Servier kept deadly Mediator on the market 33 years — then paid €415M

Servier, a French pharmaceutical company, developed Mediator (benfluorex) in the 1970s as a treatment for overweight diabetics. The drug soon found a much larger market as an off-label appetite suppressant for weight loss. Over 33 years, about 5 million people in France were prescribed Mediator. The drug was available in France until 2009 — even after other European countries including Italy and Spain had banned it years earlier due to growing evidence that it caused heart valve damage and pulmonary hypertension.

French pulmonologist Irène Frachon exposed Mediator's side effects in 2009, forcing its withdrawal. Studies estimate Mediator caused 500-2,000 deaths in France. In 2021 a Paris court convicted Servier of aggravated deceit and manslaughter. The company was fined €2.7M; former deputy chairman Jean-Philippe Seta got a four-year suspended sentence. France's medical regulator was fined €300,000+ for failing to act. On appeal in 2023, penalties rose to €7M in fines and €415M in repayments to social security and insurance funds.

The scandal was one of the most devastating in French pharmaceutical history. It exposed regulatory capture at France's drug safety agency, which ignored warnings from independent doctors and evidence from other European bans. The case led to reforms in drug safety monitoring in France and Europe. Servier, a privately held company, survived but with lasting reputational damage and a criminal record. The Mediator affair remains a textbook example of a pharmaceutical company putting profit before patient safety for three decades before being held accountable.