This document is adapted from the Code for Interactions with Companies published by the Council of Medical Specialty Societies (CMSS).
The CMSS document has been reviewed by a committee of Past Presidents of the International Parkinson and Movement Disorder Society (MDS) and has been adopted by MDS. The MDS Officers discussed the document on five occasions. Concern was expressed about the applicability of the document in its entirety to an international society (to date all signatories to the CMSS Code are North American societies).
Nevertheless, there was agreement that it was desirable MDS had i) a "Code of Conduct" based on the CMSS Code; ii) a statement of principles of disclosure; iii) a formal process for disclosure; iv) a Committee to oversee the process, review potential conflicts of interest and in the future review potential Key Society Leaders. Such a document would be tailored for MDS as an international organization, made freely accessible, and posted on the MDS website.
This document focuses on the "Principles for Interaction" of The CMSS Code and acknowledges the Definitions outlined in the CMSS Code. An attempt has been made to modify the code to suit the needs of MDS as an international organization while retaining the intent of the original document. The principles have been applied prospectively.
Principles for Interaction
1.1. The International Parkinson and Movement Disorder Society (MDS) will ensure that educational activities, scientific programs, products, services and advocacy positions of the Society are independent of Company influence, and will develop and adopt policies and procedures that foster independence. In any Society collaborations with a Company on a project there will be an arms-length business relationship between the Society and the Company. The Society will apply its independent judgment to the arrangement and will not allow the Company to control content or project decisions.
1.2. MDS will separate program development from efforts to seek Educational Grants, Corporate Sponsorships, Charitable Contributions and support for Research Grants.
1.3. MDS will assign the responsibility of monitoring and guiding interactions with companies to a Code of Conduct Committee who will report to the Society.
1.4. A Key Society Leader (defined as the Society President, President-Elect) and the Editors-in-Chief of the Society Journals may retain existing Direct Financial Relationships established prior to appointment for the duration of their term but shall not develop new Direct Financial Relationships with Companies or acquire or be granted new stock options during the period of office. Continuing relationships should be disclosed and managed in accordance with Principles 2.3 and 2.4. Reappointment to a position will be viewed as a new appointment.
A Key Society Leader (subject to Principle 1.4 and disclosure in accordance with Principles 2.3 and 2.4) may:
- provide uncompensated service to Companies and accept reasonable travel reimbursement in connection with those services
- accept research support as long as grant money is paid to the institution (e.g., academic medical center) or practice where the research is conducted (not to the individual)
- accept reasonable compensation for serving on an independent data safety monitoring board in a Company study
- receive royalties or similar fees relating to intellectual property or patents
1.5. Funds obtained for Educational Grants, Research Grants, Corporate Sponsorships, Charitable Contributions and Business Transactions shall be documented with written agreements that specify what the funds are for, the amount given, and the separate roles of the Company and the Society and affirm the independence of the Society.
2. Transparency-mechanism of disclosure and review
2.1. MDS conflict of interest policies and disclosure forms will be made available on the Society website to members of the Society and the public.
2.2. MDS will disclose and make available to members of the Society and the public details of Company support for Educational Grants, Corporate Sponsorships, Charitable Contributions and Research Grants
2.3. MDS will adopt written disclosure policies for Key Society Leaders, members of the International Executive Committee and others who serve on behalf of the Society, and a Code of Conduct Committee (see Item 11) will review and manage conflicts of interest in decision-making. Disclosure information will be updated at least annually and when material changes occur.
2.4 MDS Key Society Leaders and members of the International Executive Committee will disclose and make available to members and the public all financial (including employment, consulting or advisory arrangements, stock ownership, honoraria, research funding paid to an individual's institution or practice, expert testimony, gifts) and uncompensated relationships with Companies.
3. Accepting Charitable Contributions
3.1. MDS will control the use of Charitable Contributions in a manner aligned with the MDS mission and strategic plan.
3.2. MDS will not accept Charitable Contributions where the donor Company expects to influence Society programs or advocacy positions, or where Company restrictions would influence MDS programs or advocacy positions in a manner not aligned with the MDS mission.
3.3. MDS will adhere to applicable tax rules and legal standards for acceptance of Charitable Contributions and management of institutional funds.
3.4. Charitable Contributions can be designated to support the MDS mission (e.g., general research, research in a particular disease area, or patient information) or to support a specific Society program (e.g., a research award or fellowship), but donor influence over the program is not permitted (e.g., selecting award recipients or determining research topics).
3.5 MDS will adopt policies for consistent and appropriate recognition of donors but not in a manner that accepts donor influence over programs or advocacy positions
4. Accepting Corporate Sponsorships
4.1. MDS will only accept Corporate Sponsorship of an item or program where the item or program is aligned with the strategic plan and mission of the Society.
4.2. MDS will make reasonable efforts to seek multiple Corporate Sponsors for sponsored items or programs.
5. Society Meetings
5.1. ACCME accredited Programs
5.1.1. MDS will comply with ACCME Standards for Commercial Support when providing CME, including the adoption of policies and procedures in content development and conduct of CME activities and to identify and manage conflicts of interest in Company-supported Society CME programs. MDS is ACCME certified and has a CME oversight committee.
5.1.2. Where the purpose of a CME session is to demonstrate or train attendees in the safe and effective use of a particular drug, device, service or therapy, MDS may accept in-kind support from Companies that develop, produce, market, or distribute that drug, device, service or therapy. In accordance with ACCME Standards, MDS may accept in-kind support from a single Company when other services are not available for inclusion.
5.1.3. MDS will make reasonable efforts to seek multiple sources of support for CME programs and to achieve a balanced portfolio of support for each CME program.
5.1.4. MDS will retain control over the use of Educational Grants and implement safeguards designed to ensure that educational programs are non-promotional and free from commercial influence and bias.
5.1.5. MDS has planning committees to select the objectives, content, faculty, and format of educational activities in a manner that is consistent with the MDS mission.
5.1.6. MDS will not solicit Company suggestions about program topics, speakers, or content.
5.1.7. MDS prohibits presenters from using Company-controlled presentation materials and slides with Company logos.
5.1.8. MDS requires speakers/presenters to give a balanced view of therapeutic options and insists upon use of generic rather than trade names.
5.1.9. MDS clearly distinguishes Non-CME Informational/Educational Programs from MDS CME.
Note: MDS is an international society and adheres to regional and local regulations whenever available in written form according to the meeting location. This applies mainly to North America at present and MDS will adopt regulations as appropriate in other regions as developed.
5.2. ACCME-Accredited Satellite Symposia
5.2.1. MDS requires Satellite CME Symposia to undergo an application and selection process.
5.2.2. MDS requires Satellite CME Symposia to comply with ACCME Standards including i) peer review of slide presentations in advance; ii) prohibiting presenters who disclose unmanageable conflicts from making practice recommendations (these presenters may present on general topics only (e.g., pathophysiology, research data); iii) monitoring presentations by reviewers trained to recognize bias.
Note: The above do not apply to Programs held as an adjunct to Society meetings, not CME accredited or for which the Society does not receive a fee.
5.2.3. MDS will ensure satellite CME Symposia are clearly distinguished from Society CME in meeting programs and promotional materials.
5.3.1 MDS has written policies that govern the nature of exhibits and conduct of exhibitors, including requiring exhibitors to comply with applicable laws and regulations.
6.1. Companies are not permitted to select or influence selection of MDS award recipients.
6.2. MDS appoints independent committees to select recipients of awards.
7. Evidence-Based Reviews, Critiques and Task Force Reports
7.1. MDS is an international society and does not publish global "Clinical Practice Guidelines" since what is applicable in one country may not be available in another. Instead, MDS commissions Evidence Based Reviews, Task Force Reports and Critiques to provide rigorous, scientific and independent reviews of the published literature on a topic of interest. These articles are published on the MDS website and commissioned by the membership at large after review by relevant committees of the Society.
7.2. MDS sections can participate in regional guidelines based on Evidence Based Reviews prepared by MDS International. At present only MDS European Section / European Federation of Neurological Societies (EFNS) guidelines are produced and published according to the ethical regulations of the EFNS.
7.3. MDS reviews, critiques and reports must not be subject to Company or commercial influence.
7.4. MDS commissioned reviews are subject to peer-review by the Scientific Issues Committee and the Officers. Where publication in the Movement Disorders or Movement Disorders Clinical Practice journal is sought, the manuscript is subject to the normal submission process including independent editorial review.
8. Society Journals
8.1. The Movement Disorders and Movement Disorders - Clinical Practice journals maintain editorial independence from the Society and from Advertisers. Editorial independence is consistent with accepted standards for medical publishing, such as those established by the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME).
8.2. Authors submitting manuscripts to the Journals are required to disclose financial and other relationships with Companies. The Journal editors in evaluating the article will consider author disclosures. If the article is published, the relevant author disclosure information will appear with the online article or issue.
8.3. Editors' and reviewers' financial disclosures and other relationships with Companies are placed on the Journal websites.
8.4. The Editors-in-Chief of the Movement Disorders and Movement Disorders Clinical Practice journals have responsibility for determining when a conflict of interest should disqualify an editor or reviewer from handling / overseeing or reviewing a manuscript, according to policies established and supervised by the Publications Oversight Committee.
9. Standards for Advertising
9.1. Advertising in the Movement Disorders and Movement Disorders Clinical Practice journals is subject to review by the Editors-in-Chief and overseen by the Publications Oversight Committee all of whom report to the Officers and International Executive Committee. MDS publications (which include Advertising for CME activities and provide activities through which readers can earn CME credits) comply with ACCME requirements for Advertising set out in the Standards for Commercial Support.
10. Standards for Licensing
10.1. MDS has written standards for licensing intended to prevent misuse, unintended use, and modification of licensed materials, prohibit modification of licensed materials in a way that would change their meaning, and prohibit use of Society trademarks to imply Society endorsement of Company products or services.
11. Code of Conduct Committee
11.1 MDS has established a Code of Conduct Committee. The task of this committee is to oversee the conflict of interest statements and to advise the officers in all matters regarding the issues dealt with in this policy.