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<dc:title xml:lang="fr">Innovation thérapeutique et accident médicamenteux : socio-genèse du scandale du benfluorex (Mediator®) et conditions de reconnaissance d'une pathologie émergente : les valvulopathies médicamenteuses</dc:title>
<dcterms:alternative xml:lang="en">Therapeutic innovation and drug accidents : socio-genesis of benfluorex (Mediator®) scandal and the conditions of recognition of an emerging pathology : medicament induced valvulopathies</dcterms:alternative>
<dc:subject xml:lang="fr">Cardiologie et échocardiographie</dc:subject>
<dc:subject xml:lang="fr">Mediator</dc:subject>
<dc:subject xml:lang="fr">Médicament</dc:subject>
<dc:subject xml:lang="fr">Médecine et pratique médicale</dc:subject>
<dc:subject xml:lang="fr">Scandale sanitaire</dc:subject>
<dc:subject xml:lang="fr">Production du savoir médical</dc:subject>
<dc:subject xml:lang="fr">Victimes d’accidents médicamenteux</dc:subject>
<dc:subject xml:lang="fr">Expertise médicale</dc:subject>
<dc:subject xml:lang="en">Cardiology and echocardiography</dc:subject>
<dc:subject xml:lang="en">Mediator</dc:subject>
<dc:subject xml:lang="en">Medication</dc:subject>
<dc:subject xml:lang="en">Medical scandals</dc:subject>
<dc:subject xml:lang="en">Medicine and and medical practice</dc:subject>
<dc:subject xml:lang="en">Production of medical knowledge</dc:subject>
<dc:subject xml:lang="en">Victims of therapeutic injuries</dc:subject>
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<dcterms:abstract xml:lang="fr">Le retrait du Mediator®, médicament des Laboratoires Servier en vente de 1976 à 2009, s’effectue après l’identification de pathologies spécifiques des valves cardiaques : les valvulopathies médicamenteuses. Depuis, l’évènement est abordé sous l’angle du scandale médico-sanitaire, des défaillances du système de régulation et des méthodes d’influence d’un industriel sur des décideurs (politiques ou prescripteurs). Une procédure juridique pour établir des probables infractions aux lois pénales est en cours. Pour comprendre les origines et les conséquences de l’affaire du benfluorex – au-delà des champs de compétence juridiques et politiques – ce travail de thèse propose une analyse du processus de non-reconnaissance d’un effet indésirable grave d’un médicament pendant plus de 30 ans et surtout les effets de ce non-repérage sur ceux qui sont directement concernés : les personnes l’ayant consommé. À partir des données issues de deux enquêtes par questionnaire distinctes adressées l’une à des usagers du Mediator® et l’autre à des cardiologues notre travail établit six différentes « figures » théoriques et analytiques des personnes exposées à la molécule se trouvant au centre de notre enquête.</dcterms:abstract>
<dcterms:abstract xml:lang="en">The withdrawal of Mediator®, a drug sold by Laboratoires Servier between 1976 and 2009, occurred after specific pathologies of cardiac valves were identified: the drug induced valvular heart disease. Since then, the incident has been approached from the angle of health and medical scandal, regulation failure and the influence of an industrial company on decision makers (political figures or prescribers). A legal procedure to establish probable violations of criminal laws is under way. To understand the origins and consequences of the benfluorex affair - beyond the fields of legal and political jurisdiction - this thesis proposes an analysis of the process of non-recognition of a serious adverse side effect of a drug for over 30 years and, above all, the effects of this non-recognition on those directly concerned: the people having taken it. Using data from two separate surveys, one of Mediator® users and the other of French cardiologists, this study establishes six different theoretical and analytical "figures" of people exposed to the molecule at the center of the investigation.</dcterms:abstract>
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