2023-06-04 20:27:34
Medical learned societies play a crucial role in promoting medical knowledge, developing clinical guidelines and training healthcare professionals. However, these institutions are increasingly criticized for their close ties to the pharmaceutical industry, which raises questions about the objectivity of their recommendations. Indeed, learned medical societies are responsible for developing clinical guidelines that influence medical practice globally. The influence of the pharmaceutical industry on these recommendations is concerning, as it can lead to the over-prescription of expensive and potentially unnecessary drugs, downplay alternative non-pharmacological approaches, and overlook the adverse effects of treatments.
Therefore, it was not surprising to see them rise up, massively, against the retrospective study pre-published by Professors Lagier, Brouqui, Million and Raoult of the IHU Méditerranée Infection, which showed on more than 30,000 patients the net favorable impact on mortality linked to Covid-19, of a prescription (made off-label) of hydroxychloroquine and azithromycin.
The sling took the form of a forum in Le Monde, coordinated by Professor Molimard of the Bordeaux University Hospital. For 3 years, the latter has distinguished himself in the media as a destroyer of all forms of treatment for Covid-19. His harsh criticisms (“nothing works”, “we do not reach the concentrations”) are not supported by scientific evidence. He would confine himself behind publications, which he had the possibility of criticizing objectively, and of interpreting them at will with many biases which lead to misinformation for readers or listeners. He is also a big fan of vaccines (“we no longer transmit covid once vaccinated”), for the greater benefit of the pharmaceutical industry which of course has very much more to gain from selling 20€ (and sometimes much more) an experimental vaccine to 6 billion people than selling a €2 treatment to a few hundred million. The benefit for the industry, the risk for the patient. In addition, Professor Molimard is a pharmacologist and a doctor, so he has a double degree. Free and informed consent, the Helsinki and Oviedo conventions should hold no secrets for him. Moreover, in respect of his Hippocratic oath, he was asked to respect the patient.
The database https://transparence.sante.gouv.fr, consulted via the website eurosfordocs.fr, records the amount of benefits received from the pharmaceutical industry. The sums accounted for are for the learned societies that have signed the said forum, but also for their individual representatives over the past 4 years. The amounts reported do not include agreements where the amounts are not declared.
The results are edifying:
- Individual representatives have earned an average of a whopping €152,000 over the past four years. At the “top” of the ranking, Pr Leclerc and Pr Laharie received more than 600,000 euros each.
- For their part, learned societies are granted on average more than 1,400,000 euros. The most spoiled, the French Society of Cardiology and the French National Society of Gastroenterology received respectively 6.4 and 1.9 million euros!
How, with such links of interest, can we hope for any independence of these organizations vis-à-vis industrial interests? How can we hope that their dependence and the influence of industrial interests are not conveyed in the political and media sphere, when these learned societies are the privileged interlocutors of the health authorities and the media? Why did the media, which took up this platform in unison, not declare these sums before speaking to their readers and listeners?
As far as the hydroxychloroquine study and the slanderous accusation of “wild therapeutic trials” are concerned, time will do, and will probably prove, one way or another, Professors Lagier, Brouqui and Raoult and their teams who treated tens of thousands of patients as best they could. There is no law that prohibits off-label prescription of hydroxychloroquine, and no law that transforms a retrospective study into therapeutic trials (research involving the human person, or RIPH within the meaning of the Jardé law). The same accusations have already been made against the teams of the IHU Méditerranée Infection, in the pseudo-case of the “trials” on tuberculosis, and have already flopped.
On the other hand, the damage is done at the media and political level, for once again, trying to discredit solutions and practices that go against the interests of the pharmaceutical industry. This is too often at the expense of public health considerations and budget efficiency. If we continue to authorize such acts, it is the freedom of prescription of doctors, a fundamental freedom, which is threatened. It is the freedom and independence of academic scientists that is threatened. It is public health and societal progress that are threatened.
So it is necessary to take measures to guarantee the independence learned medical societies vis-à-vis the pharmaceutical industry. The freedom of prescription for doctors, the independence of researchers and public health are at stake. Politicians, journalists, citizens and above all doctors must be actively involved in the implementation of rigorous measures to prevent conflicts of interest et ensuring transparency in the activities of learned medical societies. It is therefore high time to erect sound barriers between the pharmaceutical industry on the one hand and doctors and learned societies on the other. This will ensure scientific integrity, public trust, and evidence-based medical practices, while preserving physician prescribing freedom and promoting affordable and effective health solutions.
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