The cost of peer review will vary depending on the accredited provider's process, the turnaround time, the number of reviewers, the topic/specialty area, the profession (physician, pharmacist, nurse, etc.), and the credentials required. The amount reflected in the line item may include honoraria and associated administrative fees for coordination. While this information may not be itemized in the grant request, it is worth noting that amounts may differ significantly among grant requests.

Look for it in the grant application Look for evidence that the peer-review process is independent. Reviewers' relationships with the grantor, the presenter/author, the activity chair, and even the accredited provider can bring their independence into question. In addition to relationships with pharmaceutical companies and medical device manufacturers, inherent conflicts exist for reviewers who are employees and contractors of accredited providers.

Evaluate it At a minimum, an effective review evaluates whether the content presents treatment options—including those that are off-label—in a fair and balanced manner, is free from commercial bias, and provides evidence to support treatment recommendations. The activity evaluation should provide participants the opportunity to evaluate these same elements. At the conclusion of the activity, companies may request summary data to verify favorable feedback on these critical areas of concern.

Jane M. Ruppenkamp is president of CME Peer Review. She can be reached at jruppenkamp@cmepeerreview.com

Kristi E. Eidsvoog, president of The Red Pen, and Linda Raichle, president of Spectrum Medical Education, contributed to this article.