Témoignage Intégral de Carine Curtet Présidente de l'Association AMETIST
  
 
Témoignage Intégral du Dr Delépine Pour le film Cancer Business Mortel
  
 
 
 
  
 
 
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CONFLICTS OF INTERESTS FOR MARKETING AUTHORIZATION OF A MEDICINE 
  
NECESSITY OF A NEW JURISDICTION 
  
G. Delepine et N. Delépine  HOPITAL UNIVERSITAIRE RAYMOND POINCARE à garches
  
  
GEIRSO 2009 Milan 21 au 24 septembre 2009
  
  
The scandal of the VIOXX
  
	1999-2004 Vioxx  gave 2,5 bllions $ benefit every year 
  
	Doctor D.Graham 17/11/2005 Â"a realistic and likely range of estimates for the number of victims in the US was between 88,000 and 139,000. Of these, 30-40 percent probably died. Â" 
  
The current MA procedures are above all characterized by the opaqueness 
  
like inquisition procedures : 
  
only the decisions are public
  
 MA data and motivations remain secret.. 
  
Trials data are the exclusive property of the laboratory
  
	which can decide the scheme of the trial,
  
	The end point, 
  
	The type of analysis
  
	To publish or not, or partially
  
	Can alter data,  include ghost patients or exclude some patients with complications
  
	without any independent control 
  
All trials should be published
  
	Many results are never published, especially when clinical trials show that a drug or treatment didn't work or have unexpected toxicity. So the medical community remains in the dark over what was learned. 
  
	Â" less than 1 in 5 Cancer Trials Are Published.. Â"Â"In trials sponsored by industry, the rate was even lower: Just 1 in 20 is published.. Â"
  
The investigators
  
	The investigators are motivated by high fees which often distort their conclusions
  
	 8th april 2008, Kassirer in le Los Angeles Times published   Tainted Medicine  showing the importance of  conflicts in Financial interest
  
	 Â"can we trust in medical research? Â"
  
And for whistle blowers investigators
  
En avril 1993, le docteur Nancy Olivieri, de l’Hôpital des enfants malades de Toronto, signe avec la société Apotex Research Inc. un protocole de recherche sur une nouvelle molécule, la défériprone,. Deux ans après le début des essais thérapeutiques et la publication de premiers résultats encourageants, elle suspecte ce médicament d’aggraver la fibrose hépatique de certains de ses malades. 
  
Experts of the committees of MA
  
No experts of the committees of MA are independent from  firms.
  
This situation is the result
  
	of the faith that medical research "would be motivated only by interest of the patients or science" .
  
"today profits are tomorrow medicines" assertions denied by objective analysis : the profits of firms especially served for increasing dividends while credits allocated to research and number of real new medicines decreased 
  
  
MA is a judgment on the harmlessness and the efficiency of the product.
  
	 But if democratic justice bases on
  
	the contradictory and 
  
	public examination of all the elements of proof 
  
Propositions for transparency.
  
  
	The clinical trials intended to support a file of MA have to recover from a particular legal regime to have convincing value 
  
A new regime of property
  
	Their regime of property will be the one of a shared co-ownership enter
  
	 the laboratory which finances,
  
	 the patients who take the risk and 
  
	the State or the welfare organization which will pay the future medicine 
  
Authentic data
  
	The medical data of the trials have to be authentified
  
	With a registration of main data  at the health Autority every year (as we do for commercial firms)
  
	and to be published with independent rewievers even in case of interruption of the trial. 
  
Recommandations de Transparency International
  
 Base de données publiques sur les  essais cliniques des médicaments 
  
Publications des éventuels conflits d’intérêts 
  
Code de conduite : Un Code de Déontologie pour les professionnels de santé, les administrations de santé, les organes de contrôle, intégrant des sanctions. 
  
	Code de conduite pour les industries pharmaceutiques et de DM pour ne pas verser des pots-de-vin. 
  
	Implication et rôle de surveillance de la société civile 
  
	Protection des dénonciateurs 
  
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