INTERVIEW – The prevention of conflicts of interest with the pharmaceutical industry is slowly being implemented in French medical schools.
This is a first in France: an association has undertaken to classify medical schools according to their policy of preventing conflicts of interest with the pharmaceutical industry. The initiative comes from FORMINDEP, a collective which militates for a training “independent of any other interest than that of the health of the people” and a fortiori laboratories.
The collective took up a list of criteria implemented in the United States to assess the degree of independence of medical universities. Each criterion (limitation of gifts and meals offered by the pharmaceutical industry, supervision of teachers’ links of interest, etc.) made it possible to win one point.
Verdict: Out of 37 medical schools, only nine get at least one point. Two of them are doing well (Angers and Lyon-Est, with 4 and 5 points); all the others stagnate at zero. These results, published in the journal PLOS One, should however be taken with a grain of salt, since only three faculty deans responded to the survey. Isabelle Richard, dean of the Angers Faculty of Medicine, is one of them.
Why has Angers’ policy towards conflicts of interest been distinguished?
Isabelle Richard: Our result on this classification is completely fortuitous and linked to the fact that we answered, there is no particular Angevin particularity on this subject. We are quite simply a little more sensitive to it. We asked ourselves this question several years ago in the context of continuing medical education. Our policy includes, for example, a standard slide for declaring conflicts of interest for teachers involved in CME.
We also carefully distinguish what falls within the training activities organized by the university in which there is no participation of the pharmaceutical industry, and what relates to events organized by others (laboratories, insurance companies and all kinds). companies) on the premises of the university. At that point, we make contracts for the provision of premises, and everything is very clear. There is not a single information with the logo of the University of Angers if it is not us who are at the origin. Finally, in one of the transversal seminars, we discuss these relations with the pharmaceutical industry, but this is not a specific teaching.
We do not find such measures in other faculties?
Isabelle Richard: Yes, probably, hence the fact that the ranking does not make much sense. It makes it possible to throw a pavement in the pond and to relaunch a debate which, moreover, is not devoid of interest. The reflection on the prevention of conflicts of interest with companies of health products has as much its place in the hospital internships as at the faculty.
Students must be trained to spot situations at risk of conflicts of interest and it is certain that the universities do not do it enough, but there is a thrill, it is taking place. Students are also very much in demand for this type of training. Thus, it is not a question of classifying the faculties among themselves but of making everyone progress – Formindep has indeed reminded us of this.
Do you plan to increase stakeholder controls, or limit industrial funding within the faculty?
Isabelle Richard: As it stands, there is no question of refusing the apprenticeship tax that emanates from the pharmaceutical industry, like all companies in other sectors. It is a tax that they have to pay; if the legislator decides that it is necessary to abolish the tax resulting from the pharmaceutical sector, then, why not. But otherwise, it is irrelevant to refuse to collect it from this particular sector.
Concerning teachers, is it relevant to refuse certain accumulation of activities, and on what criteria? The answer is not obvious, there is still work to be done by the university hospital community around this question. The good idea is that there is public access to these activities. The decree of December 28 on what must be declared on the transparency.gouv site is a good thing, as is the single contract relating to clinical research activities. Thanks to this contract, the investigators and the industrialists go through the institution, it is not a question of personal links. I believe that through these two elements (transparency and single contract), as well as with training which must certainly be stepped up in the faculties, we are moving in the right direction, in Angers as elsewhere.
Isabelle Richard, Dean of the Angers Faculty of Medicine: ” We now have tools to make the situation healthier than it is. “
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