The manufacturer of the obesity vaccine, Novo Nordisk, proposed to higher-ranking government officials the idea of “profiling” individuals who receive benefits in order to specifically target those who are most likely to resume employment for their 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”.
Lars Fruergaard Jørgensen, chief executive of Novo Nordisk, acknowledged the importance of targeting specific groups in order to increase labor force participation. This includes individuals who are on the verge of becoming employable but are hindered by obesity, causing them to leave the workforce.
The remarks were shared in a closed gathering of Novo Nordisk leaders and high-level decision-makers earlier this year, following the recommendation of NHS utilization of Novo Nordisk’s weight loss injection, Wegovy, by the National Institute for Health and Care Excellence (Nice).
Barclay has reportedly extended an invitation to Sahota, Jørgensen, and other top executives from Novo Nordisk for a meeting at the Department of Health and Social Care on March 21st. The purpose of the meeting is to discuss a potential pilot program aimed at enhancing obesity treatment in the UK.
According to documents made public through freedom of information laws, the meeting included England’s top medical officer, Professor Chris Whitty, representatives from the Treasury, and Professor Sir John Bell, an Oxford academic who is a member of the Novo Nordisk-Oxford strategic alliance committee.
At the meeting, participants talked about the potential advantages to the community of introducing weight-loss injections in a pilot program, along with additional support services like counseling for returning to work.
Government officials inquired about whether the ongoing trials for Wegovy were also evaluating the effects on the job market. Novo Nordisk responded that this was not the case. A representative from the Treasury expressed interest in knowing more specific timelines, such as how soon a pilot program to assess economic impacts could be implemented and produce findings.
Martin Holst Lange, the development executive vice-president at Novo Nordisk, stated that implementing a community-based pilot program could lead to economic advantages in addition to health benefits. Jørgensen and Sahota later discussed the possibility of directing the program towards specific benefit recipients.
It is uncertain if the government implemented Novo Nordisk’s proposal to focus interventions on specific benefit recipients. The Department of Health stated that they do not intend to utilize data from the Department for Work and Pensions to categorize benefit claimants. Nonetheless, the main objective of their efforts to expand availability of weight-loss injections is believed to be to help individuals return to employment.
In March, the Times stated that there are plans to offer a new type of weight-loss medication to millions of individuals, with the goal of combatting obesity and helping those on benefits return to employment. These plans were reportedly shared by officials.
No one in attendance seemed to dispute the remarks made about targeting benefit claimants. The minutes state that the meeting ended with Jørgensen noting the government’s enthusiasm and plans to address any remaining concerns in pursuit of a common goal.
Barclay, who was recently appointed as environment secretary in the cabinet reshuffle led by Rishi Sunak, stated that the project aligns with the government’s main goal of addressing regional inequalities. He also expressed gratitude towards Novo Nordisk for their valuable input and discussion on mutual goals.
The government recently declared a £40m trial program to investigate ways to provide approved weight-loss medications to a larger number of individuals than what is currently allowed by Nice guidelines. One potential approach is allowing GPs to prescribe the drug instead of limiting it to specialized weight-loss services.
In June 2023, the prime minister and the Department of Health made a joint announcement stating that the pilot could potentially have benefits such as reducing NHS waiting lists and promoting economic growth.
According to Professor Simon Capewell, a specialist in public health policy and retired professor at Liverpool University, the statements made by executives at Novo Nordisk are both alarming and morally unacceptable. He further stated that they imply a focus on economic motives over the well-being and health of individuals, rather than prioritizing their own personal interests.
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.
Debbie Abrahams, a member of the Work and Pensions Committee and co-chair of the all-party parliamentary group on universal credit, expressed concerns about the suggestion made by Novo Nordisk to focus on benefit claimants. She stated that there are ethical concerns surrounding the use of personal data, even with the individual’s consent.
Released by the Department of Health, the notes from the meeting reveal that executives from Novo Nordisk advocated for increased collaboration with the government on obesity services. Sahota proposed integrating with “Boots, WeightWatchers, and digital health programs authorized by NHS England.”
The pharmaceutical company proposed administering their injections not just to individuals with a high level of obesity, but also to those with a lower body mass index (BMI) who are at risk of developing other health conditions. The National Institute for Health and Care Excellence (Nice) currently only approves the use of Wegovy in individuals with a BMI above 35 and at least one weight-related health issue, or those with a BMI of 30 to 34 who have a health issue and qualify for a specialized weight management program.
Novo Nordisk responded to allegations of “unethical behavior” by stating that while comments regarding profiling benefit claimants were made, the company was not involved in designing or implementing any such program. The discussions surrounding the pilot were led by the government.
The company stated its commitment to ethical and transparent practices in conducting clinical trials, in accordance with industry and regulatory guidelines. The company also acknowledged the government’s goal of promoting healthy living and workforce reintegration, and mentioned initial talks about using obesity treatment to support this goal.
However, it was stated that it was always understood that a pilot would have to adopt a diverse, community-oriented method and that evaluating a productivity result based on a single measure would pose challenges since there could be numerous factors influencing someone’s capability to return to work.
A representative stated that manipulating conversations with partners and removing them from their appropriate context only leads to distorting the facts and negatively impacting individuals with obesity and their ability to receive healthcare.
“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 Health Department reported that government officials held meetings with various parties and that a variety of opinions were likely shared during those discussions. They clarified that there are no intentions to utilize information from the Department for Work and Pensions to specifically target medications for obesity.
A representative stated that they will establish the criteria for receiving Wegovy through the NHS, which will not unfairly target individuals who receive benefits.