CME in Europe: a fragmented environment

Rebecca Aris interviews Eva Thalmann

Janssen, the Pharmaceutical Companies of J&amp,J

pharmaphorum interviews Eva Thalmann of Janssen, the Pharmaceutical Companies of J&amp,J, on the role of pharma in CME and the fragmented CME environment in Europe.

The CME environment in Europe is evolving. There is a rise in the expectation of the pharmaceutical industry to support CME. But with a lack of guidance on what their role within CME should be, the appropriate level of support is unclear.

We interviewed Eva Thalmann of Janssen, the Pharmaceutical Companies of J&amp,J to find out how Janssen have been involved in CME activities and what she believes pharma’s role within CME should be. Eva also explains how the CME environment in Europe is fragmented, and the challenges this presents.

Interview summary

RA: Eva, thank you for taking part in this interview. Could you please start by explaining your role within Janssen?

ET: My current role at Janssen is Head of External Scientific Relations and Medical Education for Europe, Middle East and Africa. As such, I am working with a team of Medical Education Scientific Relations Managers who cover the respective disease areas Janssen is focused on. All of us are responsible for interactions with the European Medical Societies as well as implementing educational activities, identified by external experts in our Therapeutic Area Steering Committees. These Steering Committees serve as guidance body for Janssen on medical activities including selection of relevant topics and faculty.

RA: How has pharma’s involvement with CME changed over the past ten years?

ET: There is a big change in the importance and visibility of CME programs. While 10 years ago CME was mainly a topic in the US, we have now CME systems in nearly all disease areas driven by Medical Societies, countries as well as UEMS in Europe. Still the CME environment in Europe is fragmented and, in addition, the importance of CME-endorsed programs differ among European countries.

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“…the CME environment in Europe is fragmented…”

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RA: What has your involvement with CME activities been?

ET: As a basic principal Janssen’s philosophy is to seek CME accreditation for all of our educational activities whenever possible. We strongly believe that educational programs need to fill educational gaps indentified by the medical community or their representatives.

We believe that these programs should be driven by external experts and whenever possible should be reviewed and endorsed by independent CME bodies. Due to the fragmented nature and different accreditation systems, CME accreditation is not always possible. What we do, nevertheless, is follow the input and guidance of our Steering Committees to ensure the scientific relevance and objectivity of educational programs. Additionally, if scientific third parties, such as medical organizations, request grant support for educational projects that fall in disease areas of interest for Janssen, we have the possibility to support these after an internal review and approval process through educational grants.

RA: What challenges do you consider there to be for pharma in supporting CME activities?

ET: There needs to be a debate on how to cooperate between CME / accreditation bodies and industry. We learned from observing the US that not all CME programs are good. We also see that not all non-accredited educational programs supported by industry in Europe are biased or promotional.

Furthermore, the question to be asked is who should be responsible to accredit programs? In Europe we have UEMS and the European Medical Societies who as a non-profit organizations are responsible for accreditation, and this ensures the relevance of accredited programs. In the US there are also Medical Communication Agencies, profit organizations, who could conduct CME programs in cooperation with individual academic institutions.

Discussion is needed as to which system would be best for Europe. Furthermore, is a uniform system in Europe possible? Just among the EU we have 27 countries with different codes of practice as well as health systems, so a completely different situation to the US.

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“We strongly believe that educational programs need to fill educational gaps indentified by the medical community or their representatives.”

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RA: What benefits do you see for pharma supporting CME?

ET: In my opinion the basic principle of pharma should be to support scientific relevant educational programs independent of whether its CME accredited or not. Nevertheless, in all of our minds we see the pharmaceutical industry as promotional, as we have a financial interest as for profit organizations. In general, CME programs are associated with more independence and unbiased information. The major benefit for us as industry to support good CME programs is certainly this aspect of more credibility. Conversely, the industry should also work on the quality of non-CME programs to increase our credibility.

RA: What guidance is currently available surrounding pharma’s involvement in CME?

ET: Each Medical Society has guidance on how it applies its CME systems and so does UEMS. I also suppose each company has operating procedures on how to work with CME bodies or how to support CME programs through grant processes.

The CME agencies have a broad range of how they define CME and support from pharma. There are also differences from disease area to disease area.

RA: What do you think the role of pharma in CME should be?

ET: This is not an easy question. One might argue that the industry should only support CME programs with educational grants. This is more or less the system in the US, but as said before that does not make all CME programs good and relevant.

One could also argue that as the industry in developing treatments in specific disease areas it has a good in-depth knowledge in these areas and to not cooperate could mean losing expertise. In Europe we certainly need more cooperation and guidance on educational programs and topics from the Medical Societies.

The Medical Societies also should review more educational programs and could ask the industry to cover topics that are important.

I think we need to find new approaches between Medical Societies, accreditation bodies and the industry to ensure that all medical programs are meeting the highest possible standard.

RA: How do you think pharma and CME will collaborate in the future?

ET: I hope that we will find a good cooperation between industry and CME bodies in the future to ensure that scientifically relevant programs will ensure the best care of patients. The role of CME bodies should be to supervise and ensure the clinical necessity of such programs, and the industry not only should support such programs financially but should act as a trusted scientific partner. How this collaboration should work still needs to be defined.

RA: Thank you for your time.

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About the interviewee:

Eva Thalmann PhD is External Scientific Relations Director at Janssen Medical Affairs Europe for Oncology/Hematology. Throughout her carrier she was also working in Nephrology and Virology. As External Scientific Relations Director she is focusing on close connections to major European Medical Societies such as EORTC, ESMO, EHA, EAU, as well as to top experts and patient advocacy groups. Additionally she is responsible within the EMEA Janssen organization for CME programs. She is member of several internal strategic groups and helped to implement Pan-European Health Care Compliance Guidelines and Standard Operating Procedures in Medical Education for Janssen. Eva Thalmann obtained a PhD in Biochemistry from the University of Vienna and joined Janssen-Cilag in 1990. She had various positions in Medical Affairs and Strategic Marketing for Janssen and Johnson &amp, Johnson within Europe and US.

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