Archive for April, 2010

FDA: Updated Approach to Disclosure

Monday, April 26th, 2010

The FDA has released for public comment an updated approach to disclosure. What follows is taken from that FDA release.

The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for the public, FDA advisory committee members, and FDA staff entitled “Guidance for the Public, FDA Advisory Committee Members, and FDA Staff: Public Availability of Advisory Committee Members’ Financial Interest Information and Waivers.” This draft guidance is intended to help the public, FDA advisory committee members, and FDA staff to understand and implement FDA procedures regarding public availability of information regarding certain financial interests and waivers granted by FDA to permit individuals to participate in an advisory committee meeting. The draft guidance would provide even greater transparency to FDA’s advisory committee process than current guidance. The draft guidance announced in this notice, when finalized, would replace guidance of the same title dated August 2008.

DATES: Although you may comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to ensure that the agency considers your comment on this draft guidance before it begins work on the final version of the guidance, submit written or electronic comments on the draft guidance by June 21, 2010.

FDA is announcing the availability of a draft guidance entitled “Guidance for the Public, FDA Advisory Committee Members, and FDA Staff: Public Availability of Advisory Committee Members’ Financial Interest Information and Waivers.” FDA’s advisory committees provide independent and expert advice on scientific, technical, and policy matters related to the development and evaluation of products regulated by FDA. FDA implements a rigorous process for soliciting and vetting candidates for advisory committee meetings to minimize any potential for financial conflicts of interest. The agency is authorized by statute to grant waivers to allow individuals with potentially conflicting financial interests to participate in meetings where we conclude, after close scrutiny, that certain criteria are met. (See 18 U.S.C. 208(b)(1) and (b)(3), section 712(c)(2)(B) of the Federal Food, Drug, and Cosmetic Act (the act) (21 U.S.C. 379d-1) (added by the Food and Drug Administration Amendments Act of 2007, Public Law No. 110-85), and section 701 (21 U.S.C. 371) (effective October 1, 2007)).

In January 2002, FDA issued the “Draft Guidance on Disclosure of Conflicts of Interest for Special [[Page 21001]] Government Employees Participating in FDA Product Specific Advisory Committees,” and requested comments on the draft guidance (formerly Docket No. 02D-0049 now Docket No. FDA-2002-D-0094). The draft guidance was limited in application to special government employees (SGEs) participating in advisory committee meetings at which particular matters relating to particular products were discussed.
In August 2008, after an internal assessment of FDA’s advisory committee process and based on the comments submitted to the docket for the January 2002 draft guidance and a revised draft guidance published for public comment in October 2007, the agency issued guidance that expanded public availability of relevant information, brought additional transparency to FDA’s waiver process, and increased the consistency and clarity of the process (www.fda.gov/downloads/ RegulatoryInformation/Guidances/ucm125647.pdf).

FDA is now making available for public comment revisions to the August 2008 guidance that provide even greater transparency. The agency has tentatively concluded that it is appropriate to request that individuals receiving a waiver of conflict of interest to participate in an FDA advisory committee meeting disclose the name of the company or institution when identifying the “nature” of the disqualifying financial interest.

In determining how much information to publicly disclose, FDA needs to provide enough detail so the public can understand the nature of the potential conflict and FDA’s decisionmaking regarding participation, while not disclosing so much detail that the agency would be unable to attract essential expertise to its advisory committees. Under the August 2008 guidance, the nature of the financial interest was identified only as sponsor, competitor, or other affected firm. This approach was informed, in part, by a survey in 2001 of active advisory committee members that asked whether members would decline to participate based on varying levels of disclosure.

FDA is now proposing to disclose more detail than it did under its August 2008 guidance. Specifically, the agency proposes to disclose the name of the company or institution associated with the financial interest. New information indicates that this additional detail would not be a deterrent to current and potential advisory committee members.

For example, the agency notes that academic institutions, peer-reviewed journals, and scientific symposia, among other entities/venues, have in recent years developed more rigorous policies for disclosure of potential conflicts of interest with the work that is being presented or discussed. (See “Conflict of Interest in Medical Research, Education, and Practice, Committee on Conflict of Interest in Medical Research, Education, and Practice, Board on Health Sciences Policy,” Institute of Medicine of the National Academies (see p. 62 at http:// books.nap.edu/openbook.php?record_id=12598). While policies differ among organizations, many provide for disclosure of the name of the company or entity constituting the potential conflict of interest. (See “Uniform Format for Disclosure of Competing Interests in ICMJE Journals” that describes a disclosure policy and format that includes identification of the entity that is the source of the financial interest; adopted by all International Committee of Medical Journal Editors (ICMJE) journals (accessed at http://content.nejm.org/cgi/ content/full/361/19/1896)). In addition, FDA informally polled several active advisory committee members. While not a representative sample, the survey indicated that disclosing the names of companies would not adversely affect FDA’s ability to attract and retain expert advisors.

Accordingly, we have tentatively concluded that the public now expects this level of detail to help them understand the nature of a potential conflict and that individuals would accept this level of detail as a routine part of required disclosures.

To help us in issuing a final guidance, FDA is requesting comments on whether disclosing the name of the company or institution associated with the financial interest would: (1) Increase the transparency of FDA’s decisions regarding advisory committee member participation and (2) not significantly deter current and potential advisory committee members from service on those committees.

The draft guidance also includes a template for disclosing to the public the financial interests for which waivers are granted and a template for disclosing to the public all waivers that FDA grants. The draft guidance further describes FDA’s process for making these documents available on its Web site in advance of each advisory committee meeting.

This draft guidance is being issued consistent with FDA’s good guidance practices regulation (21 CFR 10.115). The draft guidance, when finalized, will represent the agency’s current thinking on public availability of information regarding advisory committee members’ financial interests and waivers granted by FDA to permit participation in advisory committee meetings. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. An alternative approach may be used if such approach satisfies the requirements of the applicable statutes and regulations.

Persons with access to the Internet may obtain the document at either http://www.fda.gov/RegulatoryInformation/Guidances/ucm122045.htm
or http://www.regulations.gov.

SACME Spring Meeting

Monday, April 19th, 2010

The SACME Spring Meeting was a huge success by any measure.

Over 100 participants benefitted from excellent educational sessions and collegial networking opportunities. Numerous creative interactive instructional designs were utilized to keep the participants engaged and to enhance the learning experience. The focus of this year’s annual meeting was faculty development, a topic of great importance in any year, but given the recent IOM report that calls for CME to morph into CPD, a very timely focus indeed.

The annual business meeting was most notable for an outpouring of appreciation for a job well done by the outgoing President, Lois Colburn. The Distinguished Service Award was awarded to Paul Mazmanian, PhD for his service to the society and the journal for the last decade. In addition, I was installed as SACME President for the 2010-2011 year.

Upcoming events of note include the Summer Leadership Institute (www.sacme.org) and the 2010 Fall meeting will be held in conjunction with the AAMC meeting in Washington, DC. This year the SACME Fall meeting and the AAMC GEA will be working hard to craft integration across all sessions to enrich the experience for those attending from the CME community.

The next SACME Spring Meeting will be held April 6-10, 2011 in New York City and is being hosted by NYU. The 2012 meeting will be in Toronto and held as part of CME Congress 2012.

Todd Dorman to be installed as SACME President

Monday, April 12th, 2010

So I leave this week to attend the SACME Spring Meeting. The program, dedicated to faculty development, looks spectacular. This meeting is particularly exciting for me, as I will be installed as President at the Business Meeting on Saturday. I am so honored to have this opportunity to work with the dedicated professionals that make up the society membership in general and the leadership of the society in particular. Many of these professionals have been involved in CME, adult education and/or faculty development much longer than I have and they bring a collective wisdom that simply cannot be ignored. I plan to tap into this wisdom as often as possible.

This is such an exciting time in CME and CPD. Until a few years ago the majority of the field was about serving the needs of the physician community as they articulated those needs. In the past few years we have begun to change that paradigm to one where we strive to help advance health care by pushing the system to greater heights through educational interventions. Thus CME and CPD are more about driving the system forward than merely responding to the system. Thus, it is quite humbling to be elected as president of SACME at such a crucial juncture in time. I am humbled by the opportunity and extremely excited to help guide the Community of CME in its quest to advance health through lifelong learning.