A French pharmacy at the time of Covid-19 (illustration).
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SYSPEO / SIPA
“Today, in France, we are asking pharmacists to denounce on software the doctors who treat.
But where are we going?
», Was indignant, on March 14, the deputy Martine Wonner.
According to the elected official, known for her recurring criticisms of the health management of the Covid-19 crisis as well as for her support for a pro-hydroxychloroquine collective, such a system, known as the "Mésange", would be in place at the level national.
If the Mésange project does exist, it is a simple online form for collecting anonymous drug misuse data, which has collected just over 200 notifications since its launch in 2017.
The Covid-19 epidemic has not only led pharmacists to carry out PCR or antigen tests in addition to their daily activities: the latter would also engage in an organized listing of all doctors prescribing unrecognized treatments for the disease. .
At least if we are to believe a message relayed identically by various Internet users on Facebook, affirming that “software allows pharmacists to denounce doctors who prescribe early anti-Covid treatments.
"
As a source, some relay a recent intervention by the MP for Bas-Rhin, Martine Wonner, known for her critical positions on the management of the health crisis, she who had been excluded from the LREM group for having opposed the plan to government deconfinement in spring 2020.
On March 14, 2021, the trained psychiatrist thus declared, on the occasion of a rally “for sport” (without a mask) organized in Strasbourg: “The Ordre des médecins, today, has an attitude which does not is not acceptable.
Colleagues have been made redundant, colleagues have been suspended from exercising and today we are asking pharmacists in France to denounce doctors who treat on software.
But where are we going?
"
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"It is absolutely false, no software of this type exists", explains to
20 Minutes
Philippe Besset, president of the Federation of pharmaceutical unions of France (FSPF).
"This is false, we simply do not deliver fanciful prescriptions without marketing authorization", agrees Gilles Bonnefond, president of the Union of Unions of Community Pharmacists (USPO).
As the National Council of the Order of Physicians reminds us on its website, the marketing authorization (AMM) does not only concern the marketing agreement given to a drug by the National Agency for the Safety of Medicines but also “the therapeutic indications, […], the dosage, the contraindications, the precautions for use or even the undesirable effects.
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Consequently, "any prescription which does not meet all of these criteria is therefore considered to be without marketing authorization".
In fact, if a doctor remains free to prescribe an unrecognized treatment against Covid-19 - for example based on hydroxychloroquine -, he must on the other hand do it according to a very specific protocol.
Non-AMM prescriptions which engage the responsibility
“Any doctor who wants to prescribe outside of the MA must indicate this on the prescription and warn the patient that he fully accepts his responsibility.
The pharmacist has every right to refuse to dispense the prescription if he considers it to be against the patient's best interests.
But if he agrees to dispense it, he also takes responsibility, "explains Philippe Besset, while specifying:" At the start of the epidemic, we saw a lot of prescriptions for hydroxychloroquine and we refused many. .
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Joined by
20 Minutes
, Martine Wonner indicates to have had "many lifts", within the collective of health professionals "Let us prescribe", fervent defender of hydroxychloroquine and other treatments with disputed effectiveness, from doctors who would have been summoned to the departmental councils of the National Order of Physicians or even directly by the latter because of their anti-Covid-19 prescriptions outside of Marketing Authorization.
"These colleagues find themselves summoned upon denunciation and incur sanctions which can go as far as the cancellation of the National Council of the Order of Physicians", deplores the deputy, denouncing the role that the "Mésange software" would play: "A l Originally, it was made available to the Bourgogne-Franche-Comté region, well before the Covid-19 crisis, to identify and report drug misuse situations related to doctors' prescriptions.
But since March 2020, it has been expanded at the national level to raise the prescriptions against the Covid-19.
"
"Chickadee", an anonymous online form that collected around 200 returns
If the “Mésange project” was indeed set up in 2017, in the form of a Google form to be completed online, its purpose and its mode of operation are very different from those described by Martine Wonner, as explained to us. Marie-Blanche Valnet-Rabier, deputy head of the Regional Pharmacovigilance Center of Franche-Comté and co-instigator of the project: “The initial idea was to identify situations of misuse - which are not the prerogative of the doctor, since a patient can also be responsible in his use of the product - to make a local photograph and see if we could reveal unknown risks or on the contrary identify medical needs to the Medicines Agency.
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“In view of the non-AMM prescriptions on Covid-19, we found it interesting to collect this information at the national level, again to take a photograph.
But this information is handled completely anonymously: we do not collect the names of doctors, patients or pharmacists - even if the latter are free to indicate their contact details if they wish to be contacted again.
Since 2017, in total, we have received around 200 notifications of misuse and we must be within 10 notifications of prescriptions outside of Marketing Authorization concerning Covid-19, knowing that there are only around 30 notifications outside Bourgogne-Franche-Comté. », Continues Marie-Blanche Valnet Rabier.
A simple consultation of the online form shows that it can be completed without ever indicating its contact details, such as the variety of the type of misuse taken into account - whether it concerns the Covid or not.
And the pharmacologist to conclude: "I do not see how, from our anonymous data drawn from this experiment destined to be completed this year after the exhaustion of the funds allocated by the ARS of Bourgogne-Franche-Comté, we can make such allegations [around "whistleblower" software].
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Asked by
20 Minutes
, the National Council of the Order of Physicians simply refers us to two of its recent press releases on off-label prescriptions, one of them, dated April 2020, reminding us "firmly to the whole doctors that in this period of particular vulnerability and in the face of the concern of our fellow citizens, […] it would be inadmissible in this context to arouse false hopes of a cure ”and that“ the endangerment of patients, if appeared that it could be caused by treatments not scientifically validated, could justify in these circumstances the referral of the Director General of the ARS to request an immediate suspension of the activity of these doctors.
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