Continuing Medical Education and the Marketing of Fentanyl for Breakthrough Pain: Marketing Messages in an Industry‐Funded CME Module on Breakthrough Pain

In order to market transmucosal fentanyl products, industry‐funded medical journal articles and continuing medical education (CME) were used to persuade physicians that breakthrough pain (BTP) was a separate entity, and that rapid onset opioids were an appropriate treatment. We performed a pilot study on industry‐funded online CME modules on BTP that used perceptions of key points and text analysis to assess subtle bias. Thirty‐eight participants were randomized to read a non‐industry publication or an industry‐funded publication on opioids for managing pain. Twenty‐three participants were asked to assess key messages. A text analysis was also performed on key words and phrases. Those who read the non‐industry‐funded article noted that the effectiveness of opioids for chronic pain was unclear, whereas readers of the industry‐funded article viewed opioids more positively. Eight of twelve readers of the non‐industry‐funded article, compared to three of twelve assigned to the industry‐funded article, reported opioid abuse or addiction as a major theme. “Breakthrough pain” was mentioned 55 times in the industry‐funded article and once in the non‐industry‐funded article. The non‐industry‐funded article mentioned “death” 26 times; the industry‐funded article never mentioned “death.” Our study provides a new method of identifying subtle bias that may be useful for evaluating CME modules.