Revealed: obesity jab maker discussed targeting benefit claimants with UK government

  • 11/18/2023
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Obesity jab maker Novo Nordisk suggested to senior government officials that they could “profile” benefit claimants so that those most likely to return to work could be targeted with its weight-loss injections. Internal documents obtained by the Observer reveal that Pinder Sahota, corporate vice-president of Novo Nordisk UK, told the then health secretary Steve Barclay, England’s chief medical officer and Treasury officials that “data from the Department for Work and Pensions [DWP] could help profile those who are most likely to return to the labour market”. Another Novo Nordisk figure, chief executive Lars Fruergaard Jørgensen, “noted a need” to “target the right cohort to drive labour market activity, such as those on the tipping point of employability where obesity is the driver to leaving the labour market”. The comments were made during a private meeting of Novo Nordisk executives with senior policymakers earlier this year, shortly after Novo Nordisk’s obesity jab Wegovy was recommended for NHS use in England by health watchdog the National Institute for Health and Care Excellence (Nice). Barclay is understood to have invited Sahota, Jørgensen and other Novo Nordisk executives for a meeting at the Department of Health and Social Care on 21 March to discuss a pilot scheme to improve obesity care in the UK. They were joined by England’s chief medical officer, Prof Chris Whitty, Treasury officials and Prof Sir John Bell, an Oxford academic who sits on the Novo Nordisk-Oxford strategic alliance committee, according to meeting minutes released under freedom of information laws. During the meeting, attendees discussed the potential socioeconomic benefits of making weight-loss injections available in a community-based pilot scheme alongside “wraparound support”, such as back-to-work counselling. Government officials asked Novo Nordisk whether continuing pilots involving Wegovy were assessing the labour market impact, which Novo Nordisk said they were not. A Treasury official said the government would “value a clearer sense of timings”, including how quickly a pilot to assess economic impacts could be set up and “generate results”. Martin Holst Lange, executive vice-president of development at Novo Nordisk, went on to say that “economic benefits could arise as soon as health benefits” if a community-based pilot scheme were to be established. Jørgensen and Sahota then made the comments about targeting certain benefit claimants. It is not clear whether Novo Nordisk’s suggestion of targeting interventions at certain benefit claimants was taken forward by the government. The Department of Health said this weekend that it had no plans to use DWP data to profile benefit claimants.However, getting people back to work is understood to have been a key goal of its plans to widen access to weight-loss jabs. In March, the Times reported that “millions of people could be offered a new generation of weight-loss drugs under plans to turn the tide on obesity and get benefit claimants back to work”, after an apparent briefing by officials. The comments about targeting benefit claimants do not appear to have been challenged by anyone who was in attendance. According to the minutes, the meeting closed with Jørgensen saying that he sensed a “keen interest from the government, with further details to resolve but a shared vision”. Barclay – who was moved from his health department role and installed as environment secretary last week in Rishi Sunak’s cabinet reshuffle – responded by saying that the work “speaks to the government’s primary strategic objective on levelling up” and by thanking Novo Nordisk for what was a “hugely helpful discussion on shared objectives”. The government has since announced a £40m pilot scheme to explore how approved weight-loss drugs could be made available “to tens of thousands more people” than would currently be eligible under Nice guidelines, including using GPs to prescribe the drug rather than it only being available in specialist weight-loss services. A joint announcement from the prime minister and the Department of Health in June 2023 said that potential effects of the pilot included cutting NHS waiting lists and “wider economic benefits”. Prof Simon Capewell, a public health policy expert and emeritus professor at Liverpool University, said the comments by Novo Nordisk executives were “shocking and “absolutely unethical”. He added: “They suggest targeting people in the interests of the state, for economic reasons, rather than prioritising the person’s own interests and health.” He also said that setting up a pilot scheme that aimed the injections at people who were “on the borderline for returning to work” would be “scientifically dishonest” and risked biasing any results in favour of the company. “If you’ve got folk who are just over the obesity measure and are considered by the DWP to be borderline for just returning to work, it would be a marvellous bit of marketing for the company,” he said. Labour MP Debbie Abrahams, co-chair of the all-party parliamentary group on universal credit and a member of the Work and Pensions Committee, said the suggestion from Novo Nordisk to target benefit claimants was “very worrying on several levels”. She added: “There are clear ethical issues with requesting to use this personal data, even with an individual’s permission.” The meeting notes, released by the Department of Health, also show that Novo Nordisk executives pushed for closer collaboration with the government on obesity services, with Sahota suggesting integration with “Boots, WeightWatchers and digital health programmes commissioned by NHS England”. The drug company also suggested its jabs be given not only to those who were most in need of help as a result of being “highly obese”, but those with a lower body mass index (BMI) who were at risk of developing comorbidities. Nice currently only recommends Wegovy for obese people who have a BMI above 35 and at least one weight-related comorbidity, or those with a BMI of 30 to 34 who have a comorbidity and are eligible for referral to a specialist weight-management service. This weekend, Novo Nordisk said it rebutted any suggestions of “unethical behaviour”. It did not deny that the comments about profiling benefit claimants had been made but said discussions about a pilot had been led by the government, with the company not involved in designing or delivering any such scheme. It also said it took an ethical and transparent approach to its clinical trials process, in line with industry and regulatory standards. The company added that it was aware of the government’s ambition to “help people live healthier and more productive lives, and to support people back into the workforce”. As part of this, it said there were preliminary discussions on the role of treating obesity to support that ambition. But it said it had always been clear that any pilot would need to take a multidisciplinary, community-based approach and that measuring a productivity outcome based on one measure would be difficult because there may be many contributing factors to someone’s ability to re-enter the workforce. “Misrepresentation of discussions with partners, when taken out of their rightful context, only serves to distort the truth and harmfully affect those living with obesity and their access to healthcare,” a spokesperson said. “As invited consultees, Novo Nordisk provided the UK government with perspectives on economic inactivity and the opportunities within obesity to help people to live healthier, more productive lives. “The discussion included the government’s proposals for a pilot to better support people living with obesity, where we highlighted the need to focus on ensuring appropriate holistic, multidisciplinary support and a community-based distribution.” The Department of Health said ministers met a number of stakeholders and that a range of views were likely to be expressed during those meetings. It said there were no plans to use data from the DWP to target the obesity medications. A spokesperson said: “Nice determine the eligibility criteria for Wegovy on the NHS which will not target benefit claimants.

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