Nicolas Florko. STAT. July 5, 2023.
WASHINGTON – Novo Nordisk spent $11 million on meals and travel for thousands of doctors last year, federal records show, as part of its push to promote Ozempic and other weight loss-inducing diabetes drugs.
The pharmaceutical company bought more than 457,000 meals to educate doctors and other prescribers about its portfolio of drugs known as GLP-1agonists, according to the newly released data from the Centers for Medicare and Medicaid Services.
Nearly 12,000 prescribers had food paid for by the company more than a dozen times last year. More than two hundred recorded more than 50 meals and snacks paid for by the company. One doctor, who is a frequent speaker for the company, recorded 193.
Novo is currently promoting five GLP-1 drugs — Victoza, Saxenda,Ozempic, Rybelsus, and Wegovy. The lion’s share of meals purchased by the company were to push Ozempic and Rybelsus specifically; nearly 85%of the 457,000 meals listed one of them as the primary topic discussed. Of these drugs, only Wegovy and Saxenda are FDA-approved for weight loss, while the others are approved for treatment of diabetes, but all are often prescribed for weight loss off-label.
All told, the meals cost Novo $9 million.
It’s common for pharmaceutical companies to meet with doctors — often over lunch or coffee — to discuss their drugs. In a statement, NovoNordisk said that “providing modest meals to healthcare professionals …and staff members as part of an informational presentation or discussion –typically during the workday at the healthcare professional’s office – is a standard pharmaceutical industry practice” and that the company follows a code of voluntary guidelines governing pharmaceutical companies’ interactions with doctors, as well as an internal compliance program that ensures it follows all relevant laws and regulations.
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The volume of meals Novo Nordisk purchased last year raised concerns for both conflict-of-interest experts and advocates that were interviewed by STAT.
“When you have a physician eating out with the [company] reps more often than they’re eating at home, it suggests that this is excessive,” said Joseph Ross, a professor of medicine at Yale University who has researched the impact of drug companies’ promotion to doctors.
Diana Zuckerman, the president of the nonprofit National Center for Health Research, said the amounts were outrageous. “It’s one thing to reach out to physicians and say ‘We’ve got these treatments and they’re so effective and we want you to know about them,’ I don’t think that’s ever going to explain over 100 meals,” said Zuckerman. “You just have to laugh, it’s so crazy.”
Marketing drugs to doctors — commonly known as detailing — isn’t illegal, even if it comes with a free meal, and Novo has not been accused of a crime by the government. But several legal experts underscored that excessive meals from pharma companies to doctors can land these companies in legal jeopardy.
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Many of the meals Novo provided doctors were relatively cheap. The average cost was just under $20, though some cost several hundred dollars— the most expensive being $639.
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But conflict-of-interest experts say small payments still can influence doctors to prescribe their drugs.
“A gift of any value … still is associated with an increased rate of prescribing,” said Ross, whose research has shown that payments of less than $20 have influenced doctors’ prescribing patterns. “It still carries all the same risks.”
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Novo Nordisk isn’t just paying for meals, either. It’s flying doctors to places like London, Paris, Orlando and Honolulu, Hawaii. The companyspent $2 million on doctor’s travel related to its GLP-1s in 2022, according to the data.
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