AUTH/2888/11/16: Nurse v Napp — Remsima switch email found misleading and potentially offensive | PMCPA Case

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Key facts

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Case number	AUTH/2888/11/16
Parties	Nurse v Napp Pharmaceuticals Limited
Medicine / product	Remsima (infliximab) (biosimilar) vs Remicade (infliximab) (originator)
Material	Promotional email (Ref UK/REM-16038)
Audience / distribution	4,475 opted-in health professionals (rheumatologists, gastroenterologists, specialist nurses, hospital pharmacists)
Key challenged claims	“Your colleagues from across the UK are switching… and re-investing their savings…”; “Don’t get left behind – make the switch”
Complaint received	17 November 2016
Case completed	1 March 2017
Applicable Code year	2016
Breach clauses	Clause 7.2; Clause 7.4; Clause 9.2; Clause 9.1
No breach / not pursued	No breach of Clause 7.10; no breach of Clause 7.2 (patient-needs point); no breach of Clauses 7.2 and 7.4 (indications/efficacy point); Clause 7.4 not ruled on in Point 1 context
Sanctions	Undertaking received; additional sanctions not stated
Appeal	No appeal

Reviewed by Dr Anzal Qurbain (FFPM) — ABPI Final Signatory

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A hospital specialist nurse complained about a promotional email from Napp Pharmaceuticals Limited about switching from Remicade (originator infliximab) to Remsima (biosimilar infliximab).
Email subject line: “Why switch from Remicade to Remsima?”; body headline: “Don’t get left behind – make the switch”.
The email claimed: “Your colleagues from across the UK are switching from Remicade to Remsima and re-investing their savings to improve patient care”.
The complainant alleged the email pushed switching without considering patient needs; and that not all centres could re-invest savings; and objected to including indications/efficacy in a switch promotion and to the strapline.
Napp said the email was sent on 14 November 2016 to 4,475 opted-in health professionals (rheumatologists, gastroenterologists, specialist nurses, hospital pharmacists) and linked to four case studies and other resources.

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No breach of Clause 7.10 (Panel considered the email encouraged rational use, including via linked case studies emphasising stakeholder engagement and addressing patient concerns).
No breach of Clause 7.2 in relation to the allegation that switching was promoted without consideration of patients’ needs.
Breach of Clause 7.2 for the unequivocal “across the UK… re-investing their savings” claim (exaggerated and misleading given limited supporting case studies and England-only spread).
Breach of Clause 7.4 for the same “across the UK… re-investing their savings” claim (could not be substantiated as stated).
No breach of Clauses 7.2 and 7.4 regarding inclusion of indications/efficacy information in a switch email (Panel did not find this misleading or unsubstantiated).
Breach of Clause 9.2 for “Don’t get left behind – make the switch” (implied non-switchers were outdated; did not recognise professional standing; likely to cause offence).
Breach of Clause 9.1 (high standards not maintained, in light of the above breaches).
No appeal.

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