Mediator, a drug licensed for use by diabetics that became widely prescribed in France as a slimming aid, "probably" caused at least 1,300 deaths before it was withdrawn, a study published on Thursday said.

"/> Mediator, a drug licensed for use by diabetics that became widely prescribed in France as a slimming aid, "probably" caused at least 1,300 deaths before it was withdrawn, a study published on Thursday said.

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HEALTH

Weight loss drug killed at least 1,300: study

Mediator, a drug licensed for use by diabetics that became widely prescribed in France as a slimming aid, "probably" caused at least 1,300 deaths before it was withdrawn, a study published on Thursday said.

Mahmoud Zureik of the National Institute of Health and Medical Research (Inserm), who co-led the probe, told AFP that around 3,100 people had required hospitalisation during the 33 years during which the drug was sold.

However, these figures could well be an “underestimate,” he said.

The study, appearing in the specialised journal Pharmacoepidemiology & Drug Safety, finetunes an estimate by Zureik in 2010 that the death toll from the scandal was between 1,000 and 2,000.

Mediator, known by its lab name as benfluorex, was initially licensed to reduce levels of fatty proteins called lipids, with the claim that it helped diabetics control their level of blood sugar.

But it also suppressed appetite, which meant it gained a secondary official use to help obese diabetics lose weight.

In fact, it was widely sold on prescription for non-diabetics wanting to slim.

In 2009, Mediator was pulled from the European market amid evidence that it damaged heart valves and caused pulmonary hypertension.

Its French manufacturer, Servier, is being probed on suspicion of dishonest practices and deception.

The new study is an extrapolation based on figures for deaths from faulty heart valves, although not from hypertension, among major users of the drug.

The main data comes from France’s national health insurance system, which said that 303,000 patients used Mediator in 2006.

According to Mediator, 145 million packets of Mediator were sold on the French market before the drug was pulled.

The Mediator case came to light after a scandal involving a similar type of anti-obesity drug, fenfluramine, in the late 1990s.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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