As the environment within which the AAFP operates becomes increasingly complex, so do the potential relationships with proprietary entities, thus increasing the difficulty and complexity of structuring those relationships within appropriate boundaries.
II. Levels of Involvement with Proprietary Entities
Sources of Funding
A list of sources of funding to associations, ordered in increasing degree of interaction and reliance upon proprietary entities, follows:
- Dues and donations
- Fees for service (e.g., revenues from sales of products or services)
- Revenues for providing an outside entity with access to members for promoting the outside entity's product (e.g., through journals, renting mailing lists, exhibits, etc.)
- Proprietary funding to convey a message selected by the association, with attribution to the third-party company but not to specific product (e.g., corporate support with the following attribution: "Developed under an educational grant from Company X")
- Proprietary or non-proprietary funding to convey a message selected by the association, with product sponsorship and attribution (e.g., "Developed under an educational grant from Company X, maker of Product Y")
- Explicit nonendorsement language from the association
- No such language
- Proprietary funding with a message from the third-party and a message from the association piggybacked to third-party's message
- Explicit nonendorsement language from the association
- No such language
- Proprietary funding with product, plus association piggyback message and/or association seal on product package
- Explicit nonendorsement language from the association
- No such language
- Revenues derived from co-promotion of third-party product or message with payment to association for use of its imprimatur
Relations with Third Party Agents
A. Third parties, as agents of industry, bringing program/project concepts to AAFP may be:
- Advertising agencies
- PR agencies
- Health care communications firms
- Research firms (see Chapter IV)
- Production companies
- For CME projects: In general, AAFP will have its own resources and established relationships with vendors with whom to work on projects. In the event that an originating third party is chosen to develop an AAFP CME product, all rules from Section B (below) apply. Please note, however, that a letter of agreement must exist between the AAFP and the funder (eg, the pharmaceutical company).
- For Non-CME projects or events: Examples: social or promotional events. A letter of agreement between the AAFP and the funder will be established and the role of the third party (if any) may be included and defined within the terms of the agreement.
B. Third parties as agents of AAFP may be:
- Production companies, e.g. Publishers (book production, advertising/promotion), Video companies, CD-ROM publisher, Other
- Health care communications firms
- Third party agencies contracted by the AAFP in the design of CME:
- share in the obligation of meeting all CME rules set forth by accrediting agencies, AMA Ethical Opinion and FDA Guidance.
- have an obligation to protect the AAFP from inclusion of overt to subtle information that may be biased toward a particular drug or device.
- share with the sponsor the responsibility of assuring that programs will not promote one product over another.
- may not lead funding companies to have unrealistic expectations of the way their product might be recognized in a CME event.
- may not allow the funder input into the content of the program.
- share with the sponsor the responsibility of assuring that one drug's positive effects are not emphasized to a greater degree than competing products or design a program that might provide a forum for mentioning one drug more than another.
- must provide information on the cost effectiveness of various therapies whenever possible.
- share in the responsibility of designing an objective, balanced, and scientifically rigorous program, wherein both favorable and unfavorable information about a product is fairly represented.
- share an obligation to ensure that content presented is a balanced discussion of the prevailing body of scientific information, and is evidence-based to the extent possible.
- share an obligation to identify off-label uses as such.
- share an obligation to ensure appropriate disclosure of any relationship between individual faculty, authors, etc, and the funding corporation.
