The year of its ban, Mediator was prescribed as an appetite suppressant according to health insurance data published by Mediapart, therefore out of its official indication.
Up to 8 prescriptions of the Mediator out of 10 were made without the marketing authorization (AMM) between 2008 and 2010. This is what emerges from the data provided to the association. Health Transparency Initiative (ITS) by the National Health Insurance Fund for Salaried Workers (Cnamts), revealed on February 15 by Mediapart.
In 2009, 44% of private doctors prescribed Mediator at least once. In the vast majority of cases, these were general practitioners (92%) and to a lesser extent cardiologists and endocrinologists. According to the data, the inhabitants of the South of France are the main consumers of the drug: as the table indicates between 2008 and October 2010, the six most consuming departments are concentrated in this region. Leading is Guadeloupe, followed by Bouches-du-Rhône, Martinique, Alpes-Maritimes, Var and Corse-du-Sud.
A massive off-label prescription
By comparing these data with the map of the prevalence of diabetes established by the Institut de Veille Sanitaire (INVS), Mediapart concludes that “the gap between the geography of prescriptions and that of pathology supports the hypothesis according to which Mediator was massively prescribed outside of its official indication of “adjuvant of the adapted diet in diabetics with overweight.” “Non-marketing authorization prescriptions oscillate between 75 and 80% of the total number. The Cnamts weighted these estimates in a letter to Initiative Transparence Santé: they do not take into account diabetic patients treated by diet only, according to its director.
These data were published on the initiative of the ITS association, which has been asking for access since May 2013. The director of Cnamts replied in the negative two months later, but the Commission for Access to Administrative Documents (Cada) l forced it last November. Initiative Transparence Santé describes itself as a “citizens’ movement” which campaigns for access to health data in France.
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