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In Reply: Mr Boyce and colleagues and Mr Angel speak for trade associations representing medical education companies or advertising firms that work for the pharmaceutical industry. Not surprisingly, they see nothing wrong with the status quo. They criticize me for citing a Wall Street Journal article reporting that in 2001 more than 60% of the total amount spent on CME came from industry.¹ I cited only the total figure and omitted the details showing that about three quarters of this amount represented the direct cost of education and the remainder represented related exhibits and advertising. Before writing this letter, I confirmed these figures with Murray Kopelow, MD, of ACCME (oral communication, July 2003), who stated that direct commercial spending on CME has increased by more than 30% in just the past year.

Angel says I suggested that prominent physicians would risk their reputation just to earn a speaker's honorarium, and . . . [Full Text of this Article]

Arnold S. Relman, MD
Departments of Medicine and Social Medicine
Harvard Medical School
Boston, Mass

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