380. Deuxiemement, l'idee qu'une f

380. Deuxiemement, l'idee qu'une fois l'opinion des medecins arretee sur les genenques de clopidogrel, il faudrait patienter plusieurs mois pour commencer a enregistrer les effets de ses prescriptions est totalement fausse. Le sondage precite realise par l'institut AplusA (voir ci-dessus, pts. 292 a 295) montre que les medecins generalistes prescrivent le clopidogrel en moyenne
30 fois par mois, et les cardiologues 60 fois par mois200 .

381. Des lors, les pratiques en cause ayant debute au mois de septembre 2009, il est impossible qu'elles n'aient commence a produire des effets qu'a partir du mois d'avril 2010. Un decalage de huit mois n'est pas coherent compte-tenu du nombre eleve d'ordonnances emises chaque mois par les medecins.

382. Troisiemement, cette theorie est incompatible avec l'aversion au risque des professionnels de sante, decrite abondamment dans la Decision. Compte-tenu de leur aversion au risque, les medecins auraient dO precisement etre incites a modifier immediatement leurs prescriptions, afin de ne prendre aucun risque avec la sante des patients, et non d'attendre de nombreux mois avant de repercuter dans leurs prescriptions les doutes qu'aurait soi-disant distille dans leur esprit
l'information communiquee par Sanofi-Aventis France.

383. Quatriemement, cette theorie est contredite par un graphique de la CNAMTS, remis pendant
l'instruction et reproduit ci-dessous au pt. 392, qui montre clairement l'impact immediat d'autres evenements tels que les retraits de lots ou la greve de la substitution (voir ci-dessous, pts. 387 a
400). Bien que ces evenements ne soient pas de meme nature que la visite medicale, ils demontrent qu'il n'est pas besoin d'attendre le renouvellement des prescriptions des medecins pour observer des variations rapides du taux de penetration des generiques de clopidogrel.

384. C'est done a tort que la Decision a ecarte l'explication la plus directe et la plus credible, a savoir que l'information communiquee par Sanofi-Aventis France n'a eu aucun effet sur les professionnels de sante, au profit d'une theorie de circonstance, ne reposant sur aucun element concret.
3.2 D'autres facteurs exterieurs posterieurs a l'arret des pratiques ont eu une influence sur l'evolution du taux de substitution

385. Contrairement a ce que soutient la Decision201 , Sanofi-Aventis France n'a pas cause le ralentissement du taux de substitution. Celui-ci a ete affecte par des evenements exterieurs a
Sanofi-Aventis France, qui l'ont immediatement et durablement affecte la generification de Plavix, a savoir:

Les retraits de lots de gemeriques de clopidogrel par I'AFSSAPS en mars 2010 (3.2.1) ; La greve de la substitution des pharmaciens concernant Plavix en mai 2010 (3.2.2).
3.2.1 Les retraits de lots de generiques de clopidogrel par I'AFSSAPS en mars
2010

386. Le 25 mars 2010, a la suite d'inspections menees par les autorites sanitaires franc;:aises et allemandes dans les locaux d'un producteur de principe actif en lnde, celles-ci ainsi que I'Agence europeenne du medicament, ont ordonne le retrait de plusieurs lots de generiques de
clopidoqreP02.



200 Voir le rapport de l'institut AplusA en Piece 4, reponse a la question 2.

Résultats (Anglais) 1:

380. secondly, the idea that once the opinion of doctors STOPPED on genenques clopidogrel, should wait several months to start recording the effects of its provisions is totally false. the survey cited above aplusa realized by the Institute (see above pts. 292 to 295) shows that general practitioners doctors prescribe clopidogrel average
30 times per month,and cardiologists 60 times mois200.
381. of time, the practices in question having started in September, 2009, it is impossible they have started to produce effects that from April 2010. a lag of eight months is not coherent in view of the high number of issued each month by doctors orders.
382. thirdly,this theory is inconsistent with the risk aversion of health professionals, extensively described in the decision. in view of their risk aversion, doctors would do precisely be encouraged to immediately change their requirements to take no chances with the health of patients,and not to wait many months to reflect in their prescriptions doubts would have supposedly distilled in their minds
Information communicated by sanofi-aventis France.
383. fourthly, this theory is contradicted by a graph of CNAMTS
presented during instruction and reproduced below in pt. 392,which clearly shows the immediate other events such as the withdrawal of lots or the strike of the substitution effect (see below pts. 387 a
400). although these events are not of the same nature as the medical visitThey demonstrate that there is no need to wait for the renewal of prescriptions of physicians to observe rapid changes in the rate of penetration of generic clopidogrel.
384. this is done the wrong decision discarded the most direct and most credible explanation,namely that the information communicated by sanofi-aventis France had no effect on health professionals for the benefit of a theory of circumstance, not based on any concrete element.
3.2 other external factors is the posterior 'stop practices have influenced the evolution of the rate of substitution
385. contrary to what the decision201,sanofi-aventis France did not because the slower rate of substitution. it was affected by external events a
sanofi-aventis France, who immediately and permanently affect the generics of Plavix, namely:
withdrawals gemeriques lots of clopidogrel i'afssaps in March 2010 (3.2.1);strike the substitution of pharmacists on plavix in May 2010 (3.2.2).
3.2.1 withdrawals lots of generic clopidogrel i'afssaps in March 2010


386. March 25, 2010, following inspections by health authorities franc: ease and German on the premises of a producer of active ingredient in India, these European and AGENCY of the drughave ordered the withdrawal of several batches of generic clopidoqrep02
.



200 see the report of the institute in aplusa piece 4, the answer to question 2.

Résultats (Anglais) 2:

380 Second, the idea that once the opinion of doctors stopped on the genenques of clopidogrel, should wait several months to start has recorded the effects of its requirements is totally false. The aforementioned survey carried out by the AplusA Institute (see above, PTS. 292a 295) shows that practitioners prescribe clopidogrel average
30 times per month,. and cardiologists 60 times per mois200.

381. Therefore, the practices in question having started in September 2009, it is impossible that they have started to produce effects until the month of April 2010. A lag of eight months is not coherent taking into account of the orders issued student number each month by physicians.

382. Third, This theory is inconsistent with the aversion to risk professionals from health, extensively described in the Decision. Given their aversion to risk, doctors would dO precisely be incites a change immediately their requirements, in order to not take any risks with the health of patients, and not to wait many months before pass in their doubts requirements that would supposedly distilled in their mind
communicated information by Sanofi-Aventis France.

383. Fourth, this theory is contradicted by a chart of the CNAMTS, delivered during
the statement reproduced below in the pt. 392, which shows clearly the impact immediately of other events such as the withdrawal of lots or the strike of substitution (see below, PTS. 387a
400). Although these events are not of the same nature that visit medical, They show that there is not need to wait for the renewal of the prescriptions of doctors to observe rapid changes of the rate of penetration of generic clopidogrel.

384. It is done, is wrong, that Decision has discarded the most direct explanation and more credible, namely that the information communicated by Sanofi-Aventis France had no effect on the professionals of health, in favour of a theory of circumstance, not based on anything concrete.
3.2 of other factors outside posterior has the stop practices have had an influence on the evolution of the rate of substitution

385. Contrary to what supports the Decision201, Sanofi-Aventis France did not cause the slowdown in the rate of substitution. It has been affected by external events has
Sanofi-Aventis France, which have immediately and permanently affects the generics of Plavix has know:

withdrawals of lots of clopidogrel by I gemeriques'AFSSAPS in March 2010 (3.2.1); The strike of the substitution of pharmacists regarding Plavix in May 2010 (3.2.2).
3.2.1 withdrawals of lots of generic clopidogrel by I'AFSSAPS in March
2010

386. March 25, 2010, following inspections carried out by the health authorities franc;: affluent and German on the premises of an active principle producer in India, as well as I' European Medicines Agency, have ordered the withdrawal of several batches of generic of
clopidoqreP02.


200 see the report of the Institute AplusA in Exhibit 4, answer to question 2.

Résultats (Anglais) 3:

380. Secondly, the idea that once the opinion of doctors stopped on the genenques of clopidogrel, it would have to wait several months to begin a record the effects of its requirements is totally false. The survey supra achieved by the institute AplusA (see above, pts. 292 A 295) shows that the doctors general practitioners prescribe clopidogrel in average
30 times per month,And cardiologists 60 times per month200 .

381. Therefore, the practices in question beginning with the month of September 2009, it is impossible that they have begun to produce effects that starting from the month of April 2010. A lag of eight months is not consistent in view of the high number of orders issued each month by physicians.

382. Thirdly,This theory is inconsistent with the risk aversion of health professionals, described extensively in the Decision. Taking into account their risk aversion, the doctors reportedly do precisely be encouraged to immediately change their requirements, in order to take no risk with the health of patients,And not to wait for many months before to pass in their requirements the doubts that would have so-called distilled in their spirit
the information communicated by Sanofi-Aventis France.

383. Fourthly, this theory is contradicted by a graph of the CNAMTS, handed over during
the statement and reproduced below at pt. 392,Which clearly shows the immediate impact of other events such as the withdrawals of batches or the strike of the substitution (see below, pts. 387 A
400). Although these events are not of the same nature as the medical visit,They demonstrate that there is no need to wait for the renewal of the prescriptions of doctors to observe rapid variation of the penetration rate of generic clopidogrel.

384. It is done is wrong that the Decision has moved away from the explanation the most direct and most credible,Namely that the information communicated by Sanofi-Aventis France had no effect on health professionals, for the benefit of a theory of circumstance, not based on any concrete element.
3.2 other external factors subsequent to the judgment of practices have had an influence on the evolution of the rate of substitution

385. Contrary to what supports the Decision201 ,Sanofi-Aventis France has not caused the slowdown of the rate of substitution. The latter has been affected by external events a
Sanofi-Aventis France, who immediately and permanently affects the generification of Plavix, namely:

The withdrawals of batches of gemeriques of clopidogrel by I'AFSSAPS in March 2010 (3.2.1 ) ;The strike of the substitution of pharmacists regarding Plavix in May 2010 (3.2.2 ) .
3.2.1 withdrawals of lots of generic clopidogrel by I'AFSSAPS in march
2010

386. The March 25, 2010, has the result of inspections carried out by the health authorities frank; :affluent and German in the premises of a producer of active principle in include India, the latter as well as I'European Agency of the medication,Have ordered the withdrawal of several batches of generic
clopidoqrep02.



200 See the report of the institute AplusA in Exhibit 4, response to question 2.