medical Education Biotechnology Companies Examples: Amgen, Genzyme Non-Accredited Educational Conferences or Presentations For-Profit Companies Clinical Fellowship Program Examples may include: Nike supporting an obesity program or a program on fitness or exercising Other funding sources Examples may include: foundations funded by pharma/device companies (e.g. Ortho Research and Education Foundation, OMeGA Foundation, Eli Lilly Foundation) 6 What is a Partners Educational Activity? Patient Education Program Educational Tools and Resources (website and newsletter) Skills Building Training Course/Seminar Office for Interactions with Industry Key Criteria for Educational Support No industry influence – Partners and/or the Accredited Provider retains control over all aspects of the program Control of Content (requirements for discussing a company’s product or asking for specific speakers or attendees) Event (requesting a specific location, time or date) Fellowship program (requirements for selection of fellows or detailed clinical data) Funding for each program must come from more than one company All conferences must meet ACCME or comparable standards More rigorous processes to screen potential conflicts of interest and to monitor content of programs Collect COI forms from speakers and course directors Slide review Company does not have any expectation of receiving anything tangible in return for their donation: NO: IP or royalties, free booth/exhibit space, free admission 7 Budget complies with ACCME standards and PHS guidelines Office for Interactions with Industry Guidelines Approved 8 Multifunder Rule Fellowship Budget Conference Budget Travel Educational Materials/Textbooks Office for Interactions with Industry Multifunder Rule No industry support for a program unless program support comes from more than one company Companies must contribute a substantial amount “70/30 Safe Harbor”-no company should provide more than 70% of the total industry support 1st grants can be processed/approved without a 2nd grant, but they cannot be spent! In-kind support excluded 9 Office for Interactions with Industry Fellowship Budgets •Provide detail for your budget •Budgets must include all external revenue (commercial support, clinical revenue, etc.) •Indicate number of trainees in the program •Expenses must be legitimate (e.g. office supplies, pager/pda, program director’s salary) •If program expenses are less than revenue generated, the excess must be returned to the company in an amount proportional to the amount the company contributed to the total revenue. 10 Office for Interactions with Industry Conference Budgets All CME and non-CME conferences must comply with the ACCME Standards for Commercial Support Allowable Expenses (within reason) Accreditation Fees AV Advertising/Printing/Production Food and drink during program Honoraria (no more than $2500/day) Management Fees/Admin Expenses Overhead/Indirect Costs Speaker Expenses (lodging, meals, transportation) Venue 11 Prohibited Expenses Attendee Expenses (parking, travel) Faculty Dinners Gifts for participants Social Events Office for Interactions with Industry Industry Travel Support Trainees only From non-profit org. that got industry funding Course must be academic Payment can be made directly to trainee From industry directly Course must be academic Payment must go to dept, not trainee Do not need 2nd funder Travel “pool” Program director selects courses Must have multiple funders 12 Office for Interactions with Industry Industry Travel Support Prohibited: Industry covers personal expenses for fellow to attend industrysponsored training Includes device trainings/certification programs that are “mandatory” Industry agrees to reimburse fellows’ expenses at a conference (even if conference is academic) It is always acceptable to attend these programs, the question is whether it is permissible to use industry funds to cover the expenses. 13 Office for Interactions with Industry Educational Materials + Textbooks Permitted Company gives books to department, and department distributes to library or trainees Two companies give monetary support, and department buys books for library or trainees **Books must be academic in nature and selected/endorsed by program director** Prohibited Company gives books directly to trainees Bookplates with company’s name/logo 14 Office for Interactions with Industry Quality Control/ Quality Improvement Did the actual expenditures comply with guidelines? CME Budgets Actual expenses Unexpected costs/revenue Tuition Fellowship Budgets Actual expenses Clinical revenue **Track necessary information so that budget can be reconciled after program ends!** 15 Office for Interactions with Industry Apply early in the application cycle/apply to many companies OII has a 30-day advance notice deadline; follow up on your application! Firewalls and Certificates of Separation—send to OII! Grand rounds: apply for the entire academic year Avoid naming faculty/speakers in your application Properly define the parties in your CME application Companies use your application to auto-generate the LOA. Must include the Accredited Provider (usually HMS) and the Education Partner (BWH) OII reviews ALL LOAs and coordinates signatures Course Directors/Program Directors and/or Administrators are not authorized signatories for the hospitals. Read the Letter of Agreement! Requirements for disclosure, audits, reconciliation and return of excess/unused funds—you are responsible for complying with these terms! Please reference the OII intranet site for other useful tips and ideas. 16 Office for Interactions with Industry Resources OII website: http://pulse.partners.org/OII/index.html • • • Education FAQs, guidelines and templates ERB membership and meeting dates Policies, including conflict of interest OII e-mail box: PHSOII@partners.org Education grants phone line: 617-643-7833 Educational Grants Contacts: Jennifer Riconda: 617-724-3772; jriconda@partners.org (MGH, Spaulding) Erin Stewart: 617-643-8659; ecstewart@partners.org (BWH, Faulkner, McLean, NSMC) Kaley Klanica: 617-724-8081; kklanica@partners.org (general) Other resources Harvard Medical School Department of Continuing Education http://cme.hms.harvard.edu/ ACCME Standards for Commercial Support http://www.accme.org/index.cfm/fa/faq.home/Faq.cfm 17 Office for Interactions with Industry 18