Daiichi Sankyo: patient website found to promote Nustendi to Nilemdo patients (AUTH/3637/4/22)

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Key facts

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Case number	AUTH/3637/4/22
Company	Daiichi Sankyo
Complainant	Anonymous
Products	Nilemdo (bempedoic acid); Nustendi (bempedoic acid, ezetimibe)
Channel	Patient website (myldltreatment)
Main issue	Cross-promotion on a patient site: content likely encouraged Nilemdo patients to request Nustendi
Applicable Code year	2021
Complaint received	23 April 2022
Case completed	24 May 2023
Appeal	No appeal
Sanctions	Undertaking received

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

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An anonymous complainant challenged Daiichi Sankyo’s myldltreatment patient website for people prescribed Nilemdo (bempedoic acid) or Nustendi (bempedoic acid/ezetimibe).
The complainant alleged the site was meant to be non-promotional but became promotional because it was not segregated by product; Nilemdo and Nustendi could not be taken together (patients would be on one or the other).
The complainant also alleged the site was accessible to the public due to “no disclaimer”.
Daiichi Sankyo said the site was a non-promotional, post-prescription resource, accessed mainly via URL/QR codes in patient brochures given by HCPs, with self-certification and a banner disclaimer for UK patients prescribed Nilemdo or Nustendi.
The Panel reviewed the homepage content, including a “Medicines to lower your cholesterol” section describing medicine classes; unlike other classes, it named bempedoic acid and ezetimibe as examples and explained ezetimibe’s mechanism (selective cholesterol absorption inhibitor preventing absorption in the gut).
The Panel considered that this would likely encourage Nilemdo patients to ask their health professional for Nustendi, and could encourage those on separate bempedoic acid + ezetimibe tablets to request the single tablet Nustendi.

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Breach found because the webpage promoted Nustendi to individuals prescribed Nilemdo and likely encouraged them to ask their health professional to prescribe Nustendi.
No breach found regarding alleged promotion of Nilemdo to individuals prescribed Nustendi (all visitors would already be taking bempedoic acid either as Nilemdo or within Nustendi).
No breach found on the narrow allegation that members of the public were exposed due to a lack of disclaimer (the complainant did not establish this).
No breach of Clause 2 (Panel did not consider the matter brought discredit on, or reduced confidence in, the industry).
No appeal.

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Breach of Clause 5.1 Failing to maintain high standards
Breach of Clause 26.1 Promoting a prescription only medicine to the public
Breach of Clause 26.2 Encouraging members of the public to ask for a specific prescription only medicine
No Breach of Clause 2 Requirement that activities or material must not bring discredit upon, or reduce confidence in, the pharmaceutical industry
No Breach of Clause 26.1 Requirement not to promote prescription only medicines to the public
No Breach of Clause 26.2 Requirement that information about prescription only medicines must not encourage the public to ask their health professional to prescribe a specific prescription only medicine.

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