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Delivering valuable independent medical education programmes

In the next instalment in EPG Health’s HCP engagement series, Abhi Chakravorty looks at medical education’s new trajectory and how to build programmes that are credible, engaging and impactful.

In these times of turmoil there are some reassuring constants when it comes to independent medical education (IME), which continues to be appreciated by healthcare professionals (HCPs) for offering fair and balanced information.

But all is not entirely static with IME. The pandemic has wrought some significant changes to live events, driving acceleration in online education (read more about how COVID-19 has changed medical meetings in the first part of the HCP engagement series).

As new learning configurations are needed for the emerging ‘new normal’ environment, pharma companies need to focus on both the constant considerations for delivering effective medical education and the need to respond to new patterns of HCP content consumption.

Ensuring credible, independence and trusted medical education

One of those constants is the importance of IME programmes. HCPs themselves say they are a great way for pharma companies to earn trust, by supporting information and advice that is fair and balanced and will ultimately improve patient care and outcomes.

Working with a third-party that is viewed as a valued partner by HCPs is one of the most important ways to bolster the credibility of, and trust in, the IME that pharma supports. Fairly or not, learning resources directly created by a pharma company often carry an inherent perception of not being without bias, and so might not be viewed as an entirely trusted source.

Internally produced pharma content can also present another challenge, with its tendency to getting bogged down in regulatory and compliance processes. The rules are absolutely necessary to help protect patient safety, but from a process point of view they are not necessarily something that pharma companies are well set up to deal with.

Consequently, despite the high esteem in which IME is held, only 12% of pharma surveyed by EPG Health in 2019 viewed it as a focus for them. Yet IME is something that third-party partners are perfectly set up to assist with, offering a wealth of expertise and speed of execution for work that can allow pharma companies to focus their energies on brand led exercises.

Read examples of three IME programmes delivered through COVID-19

Evolving the format of IME to meet HCPs’ digital demands

HCPs actively look for IME and, in order to keep their continuing professional development (CPD) up to date, they’re swayed towards accredited learning. For obvious reasons, face-to-face accredited events have had to take a bit of a backseat during the COVID-19 pandemic. And, as we move to the ‘new normal’, there will be an increase in demand for accredited IME in the form of virtual and hybrid meetings as well as other forms of online learning.

If they are to respond to this emerging trend, pharma companies should be looking for partners that are credible and can draw on experience and results from established audiences with specific specialties, roles and geographies. Then they need to have an iron-clad approach to delivering value so that HCPs are clear how a programme will improve their clinical practice and help their patients.

To do this it’s crucial to pick the right types and formats for programmes based on the evolving ways HCPs are choosing to learn. Although different HCPs learn in different ways, we’ve long noticed that visual content, such as infographics and videos, trumps written content. Now, podcasts’ audio-only approach is seeing it draw level with videos in terms of engagement, with both video and podcasts providing valuable opportunities for HCPs to consolidate their learning.

Read how an independent podcast series added value and credibility to a pharma sponsored platform

Read how a medical congress roundtable was chunked into a series of video e-learning modules

We know that IME is HCPs’ preferred type of learning and for years has been trending towards online sources.

In our pre-pandemic study, HCPs cited independent medical websites as their preferred source of clinical practice information, with 72% visiting them on a weekly basis, compared to just 21% for pharma’s own educational websites.

We’ve since conducted follow-up research on pharma-HCP engagement and education, including independent medical education, and this confirms that the higher demand for independent, online sources will continue. (It will be published in November 2021.)

As the healthcare world’s digital transformation continues, pharma’s challenge is to support medical education programmes that are as relevant and engaging as possible by meeting HCPs’ needs according to source, channel, content and format.

• Read three case studies on providing credible, unique, relevant, engaging and impactful medical education, while maintaining high compliance standards

More from EPG Health’s HCP engagement series

• Medical meetings post-COVID – key lessons for pharma
• Developing case-based content to engage HCPs
• Leveraging multichannel and multimedia in HCP education

About the author

About EPG Health

EPG Health is the publisher of Medthority ( www.medthority.com ), an independent patient management and treatment decision support tool for healthcare professionals.

Easing the discovery and consumption of valuable medical education, EPG Health supports a personalised experience and better outcomes for all stakeholders. A bespoke and integrated toolset helps pharmaceutical companies to reach and engage target audiences with key educational messages while measuring the outcomes.

For more information visit  www.epghealth.com

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Emerging Trends in Medical Education in the Pharmaceutical Industry is the Focus of Best Practices, LLC Study

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Nov 03, 2017, 14:34 ET

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CHAPEL HILL, N.C. , Nov. 3, 2017 /PRNewswire/ -- Medical education programs in the pharmaceutical industry are evolving to meet new transparency requirements as well as interest in outcomes-focused information.

A recent study by research and consulting leader Best Practices, LLC found that a majority of companies in the study are using multi-disciplinary programs to support their medical education programs. Almost 70 percent said the increased interest in these types of programs was the result of health outcomes efforts requiring coordination among different disciplines.

At the same time, new compliance and transparency rules have tempered the sponsorship of medical education programs by the pharmaceutical industry. The study investigates emerging medical education trends at pharmaceutical organizations regarding program mix, value and technology. The study also informs medical affairs and medical education function leaders on measuring effectiveness and future directions for this group.

Best Practices in Leading Medical Education Program Strategy: Establishing the Right Structures, Resources and Activities to Optimize Biopharmaceutical Education Groups , is a 58-page benchmarking report that examines the different factors that affect the effectiveness of medical education groups.

Medical Affairs executives, directors and managers who want to understand the most important current trends and future direction of medical education programs during this transitional period will profit from the leading practices, managerial insights and benchmark metrics contained in this report.

The insights and benchmark metrics contained in this report are drawn from interviews and benchmarking surveys with 23 leaders from 19 top biopharmaceutical and medical device companies. More than 65 percent of the participants are at the level of director.

This report features original research and yields rich data on the following topic areas:

• Role played by Medical Education groups
• Medical Education groups: Regional Focus
• Collaborative & Multi-Disciplinary Approaches to Medical & Clinical Education
• Value of Medical Education Formats
• Medical Education Program Mix
• Technology & Medical Education
• Measuring Effectiveness & Future Directions for Medical Education

To access the full report or to download a complimentary summary containing insights found in this report, click on the following link: http://www.best-in-class.com/rr1471.htm .

For related research, visit the Best Practices, LLC Web site at www.best-in-class.com/ . 

ABOUT BEST PRACTICES, LLC Best Practices, LLC is a leading benchmarking, consulting and advisory services firm serving biopharmaceutical and medical device companies worldwide. Best Practices, LLC's clients include all the top 10 and 48 of the top 50 global healthcare companies. The firm conducts primary research and consulting using its comprehensive proprietary benchmarking tools and analysis.

SOURCE Best Practices, LLC

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What is IME? The values and the rules for the pharmaceutical industry

February 28, 2022

by Mia Hill

IME stands for independent medical education—but what exactly is IME, what are the rules that surround it, and why is it a valuable addition to your medical education strategy? This article will take you through the answers to these questions. If you have any additional questions, please don’t hesitate to get in touch.

What is IME?

IME is education that is produced without any involvement or influence from the pharmaceutical company providing funding for the project. Once the company has agreed to support the education, the project operates at an arm’s length, and the IME agency running the project along with the faculty have the final decisions. You may also have heard of CME; this stands for continued medical education. CME follows the same rules and best practice standards as IME, but an accredited version. CME projects undergo review from accrediting bodies and, provided they are approved, any healthcare professional who completes a CME-accredited education module can claim a credit towards their professional development. Many countries require healthcare professionals to gain a certain amount of CME credits across a time period to maintain their licences.

Why may financially supporting IME be a useful addition to your strategy?

• Some healthcare professionals are sceptical of company-driven education as they believe it will be biased towards the company’s product. By investing in IME on top of your company-driven education projects, you will be able to reach a wider audience. In fact, healthcare professionals prefer IME/CME to other sources of information, including journal articles and publications. (1,2)
• In IME, we are allowed to discuss the impact of clinical trial data on the future of clinical practice. This ensures that, when a new therapy is launched, healthcare professionals have the knowledge needed to swiftly integrate this into their practice. In company-driven education, this type of discussion needs to wait until after launch.
• One of the rules of IME (described further below) is the prohibition of company review of the content via Veeva or equivalent. This means IME is a lot less work for your internal team. If you are stretched resource wise but have leftover budget, IME could be a great solution for you.
• By supporting IME initiatives, you are raising your profile among healthcare professionals as a company committed to the development of knowledge in the field, positive clinical practice change in the field and, ultimately, improving patient care.
• At SES, we will provide you with insights in return for your support. This includes robust needs assessments highlighting the challenges faced by our target healthcare professional audience and outcomes, to show how the education you have supported has helped to solve these challenges. This provides you with valuable insights you can use to develop your medical and commercial strategies further and, importantly, prove the value of your investment in IME to key stakeholders in your team.

What are the rules of IME?

• All content for IME projects should be developed at arm’s length, with no involvement or review by the financial supporter. Veeva reviews or equivalent are not allowed for IME projects.
• IME projects should be faculty led, with the faculty and education company working together to direct the content. The supporter should not have any influence on faculty selection.
• IME projects should be non-commercial. This means they should not mention any brand names, incorporate any of the supporter’s strategic messaging, or have any company branding. At SES, we have a strict firewall in place that prevents communication between teams working on commercial and independent projects, and there is no crossover of team members. This ensures our teams have no commercial knowledge of supporters’ strategies when working on IME projects and do not insert any bias into content.
• This brings us on to the fourth rule: IME projects should be fair and balanced and not represent any bias towards one company’s product over another. All relevant therapeutics must be discussed alongside one another, and all information must be supported by clear scientific evidence. This allows healthcare professionals to make informed and independent clinical care decisions. It may be that one product does appear favourable over the others, but as long as the rule of fair and balanced representation in accordance with the evidence base has been followed, then this is allowed. At SES, we have an experienced team who have been running IME projects for over 10 years.

There are multiple ways you can partner with us and support our hubs and patient programs: ​

• Become a supporter of our hub standard offerings
• Support our hub ​bolt-on projects
• Send us your proposal request and let us share our bespoke ideas

Please don’t hesitate to get in touch if, having read this article, you would like to hear more about IME.

1. Policy and medicine. Global Education Group survey: 98% credit CME as helpful in improving patient care. http://www.policymed.com/2013/04/global-education-group-survey-98-credit-cme-as-helpful-in-improving-patient-care.html. Published May 6, 2018. Accessed Feb 10 , 2022.

2. EPG Health Media. Continuing medical education (CME): the behaviour, demands and views of healthcare professionals (HCPs) in Europe. https://www.epghealthmedia.com/asset/6E422815-2D8C-473C-A9B86AB04E8C5E3D/. Published Nov 2012. Accessed Feb 10, 2022).

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The online peer-reviewed publication for medical students, the pharmaceutical industry’s role in u.s. medical education.

In 1993, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure concluded that diuretics and beta-blockers are the preferred choice for initial hypertension drug therapy because they have been shown to reduce cardiovascular morbidity and mortality in controlled clinical trials. Surprisingly, between 1992 and 1995, prescriptions for diuretics decreased by 50 percent and for beta-blockers by nearly 40 percent. On the other hand, prescriptions for calcium channel blockers, a heavily-promoted, expensive, newly developed hypertension treatment, rose by 13 percent . Why are these more expensive, possibly inferior drugs being prescribed instead of clinically recommended, evidence-based medications?

One reason is that during this time, the pharmaceutical industry spent more than $14 billion marketing their products in the form of samples, direct mailing and pharmaceutical representative consultations. The industry has been criticized for its marketing practices, with marketing expenditures nearly double that of research and development costs at three of the largest US pharmaceutical manufacturers. The industry spends at least $5 billion annually on marketing, which is more than $8,000 per physician. This marketing effort directly affected physicians, enticing them to prescribe the latest pharmaceuticals. Though not obvious, the relationship between physicians and the pharmaceutical industry begins long before doctors have the power to prescribe medication.

Medical students are subjected to a barrage of advertising that inevitably leads to a physician-industry connection that can be harmful to our health care system. Medical students’ exposure to pharmaceutical marketing begins early , growing in frequency throughout their training. Students receive gifts such as free meals, textbooks, pocket texts, small trinkets and even drug samples. Forty to 100 percent of medical students report exposure to the pharmaceutical industry , with clinical students being more likely than preclinical students to report exposure. The number of students recalling over 20 exposures to marketing rose from 33.3 percent to nearly 72 percent as students entered their clinical training. Pharmaceutical companies, recognizing the formative nature of the clinical years of medical education, seek to form relationships with medical students years before they are ready to independently practice medicine.

These interactions intensify throughout a physician’s training , ranging from trivial gifts such as pens and pads to more questionable large honoraria and consulting fees. Some resident physicians report an average of six pharmaceutical gifts annually , up to 70 industry sponsored lunches , and nearly 75 promotional items in one year, and a survey showed that 41 percent of emergency medicine departments allowed their residents to be taught by drug company representatives. Physicians meet with pharmaceutical representatives an average of four times a month. Though these examples may seem shocking, they underscore the inherently intertwined physician-pharmaceutical relationship.

As medical students are increasingly subjected to pharmaceutical marketing throughout their education, their skepticism towards the practices of the pharmaceutical industry gradually diminishes. Multiple studies report a relationship between exposure to the pharmaceutical industry and positive attitudes about industry interactions. As students’ exposure to the pharmaceutical industry increases, their ability to determine industry bias decreases. In losing their ability to detect bias and analyze pharmaceutical marketing statements objectively, medical students hinder their future ability to practice evidence-based medicine.

Pharmaceutical industry influence can harm the social and moral character of students. In medicine, the traditional virtues of benevolence, compassion, integrity, respectfulness, honesty and justice are valued over commitments to money, power and self. Medical school seeks to impart these values, helping to train doctors that act morally in their profession. When a pharmaceutical representative gives a gift to a student, the student either feels indebted or entitled. If a student feels indebted, they are likely to alter their future prescribing habits based on industry recommendations, impairing their ability to practice medicine in an unbiased manner. If a student does not feel indebted, they are in danger of developing an unwarranted sense of entitlement. Fein et al found that nearly one-third of students at UCLA thought that a drug company should pay the cost of printing notes for them, and almost half the students felt that a meal, textbook and paid travel to a conference were appropriate gifts. A something-for-nothing experience has created a sense of entitlement among these future physicians.

As medical students become physicians, the physician-pharmaceutical industry interaction becomes increasingly linked and affects the prescribing habits of physicians. On one hand, physician-industry interactions help keep physicians informed about the latest drugs which can be invaluable as the pace of scientific discovery can exceed dissemination of application information. Some physicians also report the substantial benefit to patients in the form of free sample medication. On the other hand, the industry-physician relationship has many negative consequences. In a review of 16 studies, interactions with the pharmaceutical industry lead to physicians being more likely to request the addition of company drugs to the hospital formulary and to prescribe the company’s medication over generic drugs. These changes resulted in the use of medications that were costly and had no therapeutic advantage over older ones. Medicine relies on objective evidence, and the pharmaceutical industry’s influence underlies the short-cutting of this essential process.

Another negative consequence of physician industry-interaction is the faltering credibility of the medical profession. Weber et al report that some schools have strict policies regarding faculty-industry relationships, but fail to enforce them. For example, Stanford University banned physicians from giving paid promotional talks for pharmaceutical companies, yet more than a dozen of the school’s doctors were paid speakers — with two earning more than six figures during these speaking appointments. The American College of Physicians noted “a perception that a physician is dispensing medical advice on the basis of a commercial influence is likely to undermine a patient’s trust not only in the physician’s competence, but also in the physician’s pledge to put the patient’s welfare above self-interest.” If the patients begin to view physicians as being tainted by industry influence, then the public’s entire faith in the medical system could be eroded.

In order to prevent our future physicians from becoming puppets of the pharmaceutical industry, the current medical education system must undergo key reform. Wofford et al devised a 90-minute workshop which aimed to increase student knowledge and awareness about pharmaceutical company representatives’ (PCR) marketing techniques, address appropriate interactions with PCRs, and discuss the ethical issues surrounding PCR interaction. After the workshop, student perception of the degree of PCR influence on prescribing habits increased from 44.2 percent to 62.1 percent. Though this workshop only addressed PCR interaction, other workshops like it could address related issues such as acceptance of gifts and bias in clinical decision-making. A revamping of medical school curricula to include these supplemental educational courses would help students counter the growing influence of the pharmaceutical industry.

The pharmaceutical industry and the medical field are inextricably entangled. One creates the necessary medications, and the other delivers the medications to patients in need. Driven by capitalism, the pharmaceutical industry exerts an influence over medical students, creating an atmosphere in which students come to value the industry’s input in patient care that can lead to patient and societal harm. In order to counteract this influence, medical education must reform to help students react to these issues.

Image credit: Photo from Images Money .

Contributing Writer Emeritus University of California, Irvine School of Medicine Priscilla Q. Vu is a medical student at the University of California, Irvine School of Medicine. She recently matched into UC Irvine's Ophthalmology Residency Program. Her interests include international travel, research/technology, community service, humanism in medicine, and medical education.

Contributing Writer Emeritus University of California, Irvine School of Medicine Born and raised in Cincinnati, OH. Studied Bioengineering at UCSD and now finishing medical school at UC Irvine. Applied for residency in Otolaryngology-Head and Neck Surgery.

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Can Pharmaceutical Companies Ethically Sponsor Medical Education?

Although pharmaceutical companies sponsor multiple aspects of medical education, these relationships present a moral gray area..

• Veronica Salib, Associate Editor

The pharmaceutical industry plays a pivotal role in healthcare, driving innovation and providing new tools to optimize patient care and management. Despite the many benefits offered by pharmaceutical companies and manufacturers, there is an ever-present ethical gray area.

It is no secret that ethical concerns about drug pricing, treatment marketing, and patent exclusivity have been a constant battle between pharma companies, regulatory agencies, healthcare professionals, and patients. However, one less-known gray area is the role of pharmaceutical sponsorships in provider education.

Earlier this year, at the 2023 World Medical Innovation Forum hosted by Mass General Brigham (MGB) and Bank of America, Robert M. Califf, the commissioner of the United States Food and Drug Administration (FDA) , commented on the potential fallacies of pharmaceutical sponsorships in medical education programs.

"This is a very complicated set of issues: Why would there ever be a need for a pharmaceutical or a device company to fund coursework for medical students?” Califf asked. “The healthcare delivery industry is much larger than the medical products industry, and the academic medical centers are strong, lobbying for financial interests of the academic medical center.”

In this article, PharmaNewsIntelligence explores the historical role of pharmaceutical sponsorships in medical education, provides examples of drug company contributions to medical education, and compares the benefits and risks associated with pharmaceutical involvement in educational activities.

How Do Pharmaceutical Companies Sponsor Medical Education?

Pharmaceutical companies sponsor medical education through multiple methods and solutions. While some types of sponsorship are apparent, others are more discreet. The following methods are some examples of pharmaceutical involvement in medical education.

Funding Continuing Medical Education

Historically, pharmaceutical companies have provided commercial support for continuing medical education (CME) programs — also known as continuing professional development in the United Kingdom — by funding postgraduate educational programs for established healthcare professionals. For example, Pfizer, one of the most notable pharmaceutical companies in the world, has an Independent Grants for Learning and Change (IGLC) program that funds CME. Through the IGLC program, Pfizer provided financial support for independent medical education initiatives developed by third-party organizations. These educational opportunities span multiple therapeutic areas, such as oncology and infectious diseases.

In addition to Pfizer’s contributions, Novartis has historically sponsored educational grants and initiatives for multiple sclerosis and other chronic diseases, including heart failure.

Other industry-funded CME efforts include Novartis grants and educational initiatives, Merck CME grants, Johnson and Johnson‘s education initiative sponsorships for surgical education, AstraZeneca CME grants, industry-sponsored diabetes education initiatives by Sanofi, and Gilead Science HIV education programs .

In a 2021 essay published in BMJ , Adriane Fugh-Berman, MD, a professor and educational provider at the Georgetown School of Medicine, argues that CME should be regulated like product promotions.

According to the essay, many studies have found that CME sponsorships with industry funding favor the products developed by industry sponsorships. Fugh-Berman explains that a grand round presentation at the Minneapolis Veteran’s Affairs Medical Center by a pharmaceutical sponsor correlated with triple the prescriptions of the antipsychotic manufactured by the sponsor.

This data, alongside other phenomena, emphasizes the impacts of industry influence on healthcare organizations, clinician decision-making, and prescribing practices.

Guidelines and ethical standards are in place to ensure that CME remains unbiased and focused on improving patient care. Healthcare professionals engaging in CME activities should be aware of these guidelines and potential conflicts of interest.

Despite varying sources of funding, the Accreditation Council for Continuing Medical Education (ACCME) notes that accredited CMEs for medical professions should follow four core standards.

• Valid content : The first standard enforced by the ACCME is ensuring content is valid, meaning that all CME information should be supported by scientific evidence-based research.
• Commercial bias and marketing: The ACCME is also responsible for preventing commercial bias and marketing accredited CME programs.
• Financial relationships : The third standard focuses on identifying, mitigating, and disclosing relevant financial relationships.
• Commercial support : While not all CME programs use commercial support, those who do are expected to ensure ethical partnerships that do not get in the way of delivering accurate and unbiased medical education.
• Ancillary activities : The final standard provides guidelines for managing ancillary activities associated with CME.

Sponsoring Seminars, Conferences, and Symposia

In addition to standard or accredited CME programs, pharmaceutical companies may sponsor medical education in other formats, including conferences, seminars, and symposia.

Pharmaceutical companies may sponsor some medical societies that host annual conferences or regular sessions to help fund the program. For example, the American Heart Association (AHA) Scientific Sessions is a notable cardiovascular conference that companies like Pfizer, Novartis, and Amgen have sponsored.

Sponsorships like this are often accompanied by exhibits or talks from pharmaceutical representatives promoting the companies’ relevant medications or therapeutic interventions.

Other conferences and seminars that pharmaceutical companies have funded include the American Diabetes Association Scientific Sessions, the American Association for Cancer Research Annual Meeting, and the American Society of Clinical Oncology Annual Meeting, among others.

Research And Grant Funding

Some pharmaceutical companies also sponsor research grants and other forms of medical discovery. Companies may offer financial support or tools for researchers to conduct studies and manage the expensive costs of preclinical research and clinical trials.

However, there is a significant potential for conflicts or publication bias when companies sponsor these studies. Researchers may be inclined to alter data to favor the pharmaceutical manufacturer’s interests. While this opposes ethical guidelines, monitoring or managing these unconscious biases may be challenging.

Pfizer offers research grants through its Global Health Innovation Grants (GHIG) for researchers focused on addressing major global health issues, including infectious diseases and other public or global health issues. Additionally, Novartis provides financial support to independent investigators and healthcare facilities. Other companies, including Merck, Bristol Myers Squibb, Gilead, Sanofi, AbbVie, AstraZeneca, Eli Lilly, and GSK , may fund various research and grants.

Financially Supporting Medical Journals and Publications

Pharmaceutical companies can also play a significant role in the survival of medical journals and in getting research articles printed. Beyond funding the actual research that is published, pharmaceutical companies may provide financial support and donations to support publication expenditures. Manufacturers may also pay for advertising in medical journals and publications.

While different companies have various standards for industry involvement and the role of sponsorships in publications, ethical standards generally focus on ensuring that all data is scientifically sound and void of biases.

Medical School and Institution Grants

In addition to postgraduate medical education and clinical research support, pharmaceutical companies may sponsor medical schools and provide institutional grants. These grants may be given to medical schools to fund research, educational initiatives, scholarships, fellowships, collaborative researchers, medical devices or equipment, and medical libraries or informational resources.

Weighing the Benefits and Risks

Pharmaceutical sponsorships can play a significant financial role in the prosperity and availability of medical education across multiple levels; however, the associated risks may diminish the potential benefits, compromising scientific integrity, patient care, and disease outcomes. It is essential to understand the balance between the benefits and the risks.

Some of the most apparent benefits of pharmaceutical sponsorships include the following.

• Less expensive education for medical professionals and students : When pharmaceutical companies sponsor seminars, webinars, and CME programs, these programs could be covered or less costly due to the contributions. For many medical professionals who pay fees to keep their licenses up to date or are still paying off medical school tuition, free or less expensive CME could be a significant perk.
• Access to information : In addition to the tools that pharma companies may provide to support medical students and CME students, they may also be able to donate medical textbooks, maintain journals, and introduce other resources for medical students. A wide range of information can become easily accessible through these contributions.
• Research and development : Pharmaceutical companies' investments can significantly contribute to research and development. Research and development costs are astronomical, and medical institutions, especially smaller research centers without federal grants, may rely on pharmaceutical support to fund research and innovation.
• Networking : Pharmaceutical sponsorships may also provide significant networking opportunities for medical professionals. For example, seminars and conferences can be a great place for medical professionals to meet, interact, and collaborate.

On the other hand, there are some significant and potentially detrimental effects of pharmaceutical sponsorships in medical education.

• Conflict of interest : The most glaringly obvious issue with pharmaceutical funding in medical education is the potential conflict of interest. Pharmaceutical companies can compromise the objectivity of institutions, teachers, researchers, and journals by providing financial support.
• Prescribing practices : Beyond bias in the educational training and information release, sponsorships, if done unethically, may impact prescribing practices . Providers who attend regular sessions from one manufacturer that advertises a specific drug may be more likely to prescribe that drug over other available alternatives.
• Lack of transparency : Many issues arise from a lack of transparency about the funding source and how different companies may contribute to educational efforts. Despite more companies moving toward transparent practices, the continuing opacity of the pharmaceutical spaces can be a negative side effect of pharmaceutical sponsorships.
• Overemphasis on pharmaceutical solutions : Although pharmaceutical solutions have revolutionized healthcare and can be the best treatment tool, other medical interventions may provide more beneficial solutions. Pharmaceutical sponsorships will likely push providers toward drug-based treatments even if other interventions could work better.

Overall, it’s unlikely that pharmaceutical sponsorships will ever completely dissipate from medical education. Financial reliance on these sponsors and investors could cause economic repercussions if they were eliminated. However, companies providing subsidies should be conscious of the information they put forward, ensuring that they follow the best ethical practices and standards . Ensuring that all claims are backed by unbiased, scientifically sound, evidence-based data and transparency about sponsorships can position companies well for moral involvement in education.

Moreover, medical professionals and students who accept these sponsorships should be mindful of their interactions with these sponsors and investors. Students and healthcare providers should consider the potential conflicts of interest or bias in the claims presented and look for medically accurate data to support any clinical decisions.

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Redefining the Role of Medical Affairs Professionals as Innovators and Leaders in Industry-Led Medical Education

• Current Opinion
• Published: 15 April 2024
• Volume 38 , pages 167–177, ( 2024 )

Cite this article

• Sajita Setia   ORCID: orcid.org/0000-0002-7423-3742 1 ,
• Elliot Loo   ORCID: orcid.org/0009-0004-0029-7729 1 ,
• Salil Prakash Shinde   ORCID: orcid.org/0000-0003-3657-0454 2 ,
• Manmohan Singh   ORCID: orcid.org/0000-0002-9175-8559 2 ,
• Chew Hooi Wong   ORCID: orcid.org/0009-0006-1705-7603 3 &
• Karan Thakkar   ORCID: orcid.org/0000-0001-8831-6824 3  

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Medical affairs professionals are pivotal players at the intersection of medical innovation and practice in the pharmaceutical industry. They are uniquely positioned to translate complex medical knowledge into actionable insights for internal and external stakeholders. Industry-led continuing medical education (CME) programs, guided by these professionals, hold the potential to markedly improve clinicians’ application of evidence-based medicine (EBM) in clinical settings, thereby elevating patient care outcomes. However, current CME techniques often overlook the integration of diverse disciplines such as educational theories, cognitive psychology, information mastery, and implementation science, which are important for effective real-time decision-making in patient care. This gap in integrating implementation science is vital, as it is key in ensuring that medical innovations are not just developed but also effectively implemented and efficiently utilized in clinical settings. In this opinion article, we aim to highlight the crucial yet often underrecognized role of medical affairs professionals in shaping robust and practical CME programs within the industry. We explore emerging trends and approaches in medical education and CME based on the principles of adult education. Additionally, we explore how medical affairs professionals can effectively drive the adoption of EBM in clinical practice. This exploration aims to provide insights into enhancing CME programs, with medical affairs professionals at the forefront of innovation and leadership in bridging gaps in clinical practice.

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Acknowledgements

The authors would like to thank Dr. Soundravally Rajendiran, MD, Ph.D., FRCPath, Professor, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, for her invaluable critical review and insightful feedback on this manuscript.

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Setia, S., Loo, E., Shinde, S.P. et al. Redefining the Role of Medical Affairs Professionals as Innovators and Leaders in Industry-Led Medical Education. Pharm Med 38 , 167–177 (2024). https://doi.org/10.1007/s40290-024-00522-1

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Pharmaceutical companies and healthcare providers: Going beyond the gift – An explorative review

1 Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

Daan Westra

Federica angeli.

2 Department of Organization Studies, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands

Aggie Paulus

Marleen struss, dirk ruwaard, associated data.

All relevant data are within the paper.

Introduction

Interactions between pharmaceutical companies and healthcare providers are increasingly scrutinized by academics, professionals, media, and politicians. Most empirical studies and professional guidelines focus on unilateral donor-recipient types of interaction and overlook, or fail to distinguish between, more reciprocal types of interaction. However, the degree of goal alignment and potential for value creation differs in these two types of interactions. Failing to differentiate between these two forms of interaction between pharmaceutical companies and healthcare providers could thus lead to biased conclusions regarding their desirability. This study reviews the empirical literature regarding the effects of bilateral forms of interactions between pharmaceutical companies and healthcare providers in order to explore their effects.

Material and methods

We searched two medical databases (i.e. PubMed and Cochrane Library) and one business database (i.e. EBSCO) for empirical, peer-reviewed articles concerning any type of bilateral interaction between pharmaceutical companies and healthcare providers. We included quantitative articles which were written in English and published between January 1 st , 2000 and October 31 st , 2016, and where the title or abstract included a combination of synonyms of the following keywords: pharmaceutical companies, healthcare providers, interaction, and effects.

Our search results yielded 10 studies which were included in our analysis. These studies focused on either research-oriented interaction or on education-oriented interaction. The included studies reported various outcomes of interaction such as prescribing behavior, ethical dilemmas, and research output. Regardless of the type of interaction, the studies either reported no significant effects or ambivalent outcomes such as affected clinical practice or ethical issues.

Discussion and conclusion

The effects of bilateral interactions reported in the literature are similar to those reported in studies concerning unilateral interactions. The theoretical notion that bilateral interactions between pharmaceutical companies and healthcare providers have different effects given their increased level of goal alignment thus does not seem to hold. However, most of the empirical studies focus on intermediary, provider-level, outcomes such as altered prescribing behavior. Outcomes at the health system level such as overall costs and quality of care are overlooked. Further research is necessary in order to disentangle various forms of value created by different types of interactions between pharmaceutical companies and healthcare providers.

Cooperation between various organizations through inter-organizational relations has been described both as a hallmark and necessity in the healthcare industry [ 1 , 2 ]. Although inter-organizational cooperation has been studied through various theoretical lenses [ 3 ], some of which appear more applicable to healthcare than others [ 4 ], scholars generally agree that organizations are embedded in various networks of inter-organizational relations [ 5 , 6 ] and that these are crucial to organizational performance [ 7 , 8 ]. A growing field of interest within the inter-organizational relations literature is that of cooperative relations between for profit and not-for-profit organizations, also referred to as cross-sectoral organizations or public-private partnerships [ 9 , 10 ]. Scholars typically argue that for-profit and not-for-profit organizations collaborate in order to leverage complementary resources and institutional logics in order to create joint or social value and solve complex social problems [ 5 , 11 – 13 ].

Within the healthcare context, interactions between pharmaceutical companies and healthcare providers (comprising both healthcare organizations as well as professionals) arguably constitute the most widely recognized form of relations between for-profit and not-for-profit organizations. These types of interactions occur on a large scale. Research from several countries has shown that more than eighty percent of physicians have interactions with pharmaceutical companies and one-fourth of US biomedical researchers receive industry funding for example [ 14 – 17 ]. Interactions between pharmaceutical companies and healthcare providers are increasingly scrutinized by academics, professionals, media, and politicians [ 18 – 23 ] and scholars have not reached a consensus about whether they indeed have beneficial effects and enhance social value [ 24 , 25 ]. Following the social value-creation logic, various scholars argue that interaction between pharmaceutical companies and healthcare providers could foster the development of new medicines which will ultimately benefit patients [ 24 , 26 , 27 ]. Some empirical studies have furthermore shown that interaction between pharmaceutical companies and healthcare providers enhances technological innovation, fosters knowledge creation, aids disease control, and reduces polypharmacy issues [ 24 , 28 ]. Conversely, others view the opposing logics in both organizations as insurmountable and suggest that interactions between pharmaceutical companies and healthcare providers are primarily geared towards promoting the products of the pharmaceutical company, which conflicts with the social responsibility of healthcare providers. Empirically, studies find that interaction between pharmaceutical companies and healthcare providers could result in a conflict of interests (COI), negatively alter physicians’ prescribing behavior, or result in a negative perception towards professionals [ 22 , 29 – 35 ]. As a result, several guidelines have been created to help professionals navigate the opposing explanations of interactions with pharmaceutical companies [ 36 – 38 ].

Interactions between pharmaceutical companies and healthcare providers take various forms, ranging from personal gifts, free samples, visits by representatives, and marketing directed towards physicians to collaborative drug development, funding for continuing medical education (CME), sponsorships, and research-funding [ 20 , 39 ]. Each of these interactions carries distinct features and characteristics. Within the inter-organizational relations literature, a common way to distinguish between different types of interactions between for-profit and not-for-profit organizations is through Austin and Seitanidi’s [ 10 , 40 ] value creation spectrum and collaboration stages. The authors argue that collaboration between for-profit and not-for-profit organizations can result in associational value, transferred resource value, interaction value, and synergistic value. According to Austin and Seitanidi, the creation of each of these types of value is contingent on the type of interaction in which the for-profit and not-for-profit organization are engaged. In philanthropic collaboration, for-profit organizations predominantly transfer resources, typically in monetary terms, to the not-for-profit organization with limited to no exchange occurring between partners. In these collaborations transferred resource value and associational value do not enhance value-creating potential, and carry the least synergistic value [ 9 ]. In transactional collaboration, organizations’ interests are more closely linked, leading to bilateral exchanges of more specialized resources. In integrative collaborations, organizations exchange key assets in a conjoined fashion, generating greater synergistic value. Lastly, transformational collaborations constitute the most advanced stage of collaboration and are categorized by shared learning between the organizations, rather than mere resource exchanges. This type of collaboration is argued to have the strongest outcomes in terms of social value creation and bettering the lives of people.

In the context of interactions between pharmaceutical companies and healthcare providers, gifts (i.e. from the former to the latter) can best be described as philanthropic (i.e. donor-recipient) interactions. Although the motives of pharmaceutical companies might transcend, or even neglect, actual philanthropy [ 40 ], the resource flow in these types of interaction has a clear unilateral pattern. That is, the pharmaceutical company typically donates resources (often in the form of free merchandise) to healthcare providers without any resources being formally reciprocated. Conversely, interactions in the form of educational arrangements, licensing, or event sponsorships are best categorized as transactional interaction. In these types of interactions, healthcare providers are generally required to reciprocate resources in some form or the other (e.g. time). Lastly, joint research undertaken by pharmaceutical companies and healthcare providers falls within the realm of integrative transformational collaboration. That is, both need to devote considerable resources in a coordinated fashion to the project.

Despite the fact that various types of interaction between pharmaceutical companies and healthcare providers exist and that these occupy different collaborative stages, research [e.g. 20, 22] and practical guidelines [e.g. 36, 38] in this field rarely acknowledge these differences as such. However, failing to differentiate between unilateral (i.e. philanthropic) and bilateral (i.e. transactional, integrative, or transformational) types of interaction between pharmaceutical companies and healthcare providers provides an incomplete image of the effects of interactions between both industries. Consequently, interactions between pharmaceutical companies and healthcare providers are potentially over-generalized and over-scrutinized. The main aim of our study is thus to understand the effects of bilateral interactions between pharmaceutical companies and healthcare providers. We seek to contribute to the ongoing debate on this issue in two ways. Firstly, we make a clear distinction between the nature of interactions between pharmaceutical companies and healthcare providers. Consequently, the results of this study allow for a clearer comparison between the effects of bilateral, as opposed to unilateral, interactions between pharmaceutical companies and healthcare providers, as well as for a more nuanced understanding of the desirability of these interactions. Following the adoption of the distinction between unilateral and bilateral interactions, we secondly seek to integrate the knowledge produced in the business literature with that produced in the medical field. Combining both perspectives provides a more comprehensive understanding of the phenomenon.

Materials and methods

Search strategy.

We studied the effect of bilateral interactions between pharmaceutical companies and healthcare providers by systematically reviewing the quantitative evidence regarding these interactions. Our review followed the PRISMA guidelines [ 41 ]. We searched two medical databases, namely PubMed and the Cochrane Library. In order to avoid retrieving a wide range of pharmacologic studies, which are not the focus of our study, we refrained from searching the Embase database. We did however search the business database EBSCO, which covers multiple databases such as Business Source Complete, MEDLINE, CINAHL, and Econlit. We deliberately refrained from using snowball sampling techniques to further our sample following the work of Horsly et al. [ 42 ], indicating that there is limited evidence to support this approach in reviews.

The PubMed, Cochrane Library and EBSCO databases were all searched for empirical, peer-reviewed articles which used a quantitative analysis, and were written in English. The title or abstract of articles had to include a combination of the following keywords: pharmaceutical companies, healthcare providers, interaction, and effects, or variations to these keywords (see Table 1 for a list of the specific keywords used). In the PubMed database, the relevant Medical Subject Heading (MeSH) terms were furthermore used (see Table 1 for a specification). Lastly, we included only those studies published between January 1 st , 2000 and October 31 st , 2016. Articles prior to 2000 were not included for two reasons. Firstly, Wazana [ 20 ] published an extensive review on various types of interaction between pharmaceutical companies and individual healthcare providers in 2000. Focusing on the post-2000 period hence avoids duplication of this work. Furthermore, the uptake in interest surrounding collaboration between for-profit and not-for-profit organizations has arguably been sparked by Austin’s work in 2000 [ 40 ] introducing the notion of various collaborative stages in these interactions. As such, we considered it likely that most of the studies in the business literature recognized this distinction from 2000 onwards.

Study selection

Only those studies which met all of the inclusion criteria (see Table 2 for a specification) were considered relevant to our study. Most importantly, the studies had to focus on an interaction which was clearly identifiable as being bilateral in nature. Hence, studies had to contain a clear description of the interaction under investigation and only those studies which focused on interactions which involved mutual resource exchanges were considered relevant to our research question. Examples of such bilateral interactions include continuing medical education and joint research projects. In the former case, professionals have the opportunity to update their medical knowledge while the pharmaceutical company has access to the professional to market their products. In the latter case, the pharmaceutical company is provided with evidence of whether or not their product constitutes an advancement over existing treatments, while it allows professionals to enhance the quality of healthcare delivery if this is indeed the case, acquire representative insights in the product, and advance their academic career. Studies which focused on unilateral interactions, a one-directional transfer of (monetary) resources, were excluded from our analysis. Examples of such interactions include gifts to physicians and visits of sales (i.e. pharmaceutical) representatives (PSRs). Although visits of PSRs can be considered a relevant source of information to some physicians [ 43 , 44 ], the main purpose of PSR visits is to provide physicians with samples or gifts [ 20 ] and physicians do not always consciously make the decision to be visited.

Secondly, articles were only included in our review in case the interaction occurred between pharmaceutical companies and healthcare providers (i.e. actively practicing healthcare professionals or healthcare organizations). Interactions between pharmaceutical companies and non-active professionals such as medical students were excluded.

Lastly, studies had to specifically address an identifiable outcome of bilateral interactions between pharmaceutical companies and healthcare providers in order to be eligible for inclusion in our review. Examples of such outcomes include the effect of bilateral interaction on physicians’ prescribing behavior or integrity as well as patients’ perception towards healthcare providers. Our study thus specifically focuses on which potential effects have been researched and which of these effects are supported by quantitative evidence. In case a study focused on unilateral as well as bilateral interaction, it is only eligible for inclusion when the effects of both types were clearly differentiated. For example, CME leads to effect X, educational training to effect Y, and visits of pharmaceutical representatives or gifts leads to effect Z. The articles were reviewed by two reviewers (T.L. and D.W.). In cases of disagreement the inclusion or exclusion of a particular study was discussed by both reviewers until a consensus was reached.

Assessment of study quality

To assess the quality of the included empirical studies, each of the included studies was assigned a score based on the quality rating scheme of the Oxford Centre for Evidence-based Medicine for ratings of individual studies [ 45 ]. This rating scale is a proven, systemized approach which gives a score ranging from 1–5. In this rating scale, a score of 1 is an indication of high study quality (i.e. RCTs or meta-analyses), whereas a score of 5 indicates low quality (i.e. case reports). The scale was not used as a formal inclusion criteria, but served as a tool to get insight in the quality of the available literature regarding bilateral interaction between pharmaceutical companies and healthcare providers.

Included studies and characteristics

After elimination of duplicates, our search strategy identified a total of 1,498 studies. Initially, the eligibility of all articles was checked by reviewing the title and abstract of each study. This resulted in 29 studies, of which the full-text was assessed. Assessing the full text of these articles led to the exclusion of 19 additional articles. Exclusion of these additional articles was due to various reasons including: (A) the study was not empirical (N = 5), (B) the study only focused on unilateral interaction, did not made a clear distinction between unilateral and bilateral interaction, or the study did not describe the interaction between pharmaceutical companies and healthcare providers in enough detail (N = 8), (C) the study focused on other stakeholders such as healthcare authorities (N = 5), and (D) the study only focused on the prevalence of relations between pharmaceutical companies and healthcare providers but not on their effect (N = 1). As a result, a total of 10 empirical studies regarding the effects of bilateral interaction between pharmaceutical companies and healthcare providers were included in our review [ 18 , 46 – 54 ]. The process of including and excluding articles is graphically represented by the PRISMA-diagram in Fig 1 .

Most of the included studies in our review utilized a cross-sectional research design (N = 8). Additionally, one study had a quality rating of one [ 50 ], one study had a quality rating of three [ 46 ], seven studies had a quality rating of four [ 18 , 47 , 48 , 51 – 54 ], and one study had a quality rating of five [ 49 ]. Table 3 provides an overview of each study’s characteristics.

Types of interaction

The studies included in our review were categorized into two categories based on the type of interaction under study. These categories were; (a) education-oriented interaction [ 18 , 52 ] (N = 2), and (b) research-oriented interaction [ 46 – 51 , 53 , 54 ] (N = 8). Interactions which were focused on increasing professionals’ (e.g. physician or nurse-practitioners) awareness, knowledge, and attitude towards innovative products and services by providing scientific and educational information were considered an education-oriented interaction. Interactions which were specifically focused on supporting, funding, or sponsoring research projects were considered research-oriented interactions. Furthermore, the articles included in our review studied various types of outcomes of interactions between pharmaceutical companies and healthcare providers. Four of the ten articles studied how these interactions influenced the prescribing behavior of physicians, for example in the form of increased prescription of brand-name medicines [ 18 , 46 , 48 , 52 ]. Four other studies investigated whether interactions between pharmaceutical companies and healthcare providers were associated with ethical dilemmas, such as perceived conflicts of interests [ 47 , 49 , 53 , 54 ]. The remaining two studies investigated the effects of bilateral interactions on research output, for example measured through professionals’ scholarly impact [ 50 , 51 ] (N = 2). Table 4 presents a summary of the results of the studies included in our review.

None of the studies included in our review showed interaction between pharmaceutical companies and healthcare organizations but merely between pharmaceutical companies and healthcare professionals. Table 3 presents the investigated population from the included studies.

Education-oriented interaction

The two studies in our review which assessed the effect of education-oriented interactions between pharmaceutical companies and healthcare providers both utilized a quantitative, cross-sectional design. The objective of both studies was to determine the association between education sponsored by pharmaceutical companies and the prescribing behavior of physicians. The studies were both conducted in the United States in 2016 and were based on the open payments database which was linked to other secondary data repositories. The open payments database contains information on payments from pharmaceutical companies to healthcare providers and was used in both studies to retrieve information on education-oriented interaction [ 18 , 52 ]. Both studies conclude that education-oriented interactions between pharmaceutical companies and healthcare providers alter physicians’ prescribing behavior. That is, physicians who engaged in education-oriented interactions, prescribed more brand name drugs [ 52 ] and used a specific injection more frequently [ 18 ]. Lastly, both studies find a binary effect of education-oriented interactions on physicians’ prescribing behavior. That is, a higher monetary value of the education-oriented interaction does not have a significant influence on physicians’ prescribing behavior.

Research-oriented interaction

The eight studies in our review which assessed research-oriented interaction were all conducted in the United States or western European countries and six of the eight studies utilized a cross-sectional research design. The studies furthermore identified three types of effects resulting from research-oriented interaction between pharmaceutical companies and healthcare providers. These are altered prescription behavior, ethical dilemmas, and research-related effects. The studies report that research-oriented interaction can have a negative effect on the practice of physicians [ 47 ]. This is for example due to an increase prescription rate of a trial sponsor’s drugs [ 46 ]. Similar to education-oriented interactions however, physicians’ prescribing behavior is not influenced by the monetary amount of a research grant [ 48 ]. Studies on research-oriented interaction furthermore indicate that physicians with professional identities that are closely aligned with the pharmaceutical company (i.e. physicians who primarily consider themselves entrepreneurs), are more likely to be susceptible to having the pharmaceutical companies assert higher levels of control over various aspects of research projects [ 54 ]. Such control can in turn lead to compromises, distort independence, and self-censorship [ 49 ].

One study on research-oriented interaction reported that papers published based on joint research projects between pharmaceutical companies and healthcare providers have greater scholarly impact [ 51 ]. However, these interactions were not reported to have a methodological influence. That is, one study in the review revealed that survey response rates are not significantly different in pharmaceutical industry-funded research projects compared to university sponsorships [ 50 ]. The studies in our review furthermore find no evidence that research-oriented interaction affects physicians’ adherence to international treatment guidelines [ 46 ], nor the development of clinical practice guidelines [ 47 ]. Lastly, research-oriented interaction was found to have a Matthew-effect. That is, research-oriented interactions between pharmaceutical companies and healthcare providers led to multiple additional relations between the providers and pharmaceutical companies, for example in the form of roles on advisory panels [ 53 ].

This study aimed to deepen our understanding of the effects of inter-organizational relations between pharmaceutical companies and healthcare providers, by reviewing the quantitative evidence regarding the effects of bilateral interaction between these organizations. The studies included in our review identified education-oriented and research-oriented interactions as the two main forms of bilateral interactions between pharmaceutical companies and healthcare providers, but vary in terms of the effects under study [ 18 , 46 – 54 ]. All studies included in our review report negative or neutral effects of interactions between pharmaceutical companies and healthcare providers. Our findings are thus in line with the literature regarding gifts (i.e. unilateral interactions) from pharmaceutical companies to healthcare providers [ 55 ]. However, they do not seem to provide support for the theoretical notion that bilateral interactions between for-profit and not-for-profit organizations have greater value-creating effects [ 9 ].

While the type of effects studied for bilateral interactions overlap to a great extent with those studied for unilateral interactions [ 56 , 57 , 58 ], the use of different outcome measures does not explain the deviant findings. Even though we refrained from selecting only those studies which used individual providers as the unit of analysis, all studies in our review focus on effects at the level of individual healthcare professionals [ 18 , 46 – 54 ] That is, research predominantly seeks to identify how interactions with pharmaceutical companies affect physician-level outcomes such as prescription behavior, research output, or ethical dilemmas [ 18 , 46 , 48 , 52 ]. Outcomes which manifest at an organizational level rather than on the level of individual professionals are overlooked in most studies. While gifts commonly involve specific professionals in an organization, interactions further down the collaboration continuum become more strongly embedded in an organization [ 9 , 40 ]. Yet, none of the studies in our review focus on such effects, which could provide an explanation for our deviant findings. That is, in case bilateral exchanges of resources only occur at the level of the individual professional, interactions between pharmaceutical companies and healthcare providers might not reach the strategic organizational level. As a result, resource exchanges do not conjoin and the value-creation potential is not fulfilled. Ultimately, the effect of bilateral interactions on more general and overarching health systems outcomes such as costs, quality, and accessibility of care remain unclear.

Secondly, our review revealed that there is a lack of quantitative evidence regarding bilateral interactions between pharmaceutical companies and healthcare providers. Many of the papers which were retrieved by our initial search strategy constituted opinion papers, editorials, or conceptual studies regarding the topic. Few studies hence met the stringent inclusion criteria of our review, even though the topic has been widely discussed in academic journals. The quantitative studies which were ultimately included in our review, predominantly utilized cross-sectional designs and scored relatively low on the quality rating scale (i.e. an average of 3.45). Given the relatively low study quality, there is no definitive answer regarding the desirability of these types of interactions. These considerations could indicate that researchers encounter difficulties, for example feasibility-wise or ethically, to construct high-quality studies regarding bilateral interactions between pharmaceutical companies and healthcare providers. However, given the vast amount of attention paid to this subject and its inherent societal relevance, future research of high empirical quality could make the effects and desirability of bilateral interactions between pharmaceutical companies and healthcare providers clearer.

Limitations

Our work is subject to some limitations. Given the exploratory nature of our work, we refrained from specifying specific types of interactions or effects in our search strategy. Instead, we focused on generic keywords such as ‘interaction’ or ‘cooperation’ and ‘effect’ or ‘outcome’. As a result, it is possible that some studies were overlooked, which could explain the low number of studies included in the review. However, we refrained from pre-specifying specific types of interactions or effects in order to avoid any a priori bias in our search. Secondly, distinguishing between unilateral and bilateral interactions is a novel approach to the literature regarding interactions between pharmaceutical companies and healthcare providers. As a result, not all types of interactions between pharmaceutical companies and healthcare providers are pre-defined as belonging solely and unambiguously to one of the two categories or were clearly identifiable from the studies. Lastly, we have limited our review to include quantitative studies of bilateral interactions between pharmaceutical companies and healthcare providers. While qualitative studies are able to reveal relevant details of a phenomenon under study, their generalizability is inherently restricted to the empirical setting in which they were studied. Since we aimed to connect two previously unconnected streams of literature, we instead focused exclusively on quantitative studies. These carry a greater degree of external validity, and are hence more generalizable across settings and across theoretical backgrounds. Consequently, qualitative empirical evidence was not included. While a considerable body of literature regarding interactions between pharmaceutical companies and healthcare providers revolves around qualitative research, and we consider this relevant work, we specifically focused on the quantitative effects in order to identify which effects have been empirically tested.

Further research

Our review identified few empirical studies regarding the effects of bilateral interaction between pharmaceutical companies and healthcare providers. Future research regarding the presence of such interactions and their effects is therefore recommended. Said research should preferably utilize robust designs and be of high methodological quality and study various outcomes at the individual, organizational, and health system level. Furthermore, this study has attempted to reconcile the theoretical framework from the business literature with the empirical research from interaction between pharmaceutical companies and healthcare providers. While both streams of literature study inter-organizational relations between for-profit and not-for-profit organizations, they have remained largely separate. While we have made a first step towards drawing lessons from both research paradigms, we believe that further congruence between these two fields in future research would greatly advance our understanding of this phenomenon on the theoretical as well as the empirical side of this phenomenon. Ultimately, this will enable more adequate identification and explanation of beneficial or adverse effects of interaction between pharmaceutical companies and healthcare providers, and could form the basis for future practical guidelines.

This study reviewed the empirical literature regarding bilateral interactions between pharmaceutical companies and healthcare providers. Similar to the evidence regarding unilateral interactions, bilateral interactions between pharmaceutical companies and healthcare providers either have no effect or lead to negative outcomes. Bilateral interactions between pharmaceutical companies and healthcare providers hence fail to create the value which theory predicts. However, the existing empirical evidence is limited and largely overlooks outcomes at the organizational or health system level. There is ample opportunity for future research to advance this body of knowledge using robust research designs.

Supporting information

Funding statement.

The authors received no specific funding for this work.

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Continuing medical education and pharmaceutical industry involvement: An evaluation of policies adopted by Canadian professional medical associations

Affiliations.

• 1 Osgoode Hall Law School, York University, Toronto, ON, Canada.
• 2 Faculty of Health, York University, Toronto, ON, Canada.
• PMID: 28885217
• DOI: 10.3233/JRS-170731

Background: Professional medical associations (PMAs) play a crucial role in providing accredited continuing medical education (CME) to physicians. Funding from the pharmaceutical industry may lead to biases in CME.

Objective: This study examines publicly available policies on CME, adopted by Canadian PMAs as of December 2015.

Methods: Policies were evaluated using an original scoring tool comprising 21 items, two questions about PMAs' general and CME funding from industry, and three enforcement measures.

Results: We assessed 236 policies adopted by Canadian PMAs (range, 0 to 32). Medical associations received summative scores that ranged from 0% to 49.2% of the total possible points (maximum score = 63). Twenty-seven associations received an overall score of 0%. The highest mean scores were achieved in the areas of industry involvement in planning CME activities (mean: 1.1/3), presence of a review process for topics of CME activities (mean: 1.1/3), content review for balanced information (mean: 1.1/3), and responsibility of distribution of funds (mean: 1.0/3). The lowest mean scores were achieved in the areas of awards (mean: 0.0/3), industry personnel, representatives, and employees (mean: 0.1/3), distribution of industry-funded educational materials at CME activities (mean: 0.1/3), and distinction between marketing and educational materials (mean: 0.1/3).

Conclusion: These results suggest that Canadian PMAs' publicly available policies on industry involvement in CME are generally weak or non-existent; therefore, the accredited CME that is provided to Canadian physicians may be viewed as open to bias. We encourage all Canadian medical associations to strengthen their policies to avoid the potential for industry influence in CME.

Keywords: Canadian professional medical associations; Continuing medical education; financial bias; pharmaceutical industry; physician education; policy evaluation; scoring tool.

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• Improving recognition of the clinical presentation and diagnostic criteria
• Exploring the importance of tailoring care in adult and pediatric patients, including treatment and prophylaxis
• Assessing the impact of HAE on quality of life and exploring strategies to improve it
• Examining social determinants of health (SDOH) faced by patients with HAE and the impact on disease management and outcomes
• Understanding the unique challenges faced by patients living in rural areas and effective strategies to manage HAE in these populations

Neuroscience

• Raising awareness of cerebral cholesterol pathway in epilepsy
• Reviewing data regarding safety, efficacy, and mechanisms of action of emerging treatments for drug-resistant epilepsies such as DEEs
• Narcolepsy or sleep disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Parkinson Disease
• Huntington Disease
• Alzheimer Disease

Rare Metabolic Diseases

• Emphasizing the importance of newborn screening initiatives and biomarkers to enable early diagnosis
• Evaluating the safety and efficacy of available treatments
• Addressing challenges in Women’s Health in Gaucher Disease and strategies to support personalized care
• Identifying the challenges faced by patients with Gaucher Disease and their caregivers
• Improving patient outcomes through newborn screening (NBS) and strategies to support implementation of NBS
• Optimizing disease management strategies to support personalized care for individuals
• Identifying the challenges faced by patients with Hunter Syndrome and their caregivers
• Metachromatic Leukodystrophy (MLD)
• Fabry Disease
• Adrenal Insufficiency
• Complications of Prematurity
• Dystrophic Epidermolysis Bullosa
• Neonatal Complications
• Stem Cell Transplant
• Understanding the burden of illness and unmet needs of inadequately treated CMVi among transplant recipients
• Identifying risk factors and mitigation strategies for CMVi reactivation and inadequately treated CMVi
• Highlighting the importance of early identification and monitoring of hig-risk post-transplant patients for timeline treatment intervention/s
• Addressing challenges in managing tolerability or adverse effects of anti-viral treatments for CMVi
• Identifying barriers and unmet treatment needs for post-transplant recipients with CMVi, including treatment intolerance and inadequately treated, refractory or drug-resistant CMVi
• Evaluating safety, efficacy and impact of modern treatment strategies for CMVi

Dermatology

• Psoriasis and Psoriatic Arthritis

Please visit Takeda Support for additional information on submitting medical education grant requests.

If you have any questions regarding Takeda’s medical education grants, please contact [email protected] .

• Medical Education: Bridging the Gap ...

Details Matter

• Issues 2012 07 - June

Medical Education: Bridging the Gap between Promotion and Science

• Digital Tactics
• Feature Articles
• Healthcare Industry
• Industry News

• by David Rear June 1, 2012

Through five core principles, medical education programs can truly educate providers and compel engagement by focusing on improving the patient’s health.

Once upon a time, many of the promotional education programs that were marketed to providers emphasized one thing—sell brands. And it worked…for a while. But it became evident that some of the programs fell short of sharing scientific rationale, leading to skepticism and perceptions of potential bias. While this purely promotional approach may not have been the sole reason for the stringent regulations we’re feeling today, it certainly didn’t help. Nor did it improve the perceptions consumer media and the public have of our industry.

Perceptions of reduced scientific and clinical rigor in promotional content created a gap between the companies that develop the medicines patients need and the healthcare providers who care for them. And with growing concern about content bias, speakers shied away from collaborating and presenting promotional medical education programs.

In general, many in our industry produce education programs that are balanced and insightful. But there are still opportunities to strengthen the quality of programs and deliver content that providers deem more valuable.

Given today’s new normal (stringent regulatory environment), brand marketers are now challenged on how to effectively combine information that providers want while promoting their brands. One approach is to create a bridge—a Science Bridge— that connects the marketing with the science behind the brand.

The Science Bridge facilitates improved patient outcomes by connecting knowledge about the most recent scientific advances with clinical needs. Through a more thorough understanding of the disease and drug therapy, a valid and reasonable scientific rationale is established for how and why the drug therapy benefits patients. Simply, instead of programs that communicate “my brand works,” ethical promotional education communicates the how and why the brand works.

ETHICAL MED ED: WHAT IS IT?

Ethical promotional medical education emphasizes the clinical value behind the program. It means providing a clear understanding of complex scientific concepts to help providers understand the appropriate place for the brand in their clinical practice. When providers are better informed, they are then able to make clinical decisions that lead to better patient care.

This approach also gives value to participants, which in turn, gives marketing greater credibility. Therapeutic experts are more willing to conduct and participate in programming because they are serving as true educators, delivering the translation of highly complex scientific concepts into applicable clinical practice knowledge.

Developing an effective medical educational program that bridges promotion and science may not be rocket science, but it does require a different mindset. Here are the core principles.

One: Engage Providers Early.

Who is better suited to help develop clinical content than therapeutic experts who are on the front lines? Their insights and clinical experience provide great value and are of interest to their peers. Content collaboration that begins early also ends with a stronger relationship based on trust.

But to make sure that the brand isn’t lost in the process, weave the “brand story” early in the development phase and keep the target audience firmly defined. This focused approach helps tailor the content specific to the needs of providers while meeting the marketers’ promotional objectives.

Two: Apply Adult Learning Principles.

This approach heightens participants’ ability to absorb, retain, and apply the knowledge gained. Incorporation of these principles increases the likelihood that participants will be motivated to apply the knowledge in real clinical situations. Best of all, using these principles naturally allows for sharing clinical experiences.

The best program formats are those that encourage participants to:

• Share their knowledge and experience in learning situations,
• Participate to maximize retention, and
• Present relevant information they can apply to their daily practice.

Three: Choose the Right Format.

Scientific or not, an educational program can fall flat if the wrong type of format is chosen to deliver the content. Here are four types to consider:

• Didactic presentations are useful for large groups. The flow of information is, however, unidirectional and may not encourage discussions or the sharing of ideas. In this format, choose an animated presenter who can bring life to generally dry content.
• Discussion-based formats are effective in small-group settings and allow for more dynamic interactions between speaker and participants. Not every speaker has the skills to facilitate a discussion-oriented program, though, so select facilitators who are skilled and comfortable in this type of setting.
• Paired presentation formats usually pair a national thought leader with a local speaker. Typically, the national expert would provide the scientific story, and the local speaker would lead the discussion on how the content can be applied in a clinical setting. When bringing two individuals together, make sure that they present well as a team.
• Panel discussions are more appropriate for large-group meetings. They are effective not only in delivering critical information but also in sharing varied opinions from multiple speakers.

Four: Include Case Studies.

Case studies can help bring the brand to life by demonstrating how a product may fit into the clinical practice and the types of patients who might be appropriate candidates for treatment. When selecting case studies, try to incorporate different patient types, which can help providers better understand the brand’s utilization. Turn to presenters, who are usually the brand’s therapeutic experts, to help pinpoint the types of case studies to include.

Five: Facilitate Professional Exchange.

It’s no longer that easy for providers to travel to a live program. Time, cost, patient load, and overwhelming administrative tasks can keep them away from attending, no matter how valuable the program.

That said, peer-to-peer interaction can be a powerful motivator. Many providers favor live group discussions and one-on-one dialogues. In fact, according to independent research, one minute of peer-to-peer time is equal to 60 minutes of time with a sales representative. Some marketers may turn to digital media and the Internet to conduct their promotional medical education. Remember, though, these high-tech forms of delivery can’t replace the higher level of interaction and engagement that live programs offer.

So how should we bring providers together? Consider using satellite or web-based broadcast technology. These technologies allow participants to interact, ask questions and share knowledge in real time. They reap near similar benefits as those attending the live events and are more easily accessible. Web-based broadcasts can be accessed right from the office or home.

THE BRIDGE THAT CONVEYS A MUTUAL GOAL

The industry can demonstrate its leadership through the development of promotional medical education content that has improved scientific rigor and benefits to participants. By applying approaches such as the Science Bridge to programs, savvy marketers convey that their goal is the same as the providers: to improve patient care. Marketers can accomplish this shared goal by developing content based in science with a compelling brand story. The principles required are thoughtful and strategic, logical and executable. The end result includes increased trust, greater brand knowledge, and healthier patients.

David Rear, RPh, is President at Advanced Clinical Concepts, a medical communications company that delivers scientific content to facilitate better clinical decisions and advance patient care.

Inside Patient Advocacy Programs

Experts on call.

Thomas Shea Programmatic Marketing

Paul Theisen Patient Acquisition

Matthew Durham Omnidynamic Marketing

Frank Burrell Scientific Storytelling

Amy Giles Increasing Engagement

Frank X. Powers Healthcare Challenger Brands

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Daniel Sontupe Market Access

Brenda Snow Authentic Patient Voice

David Linetsky Patient Activation

Liz Kane Impactful Strategy

Bud Bilanich Success Coach

Anil Bhaskar Unified Customer Experience

Pat Purcell Meeting Engagement

Stacey Gandler Brand Nourishment

Suma Ramadas, PhD Medical Affairs

Mike Viscel Increasing Engagement

Laura Blair Medication Adherence

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Working together, we can reimagine medicine to improve and extend people’s lives.

Portfolio Scientific Communications Director

About the role.

Major Accountabilities:

Drives the development, implementation, and dissemination of strategic global scientific communication plan / scientific platform for assigned launch asset/disease area:

Drives development of the strategy for the scientific communications plan in alignment with Therapeutic Areas

Accountable for leading a cross-functional publication team and development / implementation of global publication plan(s)

Collaborates with Therapeutic Area team for development of scientific communication platform, including scientific statements, lexicon, and scientific narrative

Utilize enterprise thinking to execute on strategy and tactics, with a focus on high quality stakeholder engagement

Develop and track value and impact measuring of the scientific communication plan in partnership with therapeutic areas, CE&E, and integrated insights team

Responsible/accountable for congress scientific communications including:

Data interpretation in collaboration with GMD/GDD/NIBR and Therapeutic Area on both internal trial results and key competitor data

Develop internal global communications and education for Novartis products

Lead preparation for upper management, regions and countries for cohesive congress narrative aligned with Therapeutic Area strategy  

Establish strong working relationships and actively collaborates with key internal and external stakeholders including medical experts, speakers, etc. Leads medical scientific communication innovative pilots and initiatives with strategic impact in partnership with Scientific Communication Excellence

Manage all aspects of publication and medical education agencies in support of scientific communications. Identify and screen appropriate vendors, solicit, evaluate, and approve proposals. Ensure compliance with all legal regulatory and Novartis requirements for scientific communications (publications and medical education materials) such as GPP, CME, NVS policies (P3), relevant SOPs and guidance)

Manage financial and contractual aspects of assigned projects, including vendor negotiations.  Develop yearly budget for assigned product (s) and manage monthly spend within allocated budget

Requirements

• 7+ years’ experience in pharmaceutical industry or healthcare related, ideally in publication planning and/or medical education activities
• Advanced degree (e.g., MD, PharmD, PhD) or equivalent education/degree in life science/healthcare is preferred
• Experience in the development of communication strategies & key scientific platforms.
• Ability to provide strategic insight and functional guidance into scientific expert development activities, publication planning and developing medical education that support launch assets.
• Experience in driving the development of scientific messaging and execution of publications preferred
• Must be able to adapt, organize, prioritize, and work effectively on multifunctional teams in a constantly changing environment
• Proven ability at communicating complex medical and scientific concepts to lay audiences, including patients and caregivers
• Thorough understanding of internal/external ethical guidelines relevant to the pharmaceutical industry
• Strategic mindset including innovation and critical thinking with both performance and impact-oriented drive. 
• Experience working in a matrix environment, across functions, therapeutic areas regions and countries

Languages :

Why Novartis: Helping people with disease and their families takes more than innovative science. It takes a community of smart, passionate people like you. Collaborating, supporting and inspiring each other. Combining to achieve breakthroughs that change patients’ lives. Ready to create a brighter future together? https://www.novartis.com/about/strategy/people-and-culture

Join our Novartis Network: Not the right Novartis role for you? Sign up to our talent community to stay connected and learn about suitable career opportunities as soon as they come up: https://talentnetwork.novartis.com/network

Benefits and Rewards: Read our handbook to learn about all the ways we’ll help you thrive personally and professionally: https://www.novartis.com/careers/benefits-rewards

Novartis is committed to building an outstanding, inclusive work environment and diverse teams' representative of the patients and communities we serve.

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Digital Transformation in Healthcare in 2024: 7 Key Trends

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Stay up to date with the latest digital trends.

As a healthcare business, you probably know that keeping up with digital transformation in healthcare can feel overwhelming.

Deciding which emerging technologies are worth investing in and getting your team on board with change is often the hardest part.

Look, adapting to the digital era requires a shift towards a flexible and risk-taking mindset.

It means letting go of outdated business processes and trusting that disruption could yield big results. Before we dive deeper into this topic, a quick recap.

Want to learn more about the Digital Authority Partners approach to Digital Marketing? Watch this video!

Digital transformation in healthcare is the positive impact of technology in healthcare.

Here's why: Telemedicine, artificial intelligence (AI)-enabled medical devices, and blockchain electronic health records are just a few concrete examples of digital transformation in healthcare which are completely reshaping how we interact with health professionals, how our data is shared among providers and how decisions are made about our treatment plans and health outcomes.

Innovation is the name of the game here, with the main goal of streamlining physicians’ work, optimizing systems, improving patient outcomes, reducing human error, and lowering costs through amazing web and mobile experiences .

Unfortunately, the healthcare and pharmaceutical industries have lagged behind when it comes to implementing digital strategies. Yes, you read that right!

In fact, in a recent survey , only seven percent of healthcare and pharmaceutical companies said they had gone digital, compared to 15 percent of companies in other industries.

Despite that, the U.S. healthcare market is enormous; with the national health spending projected to reach $5.7 trillion by 2026 . There’s still time for you to get well-versed in digital technology and use it to bring in more business.  But in order to transform your standard practice into a thriving, digital machine in 2024, you first need a comprehensive picture of the modern healthcare landscape.

Thanks to technology, patients get better treatment with virtual reality tools, wearable medical devices, telehealth, and 5G mobile technology. Doctors, on the other hand, can streamline their workflows using artificial intelligence-powered systems.

AI & Emerging Tech

Drive growth with intelligent solutions.

Here’s a better look at the state of digital transformation in healthcare in 2024:

1) The rise of on-demand healthcare (why patients want healthcare on their own schedule)

When you think of ‘on-demand,’ you think of consumers who want things at their own convenience, on their own time, and wherever they happen to be. The healthcare industry is entering the era of digital innovation, as patients seek on-demand healthcare because of their busy schedules.  Mobile is especially important when considering content marketing.

People have simply become far more mobile in the past decade. Mobility is the name of the game, and recent statistics show that more than 50% of all web browsing in the world occurs on mobile devices.

One of the first rules of content marketing is that you must identify where your targeted consumers gather and reach them on those platforms, i.e. mobile. That’s not surprising given that 77 percent of U.S. residents own a smartphone . On top of that, the number of mobile phone users in the world passed the five billion mark in recent years.

Factor in the billions of people globally on the Internet and you can start to see the possibilities that digital transformation in healthcare offers.

Consumers are going online to obtain medical information for the following reasons:

• 47% want to research doctors
• 38% want to research hospital and medical facilities
• 77% want to book medical appointments

But on-demand healthcare is also driven by the growth of the ‘gig’ economy, in which freelance professionals in various industries hire themselves out per job or ‘gig,’ instead of tethering themselves to one company.

Companies such as Nomad Health – an online marketplace that links doctors directly with medical facilities for short-term work – are making it easier for physicians to provide on-demand healthcare to clients in specific circumstances that match their talents, expertise, and schedule. In other words, doctors themselves become on-demand healthcare providers to better meet the changing needs of their patients, another benefit of digital transformation in the healthcare industry.

2) The importance of big data in healthcare

Big data aggregates information about a business through formats such as social media, ecommerce, online transactions, and financial transactions, and identifies patterns and trends for future use.

For the healthcare industry, big data can provide several important benefits , including:

• Lower Rate of Medication Errors – through patient record analysis, software can flag any inconsistencies between a patient’s health and drug prescriptions, alerting health professionals and patients when there is a potential risk of a medication error.
• Facilitating Preventive Care – a high volume of people stepping into emergency rooms are recurring patients also called "frequent flyers.” They can account for up to 28% of visits . Big data analysis could identify these people and create preventive plans to keep them from returning.
• More Accurate Staffing – big data’s predictive analysis could help hospitals and clinics estimate future admission rates, which helps these facilities allocate the proper staff to deal with patients. This saves money and reduces emergency room wait times when a facility is understaffed.

With these benefits in mind, healthcare and pharmaceutical companies should invest in organizing their data. That requires an investment in analytics experts who can crunch the data to not only identify areas of weakness but also help companies better understand their market.

For example, if you’re in the pharmaceutical industry, you probably understand that marketing dynamics are constantly shifting. In fact, drugmakers believe that the biggest advantage of big data is how it helps them understand the market . And with that understanding, they can determine product iteration and product budgets based on existing and future demand.

With a better grasp of the market, your healthcare marketing and sales teams can have an easier time identifying your ideal consumer. A big part of that is creating a customer persona , which compiles demographic information on what your prospects want and need, and the platforms where you can reach them.

3) Treating patients with virtual reality

Ten years ago, telling people you could reduce their pain with a device similar to a video game would have garnered a lot of blank stares. Now, Virtual Reality (VR) is the pièce de résistance of digital transformation in healthcare. Its myriad of applications are profoundly changing the way patients are being treated.

Take pain management, for instance. Up until recently, doctors were handing out opioid prescriptions without much thought. Migraines? Postoperative pain? Here’s some OxyContin, Vicodin, or Percocet. As a result, the country is currently facing the worst drug crisis in American history, representing an economic burden of dozens of billions a year . 

Here’s the thing: millions of people are still struggling with chronic pain. According to the CDC, 50 million U.S. adults experience chronic pain. For them, VR could be a safer, more efficient alternative to drugs . VR technology is being used not only to treat pain but everything from anxiety to post-traumatic stress disorder and stroke.

And that’s just a fraction of VR’s proven capabilities in the medical field. Other uses include doctors and residents using virtual-reality simulations to hone their skills or to plan complicated surgeries. VR headsets could also motivate wearers to exercise and help children with autism learn how to navigate the world.

From startups to pharma giants, everyone is betting on VR and there are numbers to back them up. The global virtual and augmented reality healthcare market is expected to reach $5.1 billion by 2025 . If you’re a healthcare company planning your digital marketing strategy, consider investing in this technology.

VR is a powerful communication channel that would allow you, among other things, to get a better sense of your customers’ needs and virtually engage them with your products or services .

4) The growth of wearable medical devices

Another trend of the digital transformation in healthcare is companies collecting their own health data from medical devices, including wearable technology.

In the past, most patients were satisfied with undergoing a physical once a year, and only checking in with their doctors when something went wrong. But in the digital age, patients are focusing on prevention and maintenance, and demanding information about their health more frequently.

As a result, healthcare companies are being proactive by investing in wearable technology devices that can provide up-to-date monitoring of high-risk patients to determine the likelihood of a major health event. According to a recent report, the wearable medical device market is expected to reach more than $27 million soon (a spectacular jump from almost $8 million in 2017).

Some of the most common of these devices include:

• Heart rate sensors
• Exercise trackers
• Sweat meters – used for diabetics to monitor blood sugar levels.
• Oximeters – monitor the amount of oxygen carried in the blood. They are often used by patients with respiratory illnesses such as COPD or asthma.

Other benefits for healthcare companies who invest in these products:

• Personalizes the healthcare experience – medical devices give patients a sense of ownership in the process of improving their health.
• Targets insurance pricing – information obtained from wearable devices can help insurers more accurately rate a patient’s risk for illness.
• Provides insurance incentives – patients who take preventive measures to improve their health can obtain lower insurance premiums.
• Provides gamification opportunities – some medical devices, such as fitness watches can create competitive goals for users to achieve through exercise, diet, and nutrition. 

Furthermore, wearable technology can also help healthcare companies save money. One study found that health apps and wearables for preventative care could save the U.S. healthcare system close to $7 billion per year.

5) Predictive healthcare

Earlier, we touched on how big data could provide healthcare companies with predictive analysis about admission rates and help them properly staff their facilities. Another factor supporting the digital transformation in healthcare is predicting what illnesses and diseases could become major problems in the near future.

Information aggregated through Big Data and other marketing sources can help healthcare companies develop healthy lifestyle recommendations for their patients.

For example, you could hire an analyst to analyze keyword activity across social media channels and on major search engines to determine the most common searches for medical conditions , illnesses, and general health. The analyst could then develop a predictive model that would anticipate where and when the next big health scare might occur and how your company can prepare for that event.

But on a smaller scale, predictive analysis could help businesses of all sizes determine when to hire temporary staff due to impending outbreaks of colds and flu that could result in a worker shortage.

6) The wonders of artificial intelligence

Artificial intelligence (AI) is more than just a digital transformation trend in healthcare. AI represents the epitome of medical innovation. Industry players are eager to invest millions in it. The healthcare AI-powered tools market is expected to exceed $34 billion by 2025 , which means this technology will likely shape almost all facets of the industry.

For most patients, AI in medicine brings to mind Japanese nurse robots. But now, there are plenty of American versions too, like Moxi , a friendly hospital droid designed to assist human nurses with routine tasks such as fetching and restocking supplies.

Chatbots and virtual health assistants are another AI-based technology that patients are becoming familiar with. Chatbots can fill a multitude of roles, from customer service representatives to diagnostic tools and even therapists . Their versatility is being translated into heavy investments. The global healthcare chatbots market is projected to reach $314.3 million from $122 million in 2018.

But the real power of AI can be best observed in areas like precision medicine , medical imaging, drug discovery, and genomics. For instance, cancer patients used to receive cookie-cutter treatments with high failure rates. Now, thanks to AI’s sophisticated pattern recognition, these patients have access to personalized therapies tailored to their genetic makeup and lifestyle.

What AI-powered computer programs do for oncology, in a nutshell, is analyze thousands of pathology images of various cancers to provide highly accurate diagnoses and predict the best possible anti-cancer drug combinations. And, in medical imaging diagnostics, this technology helps radiologists spot details that escape the human eye.

What’s more, top pharmaceutical and biotechnology companies are using machine learning algorithms to shorten the drug development cycle. In fact, recent findings show that AI can slash early drug discovery timelines by four years against the industry average and generate cost savings of 60 percent.

Overall, AI is predicted to bring billions of dollars in annual savings for the US healthcare economy. Startups are already jumping on this opportunity; the number of active AI startups has increased 14-fold since 2000 .

These numbers alone should be enough to convince any CEO looking to usher their health organization into reaching digital maturity that AI is worth the investment.

7) Blockchain and the promise of better electronic health records

Blockchain has recently developed a bad reputation due to cryptocurrency instability . Now, many might think blockchain to be a vague, puzzling concept that doesn't have much of an impact on their life. In reality, this technology might soon play an instrumental role in keeping their electronic health records accurate and safe.

Blockchain is a digital ledger or a computerized database of transactions.  Shared across a network of computers, it allows customers to safely exchange financial information with suppliers, without the need of a third party such as a bank.

The healthcare and pharmaceutical industries are already vouching for its efficiency by investing millions in this market. According to a recent report, blockchain in the healthcare market is expected to reach $890.5 million by 2023 .

In healthcare, blockchain can be an effective tool in preventing data breaches, improving the accuracy of medical records, and cutting costs.

For years, health officials and experts have been trying to come up with doable solutions to the problem of fragmented medical records .

An electronic health record (EHR) is basically the digital version of a medical chart and includes everything from a patient’s medical history and diagnoses to treatment plans, immunization dates, and test results. It also contains their home address, previous workplaces, as well as financial information like credit card numbers. This is what makes EHRs such an appealing target for hackers, who are selling them for up to $1,000 on the black market.

Yet, as valuable as they are, hospitals are falling short in managing their EHRs. 

Medical data is currently being recorded in unstructured formats and stretched across multiple EHR systems. Already short-staffed doctors and nurses struggle to manually log in every piece of information. This leads to huge errors such as duplicate medical records, misdiagnoses, delayed treatments, and even deaths.

Some countries like Australia and the UK have started to experiment with blockchain technology to manage medical records and transactions among patients, healthcare providers, and insurance companies. Thanks to a decentralized network of computers that handle the blockchain and simultaneously register every transaction, conflicting information is automatically detected. Records are not only closer to 100% accurate but are also harder to hack.

I n the U.S., regulations make it harder for companies to create blockchain-based EHRs. Some startups are making big strides toward a future  where patients can control their EHRs from an app , where doctors, pharmacists, or health insurers may request permission to access their data, and where all transactions can be recorded on the distributed ledger.

Health in the palm of your hand

The healthcare system is undergoing a seismic shift in how information is obtained and disseminated. Gone are the days when all medical information was under the lock and key of doctors and surgeons, and patients had to sign away their lives to access their own health information – consumers want to be able to access all aspects of their health records and do so from the palm of their hand.

Through tools such as online patient portals that provide medical test results, diagnoses, and explanations of illnesses, patients are now becoming participants in their well-being. T hat allows doctors to analyze patients in real time.

What does it really mean when your smartwatch says you’ve completed 14,000 steps in a day? By itself, that is just information. It becomes valuable when doctors and medical analysts transform that this data into actionable knowledge about how those steps helped you. While digital technology is a valuable tool in healthcare, it’s important to remember that it is still just a tool that you can add to your repertoire.

5G mobile technology for instantaneous healthcare

Speaking of health in the palm of your health or in your pocket…As wireless technology gets more sophisticated, so does the delivery of medicine.

Introduced by Qualcomm, the world's largest mobile chipset supplier, 5G enhanced Mobile BroadBand (eMBB) is considered to be the driver of the new mobile industry revolution.

The technology can run up to 100 times faster than the current cellular connection, which made industry experts confident that it could completely change the healthcare landscape and lead to savings of up to $650 billion by 2025 .  

Here’s how.

First, Qualcomm says 5G could make “buffering” a thing of the past, allowing for instantaneous streaming, downloading, and uploading. For telemedicine, this means patients could experience better video conference quality, regardless of location. More importantly, doctors have access to accurate, real-time imaging of organs, soft tissue, and bones, which in turn could greatly decrease the risk of misdiagnosis .

With the current network bandwidth, it takes hours for doctors to send large imaging files to a specialist. Once health facilities might switch to 5G networks, the transmission process could take just a couple of minutes.

And that’s not even a fraction of how 5G could transform healthcare. Pairing 5G with tech like AI and XR can improve existing services and applications for a more friendly, personalized user experience. 

Let’s take a look at some practical examples:

• Clinicians could soon use ultra-reliable connections to teleport to virtual environments and perform robotic surgeries.
• Augmented reality (AR) glasses would allow first responders to connect with faraway specialists and “show” them exactly what they are seeing, in order to receive better guidance.
• 5G could also support medical training, enabling students to use virtual reality headsets to practice at their own pace the steps of complex surgeries.
• 5G-enabled drones could deliver life-saving medicine or devices to patients in hard-to-reach rural areas. A university in Sweden is already testing these drones to deliver defibrillators to cardiac arrest victims.

But it is in the wearable medical device market where 5G causes the greatest disruption. Remote monitoring technology has yet to reach its full potential due to slow network speeds and unreliable connections. With 5G, clinicians can able to instantaneously collect medical data such as vitals or physical activity levels from disparate sources and large groups of patients and make fast, reliable diagnoses .

This is preventative care at its best: fewer people developing chronic conditions and less money spent caring for patients in hospitals or in emergency rooms. All in all, 5G is guaranteed to play a major role in healthcare this year and patients might be the first ones to feel the positive changes. The first 5G data cards were launched in 2019 along with 5G smartphones.

The state of digital transformation in healthcare (both web and mobile ) in 2024 looks quite promising, doesn’t it?

As with any business, the goal is to create products and services that improve lives or fulfill a want or need. Technology can help you realize this goal. Use this guide as a compass to navigate your way through the digital healthcare space and to build transformative experiences – with the client at the center of everything you do.

Do you need guidance with your digital transformation initiatives? Digital Authority Partners has worked with companies like Athenahealth, Omron Healthcare, and Blue Cross Blue Shield on cutting-edge digital initiatives that improve patient outcomes and quality of care. Contact Digital Authority Partners at [email protected] or 312-820-9893.

You may also be interested in reading our in-depth Healthcare industry reports:

• Blockchain in Healthcare: An Executive’s Guide for 2024
• Artificial Intelligence in Healthcare: 27 Companies Leveraging AI to Improve Health Outcomes
• Artificial Intelligence & the Pharma Industry: What’s Next
• Big Data in Healthcare: All You Need to Know
• 5 Tips for Healthcare Website Design Initiatives in 2024
• The State of Digital Transformation in Healthcare in 2024
• 9 Cardiovascular Health Technologies Doctors Should Know
• Alexa in Healthcare: 17 Real Use Cases You Should Know About

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It’s no secret that prescription drugs are unaffordable for many Californians. In just five years, spending on prescription drugs ballooned from $8.7 billion to $12.1 billion, an increase of 39%, according to the most recent state data .

Consumer advocates and health economists are placing some of the blame on pharmaceutical middlemen, which they say needlessly drive up costs by tacking on fees and withholding discounts as profit. It’s a problem that has plagued regulators across the country. This week, California lawmakers are set to vote on first-time regulations aimed at curtailing their tactics. 

Pharmacy benefit managers, also known as PBMs, most often serve as intermediaries between insurance companies and drug manufacturers. They process claims, negotiate the price of drugs using a complex system of rebates , and control the list of drugs that health insurance plans cover, also known as a formulary.

They’re already regulated to some degree in most other states, including Texas and Florida. The California proposal would require the state insurance department to license pharmacy benefit managers, and would require pharmacy benefit managers to disclose prices paid and discounts negotiated with drug manufacturers. It would also mandate that 100% of the discounts from drug manufacturers be passed onto health insurance plans.

“(Pharmacy benefit managers) have insinuated themselves into the nerve center of the health system where they exercise enormous leverage over the health plans, over the pharmaceutical manufacturers, over the consumers,” bill author Sen. Scott Wiener said. “They’re making enormous amounts of money at the expense of consumers.”

The companies argue that they save money for patients and insurance plans — the more patients they represent, the more leverage pharmacy benefit managers have to negotiate lower drug prices, for example. They are fiercely opposed to the legislation and warn that the proposed regulations will increase health premiums for Californians by $1.7 billion in the first year and $20 billion over a decade.

“The bottom line is (Senate Bill) 966 does nothing to reduce prescription drug costs or improve patient access and safety,” said Greg Lopes, a spokesperson for Pharmaceutical Care Management Association, an industry lobby for pharmacy benefit managers

Three pharmacy benefit managers dominate the industry: CVS Caremark, Express Scripts and OptumRx represent more than 80% of the market.

Increasingly, research suggests consolidation drives prescription drug prices higher . The biggest player, CVS, has grown to encompass the familiar retail pharmacy stores, pharmacy benefit management services, and health insurance through a merger with Aetna.

“They’re way overdue for regulation,” Wiener, a Democrat from San Francisco, said.

Previous attempts to regulate pharmacy benefit managers have failed in California. In 2021, Gov. Gavin Newsom vetoed legislation that would have prevented pharmacy benefit managers from “patient steering,” a practice that forces patients to use only specified pharmacies that are also often owned by the pharmacy benefit managers.

“In California we’re really behind. They have been far more aggressive in other states regulating (pharmacy benefit managers),” said Michelle Rivas, executive vice president of government relations at the California Pharmacists Association, which co-sponsored the bill. “The ideal would be comprehensive federal legislation. Unfortunately, we don’t have the luxury of time to wait for Congress to move on this issue.”

California wants to cap your medical bills. Guess who’s pushing back.

While more than a dozen proposals have been introduced in Congress, to date none has passed. A recent report from the Federal Trade Commission , which is investigating pharmacy benefit managers, suggests that the largest organizations may be engaging in practices specifically to evade regulation, such as moving portions of their operations out of the country.

“These guys are smart and historically we’ve seen them evolve and we’ve seen them find ways to make more money,” said Geoffrey Joyce, director of health policy at the USC Schaeffer Center who studies pharmaceutical markets.

California’s effort to regulate pharmacy benefit managers is commendable, Joyce said, but he’s pessimistic that regulators can adapt as quickly as the market changes.

Concessions to pharmacy benefit managers

Wiener’s bill would break new ground in California, but it won’t go as far as he intended.

Amendments to the proposal significantly curtailed its reach in the final days of the legislative session. Industry groups requested the changes, but Wiener said the remainder still leaves “a very strong bill.”

Previous versions of the proposal would have prohibited pharmacy benefit managers from paying pharmacies less for a drug than they charge insurers and keeping the difference as profit. It would have also prohibited insurers from paying out bonuses based on drug cost savings.

Learn more about legislators mentioned in this story.

Scott Wiener

Democrat, State Senate, District 11 (San Francisco)

The Assembly Appropriations Committee, which is chaired by Buffy Wicks, a Democrat from Oakland, struck those provisions. 

Wiener said neither he nor the industry opponents got everything they wanted. Wicks’ office did not respond by deadline to a call asking why the amendments were added when the bill had previously made it through all committees and the Senate without a single no vote.

Lopes, with the pharmacy benefit manager lobby, said the group remains opposed to the bill even after the amendments. 

“While we are taking a close look at the new language and its implications, it’s evident the bill still benefits Big Pharma at the expense of California patients,” Lopes said. 

Pharmacy benefit managers argue that federal investigations and criticism of their business practices are flawed and misguided. As middlemen, pharmacy benefit managers are able to negotiate prices with pharmacy chains, health insurers and drug manufacturers on behalf of their clients. Designing preferred pharmacy networks, formularies and discounts are all strategies that allow pharmacy benefit managers to keep prices reasonable, said Ed Devaney, president of the employer division at CVS Caremark.

“This bill would not allow employers to continue to leverage those cost containment solutions that they have enjoyed over the last 10 to 20 years,” Devaney said. The proposal is also opposed by health insurers, some unions, and a coalition of business associations.

CVS Caremark is the largest pharmacy benefit manager in the country, representing more than 100 million members. Devaney said CVS passes 99% of rebates to consumers and that it has no issue with increased transparency. 

Instead, the benefit managers blame pharmaceutical companies for skyrocketing drug prices.

‘No saints’ in pharmaceutical industry

Reid Porter, a spokesperson for Pharmaceutical Research and Manufacturers of America, said Wiener’s proposal is a “step in the right direction” but that California legislators have more work to do to address “the perverse incentives and harmful practices of PBMs that lead to higher costs, including higher premiums, that patients face.” The trade organization representing drug companies supports Wiener’s measure.

Drug manufacturers have long accused pharmacy benefit managers of holding prescription drugs hostage in order to get bigger rebates that patients never see. Rebates made up just 17% of the $12.1 billion spent on pharmaceuticals in 2022, according to the Department of Managed Health Care’s most recent drug cost report.

Joyce of USC said both players are at fault. 

“There are no saints. Everyone is trying to make a buck,” Joyce said. 

Pharmacy benefit managers representing tens of millions of patients have enough leverage to negotiate lower drug prices, he said, but the problem is that their business practices are so opaque no one really knows how much in savings is being passed down to patients and how much benefit managers are keeping in profits. 

Joyce said he has also witnessed negotiations where manufacturers withhold price discounts if the benefit manager includes coverage of competitors’ drugs.

“They run an opaque, non-transparent business, and that is never good,” Joyce said.

The Federal Trade Commission report suggests that pharmacy benefit managers increasingly make money through administrative fees and other payments tacked onto services.

Despite the leverage pharmacy benefit managers may have, Kevin Schulman, a professor of medicine at Stanford University, research shows they have only ever driven drug prices up — not down. 

For example, although generic or biosimilar insulins have been available for years, patient use of the cheaper alternatives has remained low because pharmacy benefit managers exclude the generics from covered benefits in lieu of higher-profit, name-brand insulins. Newsom’s initiative to manufacture low-cost, generic insulin for Californians , will face a similar challenge, Schulman said. Schulman was an advisor to Civica Rx, the company tapped by Newsom to run its insulin project.

“This strategy results in them being able to pocket billions of dollars,” Schulman said.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

More on California health care

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Kristen hwang health reporter.

Kristen Hwang is a health reporter for CalMatters covering health care access, abortion and reproductive health, workforce issues, drug costs and emerging public health matters. Prior to joining CalMatters,... More by Kristen Hwang

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3 lessons business leaders can learn from medical school applicants.

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Arush Chandna is the co-founder of Inspira Advantage .

Inspiration comes from the most unexpected places and for most business leaders, our instinct is to seek it from other business icons—whether it’s the trailblazing success of Jeff Bezos or Elon Musk, or simply the leaders within our own professional circles. But through my experience as the founder of an edtech company, I’ve found an unlikely yet powerful source of inspiration: medical school applicants. These future doctors may not always run businesses, but their traits and tenacity offer lessons that aspiring business leaders can definitely learn from.

Knowing When To Ask For Help: A Lesson In Humility

One of the most striking qualities of medical school applicants is their willingness to seek help from experts to reach their goals. In the business world, there’s a pervasive notion of being “self-made,” a concept that’s only amplified by social media’s relentless promotion of hustle culture. This ideology often pressures aspiring business leaders to embrace extreme independence, but the truth is, even the most successful leaders rarely go at it alone.

Medical school applicants take a different approach. Each application cycle, my team receives hundreds of inquiries from prospective med students seeking guidance on their applications. Some just need help preparing for the notoriously challenging MCAT, while others need comprehensive support throughout the entire application process. These students are more than capable of handling their applications on their own—they’re smart, driven and have been preparing for this for years. However, they understand the value of expert guidance.

They recognize that the rest of their medical careers will depend on their own efforts. No one will be there to guide them through the rigorous pre-clinical courses, ensure they thrive in their clinical rotations or guarantee their success in their residencies. But they also know that securing a place in a big-league medical school significantly increases their chances of future success, so they wisely seek help to optimize their applications. This foresight is a lesson that business leaders can take to heart. Success often requires collaboration, mentorship and the humility to recognize when we need and can truly benefit from help.

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Apple iphone 16 and iphone 16 plus: everything we know so far, secret service puts $2.5 million bounty on most wanted hacker’s head, patience: the quiet strength behind long-term success.

Medical school applicants also have an extraordinary level of patience and foresight. They understand that their dreams won’t materialize overnight. Embarking on the journey to becoming a doctor means committing to at least 10 years of education and training and they are more than willing to work toward their goal each day, despite its distant fulfillment.

This quality of medical school applicants serves as a reminder that the journey to success is marked by incremental steps rather than dramatic leaps. Each small victory—whether it’s acing a challenging prerequisite, scoring high on the MCAT or successfully navigating the application process—builds the foundation for larger achievements down the line.

This incremental approach can be mirrored in business, where celebrating minor milestones can foster motivation and momentum. Just as med students embrace the long haul, business leaders should adopt a similar approach, focusing on long-term growth rather than quick wins. It’s easy to get caught up in the allure of immediate results—chasing quarterly profits or viral marketing hits—but true, lasting success comes from laying a solid foundation and being willing to put in the time to build something that will stand the test of time.

Perseverance: The Art Of Rising After Every Fall

Perhaps the most remarkable trait of medical school applicants is their unwavering perseverance. Pre-med students are some of the most determined individuals you’ll ever meet. They face setbacks head-on, learn from their mistakes and refuse to give up. At Inspira Advantage, we’ve worked with students who have taken the MCAT five times and are still pushing forward. We’ve seen people get rejected from their dream schools but remain undeterred and others who face seemingly impossible odds—low GPAs, low MCAT scores, minimal extracurriculars—and yet they’re still giving it everything they’ve got to get into medical school. They know that some top medical schools accept as little as 3% of applicants, but this daunting reality only drives them to improve and excel.

The thing is, resilience isn’t just about bouncing back from failure; it’s about adapting to challenges and using them as opportunities for growth. Med school applicants who persevere after multiple rejections or low scores don’t just survive—they come out stronger, more prepared and more determined than before. They refine their strategies, seek out additional resources and approach the next challenge with even more tenacity.

This level of persistence is something we, as business leaders, can aspire to. The path to success is often filled with challenges and rejections. When we face a tough quarter, a failed product launch or an unexpected setback, it’s easy to feel discouraged. But if we approach these challenges with the same relentless determination that med school applicants display, we can turn setbacks into progress toward our ultimate goals.

Final Thoughts

As we navigate the complexities of the business world, it’s easy to become fixated on the success stories of well-known icons. However, the true lessons often lie in the journeys of those who quietly persevere—like medical school applicants. In a world that often celebrates instant gratification, these individuals remind us of the power of the long game. Their determination, patience and humility provide a unique blueprint for success that transcends the conventional narratives of achievement.

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