Sunshine on CMG
Creators: name: , Guillaume
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences

description: Relations between health professions and pharmaceutical companies increased for a few years, leading to a desire from medical teachers to erect the necessary shields in order to protect university medical centers’s independance (1). This wish is well identified by the WHO , the International Action for Health (HAI) and the HAS in France (2). In fact, between 2000 and 2007, pharmaceutical manufacturers devoted 23% of their turnover to sales and promotion operations (3) using numerous techniques to increase the volume of prescriptions and the consumption of health products. Most frequently used techniques are : gifts, opinion leaders, and open or disguised advertising (4). In the United States, 94% of more than 1,600 hospital and private physicians surveyed reported a link with the pharmaceutical industry in the past year, and 30% of them were consultants paid by a company or having been part of its usual speakers or its advisory committee (5). This percentage is also found in a 200 multinational recommendations for drug prescriptions study with approximately 1/3 of the authors having financial links with the companies producing the drugs they were evaluating, and approximately 3/4 of these recommendations included authors with conflicts of interest (6). In France, the journalistic collective "Data + Local" revealed in 2018 that more than 92 million euros were paid by pharmaceutical companies to 32 French University Hospital Centers practitioners. In some cities, the most important payments concern “scientific expert contracts”, where doctors are asked under agreements of several months or years for: an expertise on a subject, a participation in a study, or an intervention in congress. This brings us to the notion of medical Key Opinion Leaders (KOLs) who refers to professionals who are likely to represent a reference for doctors, at national or local level. For firms, this way to communicate with doctors tends to increase, with hindsight of visits by representatives (7). Since doctors maintain a certain distrust of medical visitors discourse, the firm’s message in the press and the KOLs expression contribute to the desired credibility (8). KOLs are therefore an evaluated instrument and made profitable by firms, but the problems of interest declaration of KOLs to the general public and to general practitioners are well known (8) (9). Doctors selectively reduce their confidence in KOLs when they declare their links of interest, especially since the declared interests are important (10). However, these links of interest must be declared since decree n ° 2007-454 of March 25, 2007, relating to conventions and links uniting members of certain health professions to companies and modifying the Public Health Code (Art. R. 4113-110): "Informing the public about the existence of direct or indirect links between health professionals and the companies or establishments mentioned in article L. 4113-13 is made, on the occasion of the presentation by this professional, either in writing when it is an article intended for the written press or disseminated on the Internet, or in writing or orally at the start of his intervention, when it is a public demonstration or a communication made for the audiovisual press ”. Our study aims to assess the rate of compliance with the mandatory declaration of potential interest links of participants in a general medicine congress in France. In addition, the Transparency - Health database, managed by the french Ministry of Solidarity and Health, is part of the “Sunshine Act” decree of May 21, 2013, implementing the Bertrand law of December 29, 2011. It groups together the declarations provided by the healthcare companies, and informs the amounts of the “advantages” or gifts declared by the healthcare companies and received by each practitioner without compensation, of a value greater than 10 euros. It also lists "conventions" or contracts, meaning the paid participation of a practitioner as a consultant or speaker in medical education, clinical trials or conferences. Using these public data, a large and recent French study was able to demonstrate that compared to the groups of doctors who received benefits, the group of doctors who received no benefits since the creation of the Transparency Health database in 2013 until 2016 is associated with: cheaper prescriptions as well as more prescriptions of generic drugs compared to the same non-generic drugs (antibiotics, antihypertensives, statins) (11). In addition, according to researchers' calculations, 90% of doctors received at least one of these "gifts" between 2013 and 2016. The Eurosfordocs database aggregates declarations of interest from the Transparency Health database online to make them accessible to the general public through a more ergonomic, more synthetic and enriched tool. Thus the secondary objective of this work is to assess the benefits perceived by the participants of a general medicine congress in France, thanks to the public data listed in the Eurofordocs project (public data in free access, directly arising from the government website ).