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HAS of cards: Looking for the new president of France's High Health Authority

02 February 2016 Choukri Genane

L'Elysée has published a statement in which François Hollande proposes to appoint haematology specialist Buzyn Agnes (current Head of the French National Cancer Institute) as the new President of the High Health Authority (HAS), a few weeks after Jean-Luc Harousseau, the former holder of this post, left his position for personal reasons. The Government claimed that the president of the National Assembly and the Senate president have been called upon to make a decision on this proposition, since they are the relevant committees to decide on the new appointment.

Ms. Buzyn, a physician and professor of hematology who became president of the National Cancer Institute in May 2011, is a strong defendant of therapeutic innovation, especially in the oncology area, supporting research on companion diagnostics. She has also initiated multiple international projects pertaining to clinical research.

Although Ms. Buzyn's experience has not yet extended to the political domain, the government values her profile compared to Claude Evin, the other candidate for the position. Indeed, she has the advantage of experience dealing with pharmaceutical groups in the context of public health issues and innovative projects. A key question is whether this experience will be enough to foster dialogue with industry and enough to give another dimension to the HAS? Let's keep in mind that during recent health controversies, such as over vaccines, the HAS has remained silent and has not added to statements issued by the Minister for Health.

The interesting question is how Ms. Busyn would react as a president of the HAS given that she once claimed she never "screams with the wolves" during public debates? This experienced health professional has always supported the industry and its potential to drive innovation. She has always espoused the importance of the independence of experts without cutting ties between the industry and researchers. Even if she is well-known for fighting against lobbying (e.g. in the tobacco and wine industries) she warns against the line of thought that would equate any common ground between public institutions and industry to a conflict of interest.

More than that, as president of the INCa, she has developed links with industry on phase I and II trials and steered away from engaging the organisation in medico-economic evaluations, reflecting her belief that public institutions and public opinion should stop promoting the idea that cancer is too expensive for society. Combined with her drive for innovation, this suggests that a HAS overseen by Ms. Buzyn has the potential to benefit from the dynamic between payers and industry in France.

The arrival of Ms. Buzyn should bring a new perspective to the industry in France, especially in a context of strong concerns from pharmaceutical companies. Indeed, the French association of pharmaceutical companies recently published a policy document on marketing authorization trends in different European countries. The results of its study revealed a strong market-access issue in France compared to other countries, attributing this issue to excessive regulations, budget restrictions and a general economic downturn. But this is only one side of the same coin! In fact, according to Ms. Buzyn, drugs evaluation and assessment procedures are strongly challenged now with the arrival of new expensive treatments which "threaten the financial stability of the health system". Thus, she declared that "it is absolutely necessary to engage in a reform of evaluation and assessment procedures tools".

It does sound like a new labor of Hercules given that she publicly committed to carry only one single term of six years. Maybe that's why she is presented as the chosen one…

Choukri Genane is a life sciences analyst for IHS
Published 2 February 2016

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