A Problem With MedTech Codes — and a Possible Solution

Author: Christopher Durso       

Ethics codes are complicated enough on their own, but sometimes they contradict or conflict with other ethics codes, and that’s when things get really fun. ABTS Convention Services has just discovered a case of this, related to the MedTech Europe Code of Ethical Business Practice, which goes into effect on Jan. 1. The new code — which Associate Editor Casey Gale wrote about a few months ago — prohibits MedTech Europe’s member companies from directly sponsoring a health-care provider’s attendance at a medical conference or other event. Instead, companies will provide indirect sponsorship via education grants made to a health-care organization such as a medical school or association.

Which sounds reasonably simple, except it turns out that the new MedTech Europe code — as well as the revised APACMed (Asia Pacific Medical Technology Association) Code of Ethical Conduct for Interactions With Health Care Professionals, also going into effect on Jan. 1 — conflicts with the U.S.-based Accreditation Council for Continuing Medical Education’s (ACCME) Standards for Commercial Support. Convene asked Patrica Andrade, ABTS’s vice president of marketing, communications, and community relations, to explain how.

What is the specific problem that you’ve identified?

MedTech is Europe and the Middle East, and APACMed is Asia-Pacific. When they crafted their codes, they talked to American counterparts, but because there is nothing like the Standards for Commercial Support outside of the United States — because that’s a very unique ACCME thing — they never realized that they were going to run into this issue. What APACMed and MedTech are trying to do is to protect [members] from the media and from public perception that they might be misusing funds to bring doctors [to medical conferences] as a gift instead of as an educational incentive, so they’ve created this new process that puts that burden — actually finding the doctors and bringing them here — on a third party.

What they had envisioned was that it was going to be either the medical associations themselves doing this grant process and requesting money to then pay for doctors to come, or on a smaller scale, the hospitals. In Europe and in the Middle East and in Asia Pacific, [those entities would be] doing the grant process and requesting grants to bring their doctors to the meeting. But they didn’t take into consideration that in the United States — and it’s a U.S.-only issue — the ACCME Standards for Commercial Support actually prohibit any entity that falls under their standards to use the funds that they’re receiving for hospitality and travel.

Is there a way around this conflict?

ABTS kind of sat down and said, “Okay, either we leave this all up to international hospitals to do, which becomes a real issue, because international hospitals are really not structured to do this in any major scale; or we start seeing a loss of international attendees coming to medical meetings in the U.S., which is a really, really sad state of affairs.” So I started going back and forth and talking to the three or four different organizations [involved]. The process that we came up with that seems to work, that everyone has agreed on, is the idea of introducing a third-party nonprofit. This third-party nonprofit would be a medical-education nonprofit that doesn’t fall under ACCME, so they don’t give medical-education credits within the United States, but they could request grants from sponsors within MedTech and within APACMed, and manage the travel of all of those international doctors to all of these U.S.-based medical meetings.

Would this be a newly created third-party organization or one that already exists?

We have talked to an existing nonprofit that already has a history of doing medical education. I don’t think that I would talk about creating a new entity to work as a clearinghouse, because I really don’t want to create that environment where it looks like we’re looking to go around the laws. We have actually have worked previously with a small nonprofit called the Society for Worldwide Medical Exchange. They’ve been doing medical education mostly abroad, but they’re based here in the U.S. So, they have offered to manage the grant process for any APACMed and MedTech member sponsor who is looking to bring attendees or to sponsor attendees to come to medical meetings in the U.S.

Where do things stand as of now?

The boards of APACMed and MedTech have taken this information that we’ve provided for them about the restrictions from ACCME and are discussing it. Because we’re talking about a code that comes into effect in two months — Jan. 1 — and international sponsors are usually organizing their groups even a year in advance, it’s not something that we can sit on and say we’ll figure it out when it gets here. Medical meetings for 2018, they pretty much start in February, March. You’re already seeing a full calendar of medical meetings, and if there’s a sponsor out there that’s looking to bring people to any medical meeting that happens in the spring, there has to be an option for them to do it in a way that meets all of these requirements, so that those meetings that happen in the spring don’t miss all of their medical-education people, all of their attendees.

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