The primary purpose of these principles is to support the mission of the American College of Rheumatology, which is to Advance Rheumatology. The ACR can succeed in this mission only if it maintains its reputation in the scientific and medical communities and with the general public as a credible, objective and unbiased entity whose statements, activities and interactions are beyond reproach. The following principles were developed to ensure this reputation is maintained by safeguarding the independence of the College’s activities, policies, statements and advocacy positions. All interactions with external entities should be consistent with these principles.

The following terms are defined for purposes of these principles.

ACR (The): the American College of Rheumatology and all its officers, directors, committees, task forces, divisions, sections, and staff.

Affected Companies: includes, but is not limited to, pharmaceutical, biotech, or other companies that manufacture or market products or therapies that might be affected by the ACR’s work, or competitors of these companies. For guidelines, affected companies are ones that are reasonably likely to be positively or negatively affected by care delivered in accordance with the guideline.

Business Transaction: an interaction between the College and a commercial entity in which commercial entity pays a fee to the College in exchange for a product or service. An example of a business transaction is exhibit space rental. Corporate support arrangements and educational grants are distinct and do not constitute a business transaction.

College (The): includes the American College of Rheumatology and all its officers, directors, committee, task forces, divisions, sections and staff plus the Rheumatology Research Foundation.

Charitable Contribution: a gift, including an in‐kind gift, given by an external entity to the Rheumatology Research Foundation for use in furthering its charitable purposes and in accordance with applicable tax rules and legal standards.

Commercial Entity: any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. This definition is not intended to include entities through which physicians provide clinical services directly to patients.

Corporate Support: an arrangement in which a commercial entity, typically through its marketing department, provides monetary or in‐kind support for a particular activity of the College and is then acknowledged in connection with the activity. Corporate support arrangements are distinct from educational grants, and do not constitute commercial support of continuing medical education.

Educational Grant: a sum awarded by an external entity, typically through its grants office, for the specific purpose of supporting an educational or scientific activity offered by the College. Educational grants awarded by an external entity to support a CME activity are referred to in the ACCME Standards for Commercial Support as “commercial support” of CME. An educational grant may also be “in‐kind.”

External Entity: any entity including commercial entities, other non-profit organizations, health care insurance companies, or individual donor/s.

Foundation (The): the Rheumatology Research Foundation and all its officers, directors, committees, task forces and staff.

Health Care Insurance Company: any entity that provides insurance against expenses incurred through illness of the insured.

Key College Leaders: include the ACR President, ACR President-Elect, Foundation President, ARHP President and ARHP President-Elect.

Non-CME Informational/Educational Programs: programs offered by external entities that provide educational or promotional information and do not offer CME credit, held as an adjunct to an activity of the College.

Foundation Awards and Grants: any award or grant that is given by the Foundation to an individual, institution, or practice.

Satellite CME Symposium: a CME program supported by a commercial entity held as an adjunct to an activity of the College where the CME credit for the symposium is provided by a third party CME provider.

Supporter: any entity that provides financial support to the College.

1. Independence

   1.1 The College will develop all educational activities, scientific programs, products, services and government advocacy positions independent of commercial entities and will maintain control via policies and procedures that foster independence.

   1.2 The College will separate its efforts to seek support for its activities from its programmatic decisions.

   1.3 Interactions between the College and external entities, and in particular solicitation of support from commercial entities, should be under the direction of the ACR Executive Vice President or his/her designee. Individual members and volunteers may work in conjunction with the ACR Executive Vice President or his/her designee to identify potential support sources and solicit external entities.

   1.4 The College will use written agreements with external entities for educational grants, corporate support, charitable contributions, business transactions, and support of Foundation awards and grants.

   1.5 Where appropriate, the ACR will seek funding from a variety of sources. Occasions may arise when support of a specific event, publication, product or service from a single source is appropriate. During these occasions, the ACR will exercise special caution to avoid conflicts of interest and guard against any perception of conflict of interest.

   1.6 The ACR will not offer exclusivity to a single commercial entity for activities/programs targeted at fellows and/or medical students. Therefore, these activities/programs must be offered to multiple commercial entities. If support from more than one commercial entity is not confirmed, the ACR board of directors must approve single commercial entity arrangements. 

   1.7 The following activities of the College should be free from influence or the appearance of the influence from commercial entities. Therefore, the College will not utilize external support for the following:

   1.7.1 ACR board of directors and committee meetings
   1.7.2 Advocacy/government affairs activities
   1.7.3 Activities of the quality of care committee and its subcommittees (see section 1.18)
   1.7.4 Practice management guidelines, criteria and quality indicators
   1.7.5 Development of registries
   1.7.6 Hotline
   1.7.7 Position Statements
   1.7.8 Drug Safety Quarterly
   1.7.9 ACR activities related to state societies
   1.7.10 Patient information activities/materials
   1.7.11 ACR Web site – no advertisements in public sections
   1.7.12 Annual meeting press room
   1.7.13 Annual meeting opening reception and/or official ACR attendee-wide social events
   1.7.14 Items that commercial entities are not permitted to give directly to health care professionals under generally accepted standards for ethical interactions (e.g., PhRMA Code).

   External support for non-CME Research conferences is not appropriate without ACR board of director's approval.

   1.8 Key college leaders will comply with the ACR Conflict of Interest Guidelines for Officers.

   1.9 Board members of the ACR and the Foundation, the ARHP executive committee, the A&R editor, the AC&R editor, the TR editor and chairs of the following committees: committee on education, annual meeting planning subcommittee, abstract selection subcommittee, abstract oversight subcommittee, professional meetings subcommittee, committee on ethics and conflict of interest, committee on corporate relations, committee on quality of care, committee on registries and health information technology and any other committees that plan CME activities may not participate in industry-supported activities, held during or at the conclusion of ACR meetings, including industry-supported symposia and innovation theater presentations, or participate as speakers or planners in the following two industry-supported activities that utilize ACR Annual Scientific Meeting program content:

   1.9.1 Post-meeting "advisory panel" meetings
   1.9.2 Enduring materials highlighting the annual meeting

   1.10 It is not appropriate for representatives of the College to accept gifts from commercial entities. When appropriate, a representative from a commercial entity may pay for modest meals for College representatives to conduct business between the two entities they represent.

   1.11 ACR members whose primary employment is with commercial entities or health care insurance companies may not serve on the following:

   1.11.1 Committee on Corporate Relations
   1.11.2 Committee on Education
   1.11.3 Committee on Government Affairs
   1.11.4 Committee on Nominations and Appointments
   1.11.5 Committee on Quality of Care
   1.11.6 Committee on Registries and Health Information Technology
   1.11.7 Committee on Rheumatologic Care
   1.11.8 Committee on Rheumatology Training and Workforce Issues
   1.11.9 RheumPAC (Political Action Committee)
   1.11.10 Any subcommittee or task force that plans or reviews ACR CME activities

   1.12 ACR members whose primary employment is in commercial entities or health care insurance companies may participate on the following:

   1.12.1 Committee on Communications and Marketing
   1.12.2 Committee on Ethics and Conflict of Interest
   1.12.3 Committee on Finance
   1.12.4 Committee on Research

   1.13 ACR members whose primary employment is in health care insurance companies, but not those whose primary employment is in commercial entities, can serve on the committee on journal publications.

   1.14 ACR members whose primary employment is in commercial entities or health care insurance companies are eligible for service on the ACR board of directors but are not eligible to become officers.

   1.15 The College will not solicit, accept support or agree to allow the ACR's or the Foundation's name to be used in a manner that could be interpreted to indicate endorsement of any commercial product or activity related to the field of rheumatology.

   1.16 For the ACR to be formally involved in an activity with an external entity, the following criteria must be met:

   1.16.1 The activity does not conflict with the College's Guiding Principles Related to Interactions with External Entities.
   The activity is aligned with the ACR strategic plan and mission.
   1.16.2 The appropriate ACR committee and the ACR board of directors, when required, have approved the ACR's involvement in the activity.
   1.16.3 When appropriate, an agreement, signed by all entities, stating the terms and conditions, including the purpose, goals and objectives of the activity, must be completed.

   1.16.3.1 There are two general categories of activities with external entities. The first category relates to educational activities that include a CME credit component. The second category relates to activities that do not have a CME credit component. Within the two categories, three levels define the ACR's participation. The definitions used to describe each level of participation are specific and should be reserved for use in the appropriate context. The levels are:
   1.16.3.1.1 "Joint-Sponsorship"/"Collaboration": Programs that receive the designation of "joint-sponsorship" (for CME activities) and "collaboration" (for non-CME activities) indicate the activity is of mutual interest to all involved entities. These activities require formal ACR participation in the planning process; all content must be reviewed by the appropriate ACR representatives and final ACR agreement must be obtained for all aspects of the activity. The final agreement must be authorized by the appropriate ACR representative. These designations may involve budget or staff support. They imply substantial College responsibility for a significant portion of the activity. Those activities for which the "joint-sponsorship" designation is sought must comply with all applicable ACCME Essential Areas and Policies. The ACR cannot enter into any joint sponsorship agreements with a commercial entity.
   1.16.3.1.2 "Co-sponsorship"/"Endorse": These designations will be applied to activities when the ACR has been involved with the activity but may not have participated in, or been responsible for, or approved all aspects of planning and development. The designation "co-sponsored" will be reserved for education activities involving CME credits and all such activities must comply with applicable ACCME Essential Areas and Policies. The designation "endorse or endorsement" will apply to non CME activities to indicate that the College agrees with the activity or position stated by an external entity/ies.
   1.16.3.1.3 "Review"/"Support or Approval": The designations "review" and "support or approve" will apply to activities or positions that are submitted to the ACR for appraisal, but in which the ACR has played no role in planning or development. The designation "review" will apply to CME activities and all such activities must comply with applicable ACCME Essential Areas and Policies. The designation "support or approve" will apply to non-CME activities or positions to indicate that the College has assessed the activity or position and agrees with the content.

   1.17 All activities must include the appropriate credit lines, acknowledgments and disclaimers.

   1.17.1 The appropriate credit line for a CME activity is "This activity is jointly-sponsored/co-sponsored by the American College of Rheumatology" or "This activity has been reviewed by the American College of Rheumatology." In addition, the appropriate ACCME and/or AMA accreditation statements must be used.
   1.17.2 The appropriate credit line for non-CME activities is "This activity was developed in collaboration with the American College of Rheumatology" or "This activity is/has been endorsed/supported/approved by the American College of Rheumatology."
   1.17.3 When appropriate, activities at the level of "collaboration" or "endorse" should use the following form of organizational identification: The American College of Rheumatology is an international professional medical society that represents more than 8,000 rheumatologists and rheumatology health professionals around the world. Its mission is to advance rheumatology." 1.17.4 With the permission of the ACR, the ACR logo may be used for all CME activities and for all non CME activities at the levels of "collaboration" and "endorse." Typically, activities at the level of "support or approval" will not receive permission to use the ACR logo. Permission will be subject to the nature and quality of the activity.

   See section 4.5.2 for disclaimers

   1.18 Investigators, authors, and organizations may seek endorsement or approval from the ACR for practice guidelines, classification/response criteria, quality measures, and other quality-related work. The Quality of Care Committee will not review quality-related products for ACR endorsement or approval if funding from a commercial entity was used to support any aspect of the process. Review for approval will be conducted according to the quality of care committee policies.

   1.18.1 Refer to ACR: Policies and Procedures for Development, Approval and Publication of Quality of Care Committee Products for manuscript titling conventions and credit lines for quality-related reviews.

2. Transparency

   2.1 The College's conflict of interest policies and forms will made available to the public online.

   2.2 All financial and uncompensated relationships that key college leaders and members of the ACR board of directors have with commercial entities and health care insurance companies will be publicly disclosed.

   2.3 The ACR will make available to the public a listing of support from commercial entities.

3. Accepting Charitable Contributions

   3.1 The College will control the use of charitable contributions in a manner that is aligned with its strategic plan and mission and that are consistent with The Code of Ethics of the ACR.

   3.2 The Foundation will decline charitable contributions where the external entity expects to influence the Foundation's activities or positions, or where restrictions required by the external entity would influence the Foundation's activities or positions in a manner that is not aligned with its mission.

   3.3 The ACR will decline charitable contributions where the external entity expects to influence the ACR's advocacy positions, or where restrictions required by the external entity would influence the ACR's advocacy positions in a manner that is not aligned with its mission.

   3.4 The College will adhere to applicable tax rules and legal standards for acceptance of charitable contributions and management of institutional funds.

4. Accepting Commercial Support

   4.1 The College will only accept support for an activity if the activity is aligned with its strategic plan and mission and the activity is consistent with The Code of Ethics of the ACR.

   4.2 Commercial entities must represent a product or service that is compatible with the College's image, its policies and its values.

   4.3 To prevent the ACR from accepting an unbalanced level of support and to avoid the potential for one commercial entity asserting undue influence over the ACR, the ACR has adopted the following principles:

   4.3.1 The ACR's upper limit for the amount of support the ACR shall receive from commercial entities for grants in any given year shall be no more than 25 percent of the ACR's overall income
   4.3.2 One commercial entity cannot provide more than 40 percent of the ACR's grant income
   4.3.3 The ACR's upper limit for the amount of support the ACR receives from one commercial entity for annual meeting programs shall be no more than 40 percent of any grant or annual meeting support that offsets the cost of the annual meeting or any of its programs or activities

   4.4 The external entity's corporate name may be included in the title of an Foundation award if the external entity endows the award or provides a commitment to the award of $5 million provided over a specified period not to exceed five award cycles.

   4.5 When the ACR accepts external support, the external entity will receive acknowledgment in the appropriate forums.

   4.5.1 Printed materials and signage should include a credit line. The credit line should acknowledge the support and disclose that support was accepted. Examples of appropriate credit lines include:

   4.5.1.1 "This (publication/material/etc.) was made possible by a grant to the ACR from (name of supporting entity)."
   4.5.1.2 "Supported by (supported in part by) a grant from (name of supporting entity)."
   4.5.1.3 "Supported by (name of supporting entity)."

   4.5.2 When appropriate, a disclaimer should appear on the same page as the credit line. Examples of appropriate disclaimers include:

   4.5.2.1 "Acceptance of support by the ACR does not constitute or imply endorsement by the ACR of any of the specific services or products of the (name of supporting entity)."
   4.5.2.2 "The American College of Rheumatology is an independent professional, medical and scientific society which does not guarantee, warrant or endorse any commercial product or service."
   4.5.2.3 "The views expressed and materials presented in this activity represent the personal views of the individual participants and do not necessarily reflect the views of the American College of Rheumatology. The American College of Rheumatology assumes no responsibility for the content of the presentations made by an individual participant or group of participants."
   4.5.2.4 "This program is being sponsored by the American College of Rheumatology for educational purposes only. The material presented is not intended to represent the only or the best methods appropriate for the medical situations discussed, but rather is intended to present the opinions of the authors or presenters, which may be helpful to other practitioners. Attendees participating in this education activity sponsored by the ACR do so with full knowledge that they waive any claim they may have against the ACR for reliance on any information presented during this educational activity."

   4.6 In return for external support, the ACR may provide the external supporter the option to include a product or corporate advertisement in non-CME ACR publications. Appropriate non-CME ACR publications include the annual meeting abstract supplement, annual meeting program book, annual meeting registration brochure, membership directory.

   4.6.1 In such circumstances, the following requirements must be adhered to:

   4.6.1.1 Product advertisements must conform to FDA guidelines 4.6.1.2 Advertisements may not include the ACR logo 4.6.1.3 Prior to publication, the ACR Executive Vice President or designee must approve advertisement

5. Educational Grants and ACR CME

   5.1 The College complies with ACCME Standards for Commercial Support, including policies and procedures designed to identify and manage conflicts of interest.

6. CME Accredited - Satellite Symposia

   6.1 The College requires satellite CME symposia to undergo an application and selection process.

   6.2 The College requires satellite CME symposia to comply with ACCME standards.

   6.3 The College ensures that satellite CME symposia are clearly distinguished from ACR's CME content.

   6.4 The College requires third party organizers of satellite CME symposia to use appropriate disclaimers to distinguish the symposia from ACR's CME activities.

7. Non-CME - Informational/Educational Programs

   7.1 The College requires non‐CME informational/educational programs to be clearly distinguished from the ACR's CME activities.

8. Exhibits

   8.1 Board members of the ACR and the Foundation, the ARHP executive committee, the A&Reditor, the AC&R editor, the TR editor and chairs of the following committees: committee on education, annual meeting planning subcommittee, abstract selection subcommittee, abstract oversight subcommittee, professional meetings subcommittee, committee on ethics and conflict of interest, committee on corporate relations, committee on quality of care, committee on registries and health information technology and any other committees that plan CME activities may not participate in the promotional/marketing events held in the exhibit space of external entities during ACR meetings. If appropriate, the A&Reditor, the AC&R editor, the TR editor may participate in activities in the publisher's booth.

   8.2 All products and services exhibited must be of professional and educational interest or benefit to the attendees and related to the field of rheumatology. If applicable, all products and services must meet FDA requirements.

   8.3 CME activities are prohibited in exhibit booths. Medical experts who are either full-time employees of exhibiting companies or paid consultants of exhibiting companies may engage in informal educational discussions about the company's products or data presented at the annual meeting related to the product (as long as they abide by the Abstract Embargo Policy) in exhibit booths. However, expert-led discussions must be either one-on-one or in small, informal groups only – not in classroom-style, seated presentations or to large groups. Discussions must not be scheduled at particular times or as a scheduled, timed "event," nor be advertised as such. Exhibiting companies may promote that experts will be available in their booth for educational purposes to discuss the product or data related to the product.

   8.4 All giveaways by commercial exhibitors must be consistent with Pharmaceutical Research and Manufacturers of America (PhRMA) Code on Interactions with Healthcare Professionals and the AdvaMed Code of Ethics on Interactions with Health Care Professionals.

   8.5 Giveaways by nonprofit exhibitors who are not subject to the PhRMA or AdvaMed codes must be of modest value.

   8.6 Giveaways must be designed primarily for the education of patients or health care professionals, not be of substantial value, and not have value outside of a health care professional's professional responsibility.

   8.7 All exhibits and exhibited items must comply with all local, state and federal laws and regulations. Exhibitors who choose to promote products to non-U.S. attendees should incorporate international areas within their booths that are not accessible to U.S. attendees in order to comply with FDA regulations. Exhibitors are responsible for complying with FDA regulations.

   8.8 Exhibitors (and their representatives) may only distribute giveaways or printed material—including product data, promotional information, periodicals, invitations, etc.—in the space rented by the exhibitor in the Exhibit Hall.

   8.9 ACR educational materials (CME and non CME) should not be disseminated from a supporter's exhibit booth in the ACR exhibit hall. Examples of ACR education materials include abstracts on disk, slide CD's, HIPPA manuals.

   8.10 Items viewed by the public shall not include the ACR logo and a commercial entities company/product logo without approval by the ACR board of directors.

9. Awarding of Foundation Awards and Grants

   9.1 The College will not permit any external entities to select (or influence the selection of) recipients of Foundation awards or grants.

   9.2 The College will appoint independent committees to select recipients of Foundation awards or grants based on peer review of grant applications.

   9.3 The College will not require recipients of Foundation awards or grants to meet with external entities.

   9.4 The College will not permit any external entity that supports Foundation awards or grants to require intellectual property rights or royalties arising out of the grant‐funded research.

   9.5 The College will not permit any external entity that supports Foundation awards or grants to control or influence manuscripts that arise from the grant‐funded research.

   9.6 If the College receives financial support from an external entity to support the College's own research, the College will disclose the supporter. The College will act independently in the selection of research topics and the conduct of the research itself.

10. Criteria, Guidelines and Quality Measures

    10.1 The ACR requires use of a standardized, evidence-based guideline development process.

    10.2 The ACR follows transparent criteria and guideline development processes that mitigate the risk or perception of influence of commercial entities or health care insurance companies. The ACR follows a transparent quality measure development process that mitigates the risk or perception of influence of commercial entities. All processes are made available to the public online.

    When developing a request for proposals, the ACR will list external entities that may be affected by the work. This list of affected companies will be included in the RFP, with a requirement that disclosures related to these entities must be explicitly included in the written disclosures submitted as part of any proposal. The list will include but is not limited to pharmaceutical, biotech, or other companies that manufacture or market products or therapies that might be affected by the College's work, or competitors of these companies. For guidelines, affected entities are ones that are reasonably likely to be positively or negatively affected by care delivered in accordance with the guideline.

    10.3 The ACR's endorsement or approval of criteria, guidelines and quality measures is subject to established standards and processes. External entities are encouraged to contact the ACR early in the development process to determine the feasibility of ACR involvement and/or eventual review for endorsement or approval.

    10.4 If funding from a commercial entity was used to support any aspect of the process of a quality-related product, the ACR will not consider it for approval. See 1.18 for more information.

    10.5 The ACR will require all individuals who contribute intellectually to an ACR criteria, guideline or quality measure development project to disclose all relationships in writing prior to start of the project and to update their disclosure statements throughout the development process as changes occur. Even if no changes occur, group members should attest at least every six months that their disclosure statement is current. Updated disclosures will also be required during the approval and publication processes. The initial look-back period for all participant disclosures is one year prior to the call for proposal deadline.

    10.6 Principal investigators of ACR project development groups must be free of conflicts of interest relevant to the subject matter of the project for at least one year prior to the proposal deadline and throughout the project until publication and are expected to remain free of such conflict of interest for at least one year after publication.

    10.7 The majority (51 percent) of the project development group must be free of conflicts of interest relevant to the subject matter of the project for at least one year prior to the call for proposal deadline and throughout the project until publication. The plan to manage the conflicts of the others must be documented in the project proposal and approved by the quality of care committee prior to the start of the project. The ACR and the principal investigator/s are jointly responsible for monitoring how any changes to the composition of the development group or a group member's disclosure/conflict of interest might affect the required majority.

    10.8 At a minimum, project development group members with conflicts of interest are recused from voting and drafting text on issues related to their conflicts. Panel member abstentions from voting during guideline development processes are documented and will be included in the disclosure information published on online with the final publication.

    10.9 Guideline project development group members and ACR representatives may not discuss a guideline's development with employees or representatives of affected companies. In addition, they may not accept unpublished data from affected companies, nor permit affected companies to review guidelines in draft form.

    10.10 Members of guideline development groups are expected to decline offers from affected companies to speak in any setting about the guideline on behalf of an affected company for a period of one year after publication of a guideline.

    10.11 The ACR will review criteria, guidelines and quality measures for approval using standardized processes and templates, against pre-determined review criteria. All papers are subjected to multiple levels of review by subject area and methodological experts. The ACR will not select as reviewers full-time employees of entities listed on the affected companies list.

    10.12 The ACR board of directors will review and approve all ACR quality-related products before final submission for publication.

    10.13 All ACR-approved criteria, guideline and quality measure papers must include in the final publication disclosures from authors and anyone who contributed intellectually to the work, plus members of the relevant ACR subcommittee responsible for reviewing the paper. Papers must also reference the disclosures of the members of the ACR quality of care committee and ACR board of directors (at the time the paper was reviewed and approved), which are made available to the public online, in perpetuity; and any abstentions from voting during guideline development processes.

    10.14 Manuscripts will be subject to independent editorial review by a journal or other publication where they are first published.

    For additional information – refer to ACR: Policies and Procedures for Development, Approval and Publication of Quality of Care Committee Products.

11. Journal

    11.1 The College's journal will maintain editorial independence from the College and advertisers.

    11.2 The College's journal will require all authors to disclose, prior to publication, financial and other relationships with commercial entities that may potentially benefit from or be harmed by publication of the results of the research or study.

    11.3 The editor of each Journal may not have any direct financial interactions with a commercial entity.

    11.4 The College's journal will require co- and associate editors to disclose to the editor all relationships with external entities that could affect impartiality of handling of specific categories of articles and will require reviewers to disclose to the editor all relationships with external entities that could affect impartiality of the review of a given article.

    11.5 The editor of each Journal will have the ultimate responsibility for determining when a conflict of interest should disqualify an editor or reviewer from reviewing a manuscript.

    11.6 The College's journal will adhere to International Committee on Medical Journal Editors policies regarding the disclosure of the names and affiliations of all non-author contributors to manuscripts and studies, in order to prevent publication of "ghost‐written"manuscripts.

    11.7 The College's journal will not place an advertisement for a product adjacent to an article on that product. No advertising will appear in the College's journals in a format that could be mistaken for editorial content.

12. Standards for Licensing

    12.1 The ACR's name, logo or identifying information may only be used on non-ACR materials with the written approval of an ACR representative.

    12.2 The ACR will provide all external entities with a written statement that specifies the terms and conditions of support, including recognition. In some situations, a contractual agreement may be required.

    12.3 When appropriate, recognition may be deferred until a written confirmation is received from the supporter.

    12.4 When appropriate, the ACR will ensure that the supporter agrees to appropriate indemnification and hold harmless provisions to protect the ACR and its officers, director, employees and volunteers against any and all claims, damages, liabilities, penalties and expenses, including but not limited to the expenses of investigation, defense or settlement of same arising out of the supporters acts or omissions with respect to a particular arrangement, including but not limited to any acts or omissions relating to the marketing, sale, dissemination and/or use of a corporate sponsor's products.

    12.5 When appropriate, the ACR may require the external supporter to add the ACR to the supporter's liability insurance.

    12.6 The College reserves the right to terminate any arrangement if the supporter or its representatives engage in any conduct, including but not limited to product promotion activities that would lead the ACR to reasonably determine that its continued participation in the arrangement with a particular external entity would adversely affect the goodwill and reputation of the College.

    12.7 Financial support from external supporters should be provided to the College in the form of payment to be administered by the College. When appropriate, support may be provided directly to vendors of particular services. It is not appropriate for external supporters to provide direct support to College representatives or individuals participating in College activities for such expenses as travel, honoraria, per diem, etc.

    12.8 It is appropriate for the College to list commercial entities scholarship/grant programs on the ACR Web site, provided the list is inclusive of other non-profit programs and is listed independently from the College's awards and grants. The list may include a brief description of each award including target audience, funding level, contact information and Web site address. However, no direct link may be made to a Web site supported by a commercial entity.

    12.9 It is appropriate for the College's Web site to include links to government and other independent Web sites related to clinical trials. It is appropriate for the ACR Web site to list patient assistance programs supported by commercial entities. Direct links from the ACR Web site to commercial entities' clinical trials Web sites, patient assistance or company/product Web sites are not appropriate.

    12.10 In return for external support, it is appropriate for the College to include the external entity's corporate logo on its Web page in acknowledgement of the support for a particular activity.

    12.11 The ACR will not provide a membership or attendee mailing list to any external entity without the permission of those on the list. For an external entity to qualify to rent an ACR mailing list, an ACR representative must review and approve a sample of the proposed mailer and the mailing list application. All materials must be reviewed and approved by the ACR including, but not limited to: flyers, brochures, invitations, envelopes, advertisements, Web sites, signage and press releases. Promotional materials must indicate the name of the supporter and/or sponsor and must not imply— directly or indirectly—that the programs are part of official ACR activities.

In addition to its internal policies, several third-party guidelines influence the College's interactions with external entities. The following list includes the College's internal policies and the most recognized third-party guidelines. To review the documents, refer to the attached link or contact the ACR Director, Corporate Relations.

College Documents:

1. ACR Advertising Policy
2. ACR Affiliate Events Policy
3. ACR Exhibitor Prospectus
4. ACR Industry Supporter Symposia Guidelines
5. ACR Innovation Theater Guidelines
6. ACR CME Mission Statement
7. ACR Discussion Group Rules
8. ACR Expert Witness Policy and Guideline
9. ARHP Expert Witness Policy and Guideline
10. ACR Mission Statement
11. ACR Policy on Linking
12. ACR Policy on Privacy
13. ACR Procedures for Resolution of Personal Conflicts of Interest Related to CME Activities
14. ACR Web Site Proprietary Legend and Disclaimer
15. ACR Call For Abstracts
16. ACR Embargo Policy
17. ACR Code of Ethics
18. ACR Conflict of Interest Guidelines for Officers
19. ACR Eligibility for Participation on ACR Standing Committees
20. ACR Media Policy
21. Foundation Award Policies
22. ACR Policies and Procedures for the Development, Approval and Publication of Quality of Care Committee Products 
23. ACR Journal Disclosure of Interest/Copyright Transfer Form 
24. ACR Registry Participation Agreement

Third-Party Guidelines

25. Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support - www.accme.org
26. ACGME: Principles to Guide the Relationship between Graduate Medical Education and Industry – www.acgme.org
27. Advanced Medical Technology Association (AdvaMed) Code of Ethics for Interactions with Health Care Professionals - www.advamed.org
28. AMA: Ethical Guidelines on Gifts to Physicians from Industry - www.ama-assn.org/ama
29. American Medical Association (AMA) Opinion 8.061 Gifts to Physicians from Industry - www.ama-assn.org
30. Council of Medical Specialty Societies Code For Interactions With Companies - www.cmss.org
31. Federal Elections Commission - www.fec.gov/
32. Food and Drug Administration - www.fda.gov
33. Office of Inspector General (OIG) Compliance Program Guidance for Pharmaceutical Manufacturers - www.oig.hhs.gov
34. Pharmaceutical Research and Manufacturers of America (PhRMA) Code on Interactions with Healthcare Professionals - www.phrma.org
35. International Committee of Medical Journal Editors: Contributors Listed in Acknowledgments - www.icmje.org/ethical_1author.html

2/11: Updated and approved by ACR board of directors
8/10: ACR board of directors – Presented American College of Rheumatology Guiding Principles for Interactions with External Entities; ACR board of directors retired the ACR's Policy on Corporate Relationships
5/10: Updated and approved by ACR board of directors
7/09: Updated and approved by ACR board of directors
5/09: Updated by the committee on corporate relations
3/08: Approved by the ACR board of directors
2/08: Updated by the committee on education
8/04: Approved by the ACR board of directors
7/04: Updated Industry task force - ACR Policy on Corporate Relationships created
5/8/04: ACR board of directors retired the following documents - ACR Policy Statement Regarding Relationship with Other Organizations and the ACR Guidelines for Industry Sponsored Activities and Services
3/22/96: Approved by the ACR board of directors
2/5/96: Reviewed by the task force on ethics
5/15/93: Approved by the ACR board of directors
4/93: Reviewed by the council on education subcommittee
3/25/93: Reviewed by the professional meetings committee
4/28/89: Initial Review