The drug giant behind weight loss injections newly approved for NHS use spent millions in just three years on an “orchestrated PR campaign” to boost its UK influence. As part of its strategy, Novo Nordisk paid £21.7m to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm, an Observer investigation has found. Among the vocal champions of the Wegovy jabs was a clinical expert who gave evidence to the National Institute for Health and Care Excellence (Nice) and others who publicly praised the so-called “skinny jabs” as a “gamechanger”. The revelations come as the Danish drug giant is investigated by the UK’s pharmaceutical watchdog after it was found to have breached the industry code seven times in relation to a “disguised promotional campaign” of another of its weight loss drugs via online webinars for healthcare professionals. The Association of the British Pharmaceutical Industry said it had ordered an audit of the firm’s practices and company culture to establish whether the breaches were a one-off or part of a wider web of compliance failures. The 3,500-plus payments from Novo Nordisk in 2019-21 include donations, event sponsorship, grants and other fees to prominent obesity charities, NHS trusts, royal colleges, GP practices, healthcare education providers, and universities. They are in addition to £28m spent by Novo Nordisk on research and development in the UK in the same period. Novo also helped fund a group of MPs that lobbies on obesity strategy. The Observer can reveal: A professor who promoted the benefits of the jab on the BBC Today programme last week is a former adviser to Novo. Jason Halford is also president of an obesity organisation which was paid more than £3.6m by the firm. Listeners were not told of these links. An expert who praised the drug as a “game changer”, Nick Finer, a former honorary professor at University College London, was a senior clinical scientist at Novo until last July and owns shares. A third prominent scientist, Prof John Wilding, who gave evidence to Nice, was president of an organisation paid more than £4.3m by Novo in three years. His declaration of interests to Nice show these donations were not disclosed. There is no suggestion the payments broke any rules, and the company says it has never “deliberately acted” outside ethical or legal standards. Recipients of the funding say they were not influenced by it and they properly declared their interests. While independent experts have described the recommendation to make the drug available on the NHS as “welcome news”, there is concern the public debate may be influenced by drugs industry funding. Simon Capewell, emeritus professor at the Institute of Population Health, Liverpool University, said the Novo payments were an effort to “buy influence and favourable opinion”. He said: “There has been an orchestrated PR campaign, and it’s regrettable so many clinical colleagues have taken part in that. We should be looking at much stricter controls on such payments.” Prof Allyson Pollock, professor of public health at Newcastle University, said Novo’s campaign was “not unusual” in the drugs industry and called for measures to improve trust. “The public really aren’t being made aware enough about the potential for bias and over-claiming,” she said. Among the biggest recipients of cash were obesity charities, according to Observer analysis of pharmaceutical industry disclosure logs. The World Obesity Federation (WOF), which calls for treatment to be funded as an “essential health service”, was paid £4,326,698 by Novo between 2019 and 2021. The European Association for the Study of Obesity (EASO) received £3,666,574 in the same period. The donations made up a substantial proportion of the charities’ income but Novo is not mentioned in their accounts. Both organisations are affiliated to the UK Association for the Study of Obesity (ASO), which gave evidence to Nice, saying Wegovy was “by far the most effective treatment for obesity at the current moment”. The ASO, which had received a £100,000 donation from Novo in 2021, said its interests were appropriately declared. Nice also heard evidence from the Royal College of Physicians, which received more than £100,000 in event sponsorship from Novo Nordisk. The sponsorship was not declared to Nice. The RCP told the Observer it should have volunteered the information but that the Novo funding had “no bearing” on the views it offered, which were based entirely on its knowledge and expertise. Nice said it had a “robust policy” for declaring interests and that openness around potential conflicts was “vital” so they could be properly managed. “We will review the information provided against our policy on declaring and managing interests for Nice advisory committees,” the watchdog said. Novo Nordisk said it was “committed to working in a transparent and ethical manner with policymakers and adheres to the strict regulatory and legal frameworks that govern both our industry and parliamentary best practice”. “The insinuation that Novo Nordisk has deliberately acted outside of ethical or legal standards and proper processes is unfounded and misleading,” it added. It said it had no part in setting up media appearances for clinicians in relation to its products, and that its involvement with MPs on the all-party group on obesity ended in July 2021. In relation to its webinars, it said its intention had been to educate health professionals on weight management but accepted significant mistakes were made. Leeds University, where Halford works, said his published papers “contain full disclosure” of his interests. A spokesperson said Halford did not receive remuneration for consultancy work, and any Novo payments were made to the university. Finer said he had always correctly disclosed his interests and had made clear when providing comment last week to the Science Media Centre, which provides comment for news outlets, that he was a former employee of Novo. The WOF and EASO say their decision-making processes and activities are not influenced by industry donations. Wilding said he “strongly refuted” the interpretation of his relationship with Novo and his role in the Nice process. He added that he had worked hard to ensure “people with severe obesity have access to all appropriate treatments”, but did not comment further. The market for obesity drugs could reach $54 billion in the next decade, according to the financial services company Morgan Stanley. Semaglutide, marketed in the UK as Wegovy, was last week approved for use in the NHS in England. In the US, the Physicians Committee for Responsible Medicine has raised concerns about payments made by Novo Nordisk to help promote the roll-out of its obesity treatment. Novo’s political action committee gave more than $210,000 to federal candidates for office in 2022, some of whom want to make the US government fund Wegovy at a cost of $1,300 per month per patient. This article was amended on 12 March 2023 to correctly refer to the Physicians Committee for Responsible Medicine, rather than the “Committee on Responsible Physicians” as an earlier version said.