AUTH/3755/3/23: Health Professional v Novo Nordisk — funding alleged to induce prescribing (No breach) | PMCPA Case

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Key facts

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Case number	AUTH/3755/3/23
Parties	Health Professional v Novo Nordisk Ltd
Issue	Alleged funding of a named obesity practitioner’s salary as an inducement to prescribe; alleged influence on hospital liraglutide criteria/guideline
Applicable Code	2019
Complaint received	23 March 2023
Case completed	25 January 2024
Appeal	Yes — by complainant (unsuccessful)
Funding described	£35,000 to a named hospital; approved 1 December 2018; paid early 2019 (also stated as 28 December 2018); one-off for one year
Medicines referenced	Liraglutide (Saxenda, 3mg) and semaglutide (allegation); Saxenda initiation referenced in appeal materials
Guideline referenced	Hospital liraglutide clinical guideline dated July 2020
Decision	No breach of Clauses 2, 9.1, 18.1, 19.1, 19.2, 21
Sanctions	None

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

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What happened

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A health professional alleged Novo Nordisk had funded the salary of a named obesity practitioner at a named hospital as an inducement to prescribe Novo Nordisk medicines (liraglutide and semaglutide).
The complainant also alleged that around the time of the funding, the hospital relaxed local criteria for liraglutide to increase its use (local guideline dated July 2020 was provided).
Novo Nordisk said the hospital requested support in 2018 to establish a prediabetes/obesity clinic within an MDT; funding of £35,000 was approved (1 Dec 2018) and paid (early 2019; later stated as 28 Dec 2018) as a one-off for one year.
Documentation was inconsistent: an initial hospital request (28 Nov 2018) referenced showing benefit of liraglutide 3mg “in a real world setting”; a revised request (2 Dec 2018) removed liraglutide reference and described funding for a specialist nurse; Novo Nordisk’s internal form referenced two roles (dietician and physical trainer).
The Panel and Appeal Board noted governance concerns (approval timing, reclassification from grant to donation, incomplete/unclear paperwork, and lack of evidence of follow-up reporting), but the complainant bore the burden of proof.
On appeal, additional information included an email from the hospital stating the named role was part funded by Novo Nordisk and part by a hospital department for ~6 months, and later exclusively hospital-funded; the role partly supported cardiology research and partly saw patients meeting criteria for Saxenda initiation.

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Outcome

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No breach of the Code was found for both: (1) the allegation that funding the role was an inducement to prescribe, and (2) the allegation that funding improperly influenced the hospital’s liraglutide guideline.
The complainant’s appeal was unsuccessful.
The Appeal Board concluded there was insufficient evidence (on the balance of probabilities) of a direct link that the £35,000 funding constituted an inducement to prescribe Novo Nordisk obesity medicines.

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Clauses

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No Breach of Clause 2 — Requirement that activities or materials must not bring discredit upon, or reduce confidence in, the pharmaceutical industry.
No Breach of Clause 9.1 — Requirement that high standards must be maintained at all times.
No Breach of Clause 18.1 — Requirement that no gift, pecuniary advantage or benefit may be supplied, offered or promised to members of the health professions or to other relevant decision makers in connection with the promotion of medicines or as an inducement to prescribe, supply, administer, recommend, buy or sell any medicine.
No Breach of Clause 19.1 — Requirement that medical and educational goods and services can be provided subject to the provisions of Clause 18.1. They must not be provided to individuals for their personal benefit.
No Breach of Clause 19.2 — Requirement that the provision of medical and educational goods and services in the form of donations, grants and benefits in kind to healthcare organisations are only allowed if they do not constitute an inducement to prescribe, supply, administer, recommend, buy or sell any medicine.
No Breach of Clause 21 — Requirement that contracts between companies and organisations under which such organisations provide any type of services on behalf of companies (or any other type of funding by the company not otherwise covered by the Code) are only allowed if such services (or other funding) do not constitute an inducement to prescribe, supply, administer, recommend, buy or sell any medicine.

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AUTH/3755/3/23: Health Professional v Novo Nordisk — funding alleged to induce prescribing (No breach)

Key facts

What happened

Outcome

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