Drugmaker spend millions on campaign to gain support of U.S. physicians for weight loss drugs

Payments made to U.S. doctors suggest an influence campaign by Novo Nordisk to promote its weight-loss drugs Wegovy and Saxenda, an investigative report by Reuters has found. The analysis showed that Novo spent approximately $26 million in payments to physicians in the U.S., with that number certain to be higher if another weight-loss drug, Ozempic, were included.

“Those payments are part of a campaign to convince U.S. doctors to make Wegovy one of the most widely prescribed drugs in history – and to persuade skeptical insurers to pay for it,” wrote the study’s authors, Chad Terhune and Robin Respaut. “That total includes only payments that Novo reported it made specifically related to those two drugs; it sometimes paid far more to obesity specialists without naming any drug in the federal data.”

The report underlined some of the controversies surrounding the popular drugs—they are expensive, not universally covered by insurers, and public demand for their use as weight loss treatment can cause supply problems for patients who need them for treating diabetes.

Reuters said its reporters were able to document the drug company spending via data from the federal Open Payments database, created more than a decade ago by the Affordable Care Act.

Big spending on physician thought leaders

The report made it clear that Novo spent a lot of money trying to get the support of top physicians who are highly respected in the field of weight loss and weight management. It highlights payments to Lee Kaplan, MD, chief of obesity medicine at Dartmouth College, who has also taught at Harvard. Novo gave $1.4 million to Kaplan for consulting work between 2013 and 2022.

“Overall, at least 57 U.S. physicians each accepted at least $100,000 from Novo in payments associated with Wegovy or Saxenda over the period,” the report said. “They were an influential group: forty-one were obesity specialists who run weight-management clinics, work at academic hospitals, write obesity-treatment guidelines or hold top positions at medical societies.”

Another physician who was given more than $1 million in the last decade was Donna Ryan, MD, a Louisiana doctor who is a former president of The Obesity Society. The report said Ryan was instrumental in persuading the U.S. Office of Personnel Management to cover the weight loss drugs for millions of federal workers in its health plan. Pharmaceutical payments to physicians have long raised questions of ethics and influence, but such payments are legal in the U.S. For their part, doctors who receive payments maintain that they support such drugs because they believe in their effectiveness, and that they would not allow their medical ethics to be compromised.

“I don’t kowtow to the companies,” Kaplan said to Reuters. “If I can’t defend what I’m doing as being both appropriate and ethical, then I shouldn’t be doing it.”

In the meantime, the high demand for obesity drugs has helped Novo become Europe’s most valuable company, according to reporting from CNBC. Income from sales of the drugs is estimated in the hundreds of billions of dollars for manufacturers.

Concerns about the drugs remain

A number of physicians have concerns about the public demand for the drugs causing shortages for diabetes patients. The Reuters article noted that some specialists say the drugs should be prescribed more for severe obesity or related conditions. In addition, some physicians have concerns about possible side effects and risks of long-term usage.

On Dec. 11, Sweden’s drug regulating agency asked doctors to hold off on prescribing this type of drug for the treatment of obesity, over concerns that there would be shortages harmful to patients who need the medication to treat diabetes.

Side effects are also a concern. Earlier this year, the U.S. Food and Drug Administration asked manufacturers to include a warning label about the possible side effect of intestinal blockage and conditions such a pancreatitis. In addition, there are concerns that the drugs may be linked to suicidal thoughts or behavior in patients taking this type of medication.

Still, the market for weight reduction drugs is likely to remain hot. In November, a U.S. study found that Wegovy may reduce the risk of serious heart problems by 20%–creating another application that could drive demand.

Read more: Employers seek to balance worker health as new weight-loss drugs show promise

And that demand may play a role in pricing for the drug: Reuters found that the $1,300-a-month price in the U.S. may discourage some payers from covering it, but the cost is not likely to come down.

“While Novo pushes for big increases in Wegovy prescriptions, it has held firm on the drug’s lofty U.S. price,” the report said. “The company charges American consumers three or four times the price of those in Europe, where national health systems negotiate better drug prices, in contrast to the U.S. free-market approach.”