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Introduction
Publications
Publications (55)
Résumé
L’objectif d’éviter le recours des mineures à l’IVG est poursuivi depuis l’an 2000 par la mise en place d’un accès facilité des jeunes filles aux médicaments de contraception d’urgence (MCU) : dérogeant aux règles usuelles de sécurité sanitaire et de sécurité sociale, la dispensation est réalisée à titre anonyme et gratuit. Or, l’analyse mon...
La dispensation des médicaments de contraception d'urgence est autorisée aux mineures moyennant anonymat et gratuité, sans limite et sans contrôle. Ce dispositif déroge à de nombreuses règles relatives à la sécurité sanitaire et à la sécurité sociale et fait fi des évolutions récentes de la réglementation pharmaceu-tique et de la régulation des dép...
"Personalized medicine" is one of the major innovations in patient care. On the one hand, we will examine the concept of treatment individualisation to highlight that the 'custom-made' is already very common in therapeutics. On the other hand, we show that interdependence between drug and companion diagnostic that characterizes targeted therapies r...
En vue d'éviter la survenue de grossesses non désirées et d'IVG chez les mineures, une série de dérogations au Code de la santé publique et au Code de la sécurité sociale a été introduite pour organiser la dispensation de la contraception d'urgence aux mineures dans l'anonymat et la gratuité. Or, le droit illimité d'accès à ces médicaments ne perme...
Après avoir décrit le contexte du don d’ovocytes en France, nous nous interrogeons sur les graves questions éthiques posées par ces pratiques à la lumière des quatre grands principes d’origine anglo-saxonne : non-malfaisance, bienfaisance, autonomie et justice, en envisageant tour à tour le bien et l’intérêt de la donneuse, de la receveuse et de l’...
The vast majority of the activity of medically assisted procreation from oocytes gifts made for French women takes place outside our borders because of the shortage of oocytes available in France. These practices are most often under conditions that are contrary to French law, posing ethical issues, problems of safety and fairness. The main recomme...
Gene therapy, cell therapy and tissue engineering constitute new advances regarding the control of the human body, or as some could say, regarding the manipulation of the living structure and the reconstruction of the human person. The latter is not only the technique’s creator ; he becomes also its object, its result. The perception of an ontologi...
Le phénomène de diffusion de l’hôpital vers la ville pourrait expliquer pourquoi des firmes pharmaceutiques concèdent certains médicaments à des prix de vente très faibles aux établissements de santé, espérant augmenter les parts de marché ambulatoires de leur produit. À ce jour, aucune étude empirique n’a testé l’existence de ce phénomène. Cet art...
Aim:
To investigate the influence of hospital drug choices on pharmaceutical consumption for nine competitive classes in the surrounding community.
Methods:
Ecological study. Data from the national survey on drugs in hospitals were used to extract quantities purchased by 25 French university hospitals for three 'hospital classes' (EPOs, LMWHs an...
The purpose of this study was to investigate geographic variations in the use of quinolones in France and their associated factors. All reimbursement claims of antimicrobials were collected for 90 % of the French population for the year 2007. Dispensed quantities were then converted into defined daily doses (DDD) and adjusted for the age structure...
The European Medicines Agency (EMA) is a European Agency as it is a decentralized body governed by European public law; it has its own legal personality and is also distinct from the European Union institutions (Council, Parliament, Commission, etc.). The EMA presents itself, and is commonly recognised, as a public health agency. This is notably su...
To give a panorama of the selectivity and agreement of French university hospitals' drug formularies (HDF) for nine competitive classes.
All university hospitals were asked to send their HDF and selection criteria as of January 2009 for nine competitive pharmacological classes (proton pump inhibitors, serotonin antagonists, low molecular weight hep...
Les règles du Code de la sécurité sociale (CSS) qui permettent de délimiter le contour du champ des médicaments pris en charge par les organismes de protection sociale visent à sélectionner ce qui est considéré comme « utile » et qui doit faire l’objet d’un financement socialisé. Cependant, les exceptions à ces règles semblent se multiplier: « par...
A contract between French hospitals and national health authorities was signed in early 2006 to improve the rational use of antibiotics in hospitals. The contract offers a financial reward in the event of decreased spending as a result of hospital prescriptions dispensedin community pharmacies compared to the previous year. The article describes th...
Methodological reflections on financial rewards gained by hospitals in the event of decreased spending as a result of hospital prescriptions of antibiotics dispensed in community pharmacies
A contract between French hospitals and national health authorities was signed in early 2006 to improve the rational use of antibiotics in hospitals. The contra...
L’utilisation des molécules pharmaceutiques est encadrée par des règles spécifiques, orientées vers des objectifs de sécurité pour leur usage et d’équité pour leur prescription . Un régime particulier concerne les molécules innovantes. La définition du caractère innovant pose de multiples questions.
The pharmacy and therapeutic committee is responsible for establishing the list of medication available in hospitals. These local choices result from a decentralized appraisal of medications, following a centralized appraisal. How should these two evaluations be articulated? How are medical service rendered (MSR) and improvement of medical service...
Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients.
The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etan...
Introduction
Les aspects médicoéconomiques de la polyarthrite rhumatoïde (PR) ont été largement modifiés depuis l’utilisation des agents inhibiteurs du TNFα. Le but de notre étude a été d’estimer l’influence de la prescription d’étanercept, en terme de consommation de soins, au sein d’une cohorte régionale de patients atteints de PR en France.
Mét...
Medical Service Rendered and Improvement of Medical Service Rendered: What Are Their Utility for Drug Selection in Hospitals?
The pharmacy and therapeutic committee is responsible for establishing the list of medication available in hospitals. These local choices result from a decentralized appraisal of medications, following a centralized appraisa...
The aim of the present study was, first to characterize profiles of coxibs' prescribers [general practitioners (GPs) and rheumatologists] in 2002 in France and, secondly, to identify factors associated with modification of this profile 1 year later. All GPs and rheumatologists from Midi-Pyrenees, Aquitaine, Languedoc-Roussillon and Pays de Loire ar...
L'auteur présente les statuts de prescription et de remboursement des médicaments au regard des impératifs de santé publique et de maîtrise médicalisée des dépenses. Elle conclut à l'existence d'une relation entre les deux démarches.
Résumé
Le traitement de la polyarthrite rhumatoïde (PR) a été profondément modifié avec l’apparition en 1999 des anti- TNFα. Peut-on faire l’hypothèse que le coût de ces traitements innovants, dont la supériorité clinique par rapport aux traitements traditionnels est prouvée, est partiellement compensé par une diminution de la consommation des autr...
AIM:
The aim of this study was to evaluate the perceptions of health professionals and non-health professionals with regard to prescribing drugs by their international non-proprietary name (INN) in the Midi-Pyrénées area, France.
METHODS:
We developed a score to assess the perception of the four criteria that make up therapeutic progress: efficacy...
Résumé
Objectif
Dans ce travail, nous avons étudié la perception des professionnels de santé (médecins et pharmaciens) ainsi que celle des assurés sociaux sur les avantages et inconvénients de la prescription en dénomination commune (DC).
Méthode
Notre interrogation a porté principalement sur les quatre critères définissant le progrès thérapeutiq...
To analyse the nature of adverse drug reactions, their frequency, the drugs incriminated, their outcome, the different ways to treat them and their cost.
Descriptive, prospective and non-comparative study, based on spontaneous reporting. Each patient was followed-up over a 6-month period.
One hundred and fifteen adverse events were reported in 113...
Objective
To analyse the nature of adverse drug reactions, their frequency, the drugs incriminated, their outcome, the different ways to treat them and their cost.
Methods
Descriptive, prospective and non-comparative study, based on spontaneous reporting. Each patient was followed-up over a 6-month period.
Results
One hundred and fifteen adverse...
Aims: The direct sale of medications which are exclusively reserved for in-hospital use to outpatients occupies an important and increasing part of the French national health fund’s pharmaceutical expenditures. The aims of this survey were to evaluate the geographic accessibility of these medications, to measure the pharmaceutical service the pract...
The list of generic medicines (LGM), published since 1997 by the Agence Française de Sécurité Sanitaire des Produits de Santé (AFFSSaPS), the French Medicine Agency, concerns a special part of the medicines reimbursed by the National Health Insurance (Social Security). The objectives of the present study were: i) to describe the components of this...
Background: The list of generic medicines (LGM), published since 1997 by the Agence Francaise de Sicurite Sanitaire des Produits de Saute (AFFSSaPS), the French Medicine Agency, concerns a special part of the medicines reimbursed by the National Health Insurance (Social Security). The objectives of the present study were: i) to describe the compone...
Rupture of intracranial aneurysms causes major mortality and morbidity. Moreover, treatment of this vascular malformation generates high medical costs. We compared the cost of two different strategies employed at the University of Bordeaux to prevent aneurysms from rebleeding: a classical neurosurgical technique consisting in clipping the neck of t...
The aim of this study is to assess the share of the generics market (in the broad sense of the term) in the therapeutic list of Bordeaux University Hospital (in 1999-2000) and to compare it with the national rate evaluated in a recent publication [1]. A detailed study of main therapeutic groups has also been carried out. The listing of orders is an...
Data on refundable pharmaceutical drugs are numerous and of various kinds. The clinical approach and the economic approach could be used together. This new approach allows for not only the synthesis but also the structuring of all the available information. The new information obtained is involved in decision trees.
In order to assess psychological morbidity in France related to genital herpes infection, we carried out a transversal study comparing infected patients with a control group. A total of 236 patients with genital herpes were first identified by means of a postal survey, then matched against a witness group of 236 noninfected persons. Detailed questi...
Diabetes is a chronic disease highly correlated to age. In 1998, the Sickness Find of the Aquitaine region has reimbursed 273 million French Francs for expenditures related to diabetes pharmaceuticals. The amount would increase to 300 million French Francs in 2005, a growth of nearly 10%, whereas the Aquitaine population would increase only 4%, fro...
Decision-making methods can be extremely useful in managing the large amount of information available on the complex effects of medication over various time spans. Event trees help to formulate data and visualise the medical strategies with the highest performance in regard to clinical benefits, adverse side effects, cost and cost-benefit ratios. H...
Pendant les premieres decennies qui ont suivi l'avenement de la penicilline, le praticien determinait le traitement qu'il destinait a un enfant atteint d'une affection microbienne en fonction d'un seul critere : l'efficacite presumee de l'antibiotique vis-a-vis du germe incrimine.
A modelling of real prescription data obtained from general practitioners and pediatricians in an ambulatory survey allowed us to evaluate and compare the costs of treating adverse effects which may arise taking certain groups of antibiotics (amoxicillins, amoxicillin-clavulanic acid combinations, cephalosporins, macrolides, sulfamide combinations...
The last three decades have been undoubtedly a "revolutionary time" in the life of pharmaceuticals. Progress in scientific knowledge and medical practice have fueled tremendous change in the drug universe. The "drug chain" has been totally transformed, from the early conception through evaluation by the public authorities to end up with the utiliza...
Sickness insurance is universal and compulsory in France. It is financed mainly by contributions from employers and employees. Consequently its soaring costs may sharply reduce the competitive French products on the world market. Successive French administrations have attempted to curb the growing health costs by increasing co-payment. The program...
With the aid of IMS, a database of drug sales statistics, the quantities (expressed in Defined Daily Doses per 1000 inhabitants and per day) of antidiabetic drugs prescribed from 1978 to 1987, in Britain, France and the Federal Republic of Germany has been compared.
