Paris (AFP)

An "obviously mercantile motivation": the lawyers of the health insurance funds denounced Tuesday in Paris at the trial of the Mediator health scandal the "stratagems" of the Servier laboratories to continue to market "at all costs" this drug held responsible for hundreds of deceased.

The Mediator, presented as an anti-diabetic but largely diverted as an appetite suppressant, had been put on the market in 1976. Listed on the list of reimbursable specialties, it will be taken care of during the 33 years of its marketing by health insurance.

Believing themselves victims of a "swindle", the funds of the compulsory schemes, complementary schemes and mutuals are civil parties to this criminal trial, opened on September 23 before the criminal court.

The total sums claimed amount to more than 450 million euros, including 331 million euros for the 107 funds of the general health insurance scheme, according to their lawyer, Georges Holleaux.

In this "extraordinary" trial, with high human but also "financial" stakes, the lawyers for the funds endeavored to demonstrate that their claims for compensation were well-founded, while their admissibility is disputed by the defense.

The pharmaceutical group and its former number 2 Jean-Philippe Seta, who is also accused of a "swindle", have always defended themselves to have deceived the health insurance funds and to have concealed the anorectic properties of the Mediator and its dangerous Side effects.

For the civil parties on the contrary, Servier has set up "a series of stratagems" to ensure this reimbursement "by national solidarity".

"It was his only obsession," tackles Me Cyril Gosset, one of the three defenders of the mutual funds for agricultural social mutual insurance (MSA) and the social security scheme for the self-employed (RSI).

His colleague Géraldine Brasier-Porterie pounded a "relentless laboratory to maintain this drug and to fight against the revelation of what it is, an appetite suppressant".

- "Very profitable" -

"They were fully aware of the appetite suppressants" of the drug, insists in turn Diane Dumas, another lawyer for the MSA.

In 1995, twenty years after its launch on the market, the Mediator was placed under pharmacovigilance investigation, due to its chemical relationship with two appetite suppressants from Servier, Isomeride and Ponderal. These two appetite suppressants were banned in 1997, after causing serious heart disease, the same as that caused by the Mediator.

Its marketing authorization will be renewed seven times. "Seven occasions for Servier to continue to voluntarily conceal the toxic effects" of the Mediator, deplores Me Dumas.

She invites the court to question the reasons of the pharmaceutical group. Its founder and former president Jacques Servier, who died in 2014, has always downplayed the importance of the Mediator: "never more than 0.7% of our turnover", he said. Jean-Philippe Seta spoke of "a minor product".

"In reality, the Mediator is 144.6 million boxes sold in France, nearly 60 million months of treatment, as if each Frenchman had had a month of Mediator treatment and almost 500 million euros in turnover since 1984 ", insists Diane Dumas.

With a "low cost of production", it was also a "very profitable drug", with "an average gross margin of more than 64% from 2002 to 2007", calculates the lawyer.

Affected by the policy of delisting from drugs with insufficient efficacy, launched in 1999 by Martine Aubry, then Minister of Solidarity, the Mediator was "in danger of death", recalls Georges Holleaux.

But the laboratories will "escape" the reimbursement of this drug, which will be reimbursed at the full rate of 65% until its withdrawal in November 2009, a year before the revelation of the health scandal.

Servier Laboratories, also fired for "aggravated deception" and "manslaughter and manslaughter", face heavy fines and compensation for many victims. The National Medicines Safety Agency (ANSM, formerly Afssaps) is appearing alongside them for having delayed suspending the Mediator, despite repeated alerts about its dangerousness.

The pleadings of the civil parties continue until Monday, before the requisitions of the parquet floor, expected on June 23 and 24.

The end of this river trial is scheduled for July 6.

© 2020 AFP