Firmin Le Bodo affair: what are the rules regarding gifts for health companies?

This is a subject that the government would have done well without on this Christmas Eve. Newly appointed interim Minister of Health after the resignation of Aurélien Rousseau on Wednesday, the day after the adoption of the immigration bill, Agnès Firmin Le Bodo did not wait long before getting noticed. The former MP, a pharmacist by profession, is in fact the target of a judicial investigation opened in June 2023 for having received gifts, without declaring them, from the multinational health products company Urgo. Luxury products, watches and other bottles of wine and magnums of champagne... In total, the minister would have received more than 20,000 euros in gifts between 2015 and 2020, according to Mediapart, which revealed the affair Thursday evening.

But are these practices, although known, really legal? What does the law say on the matter? There is in fact a so-called “anti-gift” law which applies specifically to healthcare professionals, and very clearly prohibits pharmacists from receiving benefits from healthcare manufacturers. According to this, it is therefore strictly prohibited to offer or promise advantages to persons producing or marketing health products listed in Article L. 5311-1 of the CSP or covered by mandatory safety regimes. social security, as well as to people providing health services. Among these health products, we find contraceptive and contragestive products, medical devices and their accessories or even cosmetic products.

“The anti-gift laws, which mainly concerned doctors, were extended to pharmacists in the 2000s,” explains Philippe Besset, president of the main union of community pharmacists FSPF (Federation of Pharmaceutical Unions of France). The pharmacist “does not have the right as a natural person to receive gifts”, he adds, explaining for example that the pharmacy can very well “negotiate to have a fridge from a vaccine manufacturer, but the pharmacist does not have the right to have this same fridge at home.” “It’s a slightly subtle nuance, and despite reminders from the council of the order and the union, obviously the messages do not go through completely well,” notes the professional.

In fact, all benefits in kind are prohibited, but there are a few exceptions: either because the benefit in question is not affected by the “anti-gift” system, this is particularly the case for sums received “in within the framework of an employment contract, proceeds from the exploitation of intellectual property rights relating to a health product...", or because the advantage has been previously declared and then authorized. To do this, it must be declared to the professional orders, before it is made public on the database called Health Transparency managed by the Ministry of Health. But only sums received in the context of research activities or service provision (as long as the remuneration is proportionate) or other donations intended to finance research activities or intended for associations unrelated to the professional object of the donor could be “authorized”. Far from champagne bottles.

“The “anti-gift” system aims to preserve the independence of health professionals,” recalls the Directorate General for Competition, Consumer Affairs and Fraud Control (DGCCRF). The regulatory authority emphasizes that this is above all “a health imperative”, only public health considerations should guide the acts of prescribing and dispensing health products. But it “also responds to an economic issue” according to the DGGCRF, for which “opaque practices for granting advantages disrupt the proper functioning of the market and ultimately increase the cost of health expenditure for the community”.

In 2021, the DGCCRF also carried out a vast investigation into compliance with the system in the medical product distribution sector. At the time, it had made it possible to uncover “the illegal practices of the URGO group”, which had “unduly offered to certain community pharmacists, throughout the national territory, more than 55 million euros of gifts between 2015 and 2021. The laboratory was fined a total of 1.125 million euros in this case by the Dijon court - including 625,000 suspended - accompanied by criminal seizures of more than 5.4 million euros. Last January, the DGCCRF explained that it was continuing its investigation “with the pharmacists involved”.