AUTH/2382/1/11 - General Practitioner v Novo Nordisk

Articles on Daily Mail online

  • Received
    19 January 2011
  • Case number
    AUTH/2382/1/11
  • Applicable Code year
    2008
  • Completed
    15 April 2011
  • No breach Clause(s)
    2, 9.1, 22.1 and 22.2
  • Additional sanctions
  • Appeal
    No appeal
  • Review
    August 2011

Case Summary

A general practitioner complained about articles in the Daily Mail which referred to liraglutide (Victoza) marketed by Novo Nordisk. Victoza was indicated for the treatment of adults with type 2 diabetes to achieve glycaemic control in combination with oral anti-hyperglycaemics.

The complainant alleged that in a Daily Mail online article the managing director of Novo Nordisk promoted liraglutide as a treatment for weight reduction, for which it was not licensed. His claims of phenomenal study results were exaggerated and disparaged orlistat, which was licensed as a weight loss agent. He also stated that liraglutide could cure diabetes and that its effects on confidence and health were life-changing!! Liraglutide was not a dieting medicine let alone an antihypertensive or lipid modifying agent as stated. The complainant alleged that this sort of irresponsible and disguised promotion only raised unfounded hopes.

The complainant also referred to a second article in which experts and opinion leaders, no doubt supported by Novo Nordisk, advocated or promoted liraglutide as a treatment for weight loss.

This was similar to previous rulings involving Novo Nordisk (Cases AUTH/2202/1/09 and AUTH/2234/5/09) and the complainant asked what was the point of the Authority ruling a breach of the Code including Clause 2 or imposing any other sanction on the company.

The detailed response from Novo Nordisk is given below.

The Panel noted that the complainant referred to an article published on 27 December 2010 in the Mail Online which described liraglutide as a diet drug that could be available in three years and as a jab that had produced phenomenal results. It was stated to be 'More than twice as good as anything on the market'. The article explained that liraglutide 'lowers blood pressure, raises “good” cholesterol and can prevent and even cure diabetes'. Its current use in diabetes was mentioned as was the ongoing trial programme in obese men and women. Comparative data with orlistat, a medicine licensed for weight loss, was discussed which appeared to have been taken from Astrup et al (2009) and which was provided to the Daily Mail journalist at her request. The Novo Nordisk managing director was quoted as stating 'We have had phenomenal results from the first clinical trials in obesity' and 'that the effects on confidence and health were life-changing'. The article also featured quotations from an academic expert in hormones and weight loss.

The Panel noted that Novo Nordisk's PR agency had developed a media programme to raise the profile of Novo Nordisk and strengthen its relationships with journalists. Meetings on varying topics had been arranged with individual journalists. In the Panel's view, the selection of such journalists should stand up to scrutiny; it might be unacceptable to select a journalist who had repeatedly published material related to the subject matter of a proposed meeting which was inconsistent with the Code. In its draft proposal for the media programme, Novo Nordisk's agent had listed as potential topics for discussion with the Daily Mail journalist, modern life with diabetes, how treatments were evolving to improve day-today lives of patients and the future of diabetes (pipeline).

The Panel noted that Novo Nordisk's agency had arranged a meeting with the journalist to discuss the human, social and financial impact of diabetes and Novo Nordisk's heritage with diabetes care. Slide 15 of the presentation delivered at the meeting described the company's range of rapidacting, long-acting and pre-mixed insulin although no brand names were mentioned. The following slide was headed 'GLP-1 receptor agonist': whilst not mentioning liraglutide by name it was described as a treatment for type 2 diabetes as an adjunct to diet and exercise in combination with specified anti-diabetic tablets. Slide 17 headed 'Addressing future diabetes care needs' listed 'Next generation insulin analogues', 'Incretin therapies', 'Oral insulin and oral GLP-1' and 'A cure for Type 1 diabetes'. None of the slides mentioned obesity. The presentation concluded by a discussion of work undertaken by Novo Nordisk to change diabetes through partnerships, access and quality of life. Slide 22 detailed Novo Nordisk's impact on 6 quality of life parameters for people with diabetes: the second bullet point read 'Only company with a once-daily GLP-1 analogue'. The Panel queried whether, given the stated aim of the meeting, the presentation had included disproportionate emphasis on liraglutide.

The Panel noted that the meeting notes detailed a general discussion but did not appear to cover the presentation. The Panel had no way of knowing precisely what was said about the slides.

The meeting notes showed that the journalist knew a lot about liraglutide from the European Obesity Conference and had also written about it on publication of the recommendation from the National Institute for health and Clinical Excellence (NICE) [for its use in diabetes]. The journalist requested information on how liraglutide worked,its mode of action and trials for obesity and timelines. The journalist was told she would be provided with a liraglutide backgrounder and published obesity trial results (Astrup et al). The journalist later asked about the timelines of getting liraglutide on the market for obesity and was told that a rough timeline might be three years. According to the meeting notes when the journalist referred to liraglutide and obesity the Novo Nordisk representatives steered the conversation back to the original topic. Although the Panel was concerned that liraglutide was the only specific medicine mentioned it did not appear from either the presentation or the meeting notes that the request about liraglutide and obesity was solicited by Novo Nordisk.

The Panel had some concerns about the arrangements, presentation and discussion as set out above. Nonetheless the Panel did not consider that, on the evidence before it, the presentation, discussion and material provided to the journalist promoted a prescription only medicine to the public as alleged. No breach of the Code was ruled.Nor, on balance, did the Panel consider that the material provided was not factual or balanced in relation to the licensed indication for liraglutide, nor did it otherwise encourage a member of the public to seek a prescription for it. Novo Nordisk did not proactively provide information on liraglutide and obesity. No breach of the Code was ruled.

The Panel noted the complainant's reference to Cases AUTH/2202/1/09 and AUTH/2234/5/09, wherein breaches of the Code had been ruled and additional sanctions imposed in relation to the prelicence promotion of liraglutide and its promotion to the public. Turning to the present case, Case AUTH/2382/1/11, the Panel noted its rulings of no breach of the Code above and thus ruled no breach of the Code including Clause 2.