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Friday, Dec 27, 2024
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Britain’s ‘Wild West’ of Weight-Loss Jab Promotions Faces Growing Scrutiny
Regulators step up investigations as online pharmacies skirt strict rules governing prescription-only medicines
The meteoric rise of prescription weight-loss injections, such as Wegovy and Mounjaro, has sparked a flurry of promotional activity in the United Kingdom—much of it pushing the boundaries of legal advertising.
Experts warn that a ‘wild west’ mentality has overtaken parts of the booming industry, with some online pharmacies apparently defying rules intended to protect consumers from the hard sell of prescription-only medicines.
## A Burgeoning Market
Novo Nordisk, the Danish pharmaceutical giant behind Saxenda and Wegovy, revealed that global sales of its weight-loss therapies surged to £1.94bn in the third quarter of this year alone—a 48% increase from the previous quarter.
Retailers, including both high-street chains and online pharmacies, are clamouring to meet the soaring demand for what many see as the newest frontier in combating obesity.
The injections, containing active ingredients like semaglutide (Wegovy) and tirzepatide (Mounjaro), help patients control their appetite and manage blood sugar levels, leading to significant weight loss for some users.
With the potential for these medications to be as transformative as statins were for cholesterol, the weight-loss jab market has become a lucrative opportunity, especially as Britain grapples with rising obesity rates.
## Cracks in the Regulatory Framework
Yet the legal framework around promoting prescription-only medicines (POMs) in the UK is strict: direct-to-consumer advertising of POMs is prohibited.
Under existing guidelines from the Advertising Standards Authority (ASA), pharmacies and other healthcare providers may only advertise a “weight-loss service” or “consultation,” and may not refer explicitly to prescription medications outside of a consultation context.
Even then, pricing details must be carefully positioned away from a homepage to avoid encouraging consumers to choose a product based on discounts.
Regulators say a growing number of online providers have flouted these rules, sometimes boldly.
Investigations by the Medicines and Healthcare products Regulatory Agency (MHRA) reveal that dozens of websites and online pharmacies are using discount codes, multibuy deals, and promotional content that showcase brand names and imagery of weight-loss injections.
In response, the MHRA regularly sends letters to reprimand these firms, reminding them that eligibility for weight-loss medication must be determined by a qualified professional.
“While technically not direct-to-consumer drug advertising, the distinction is lost on most consumers,” observes Oksana Pyzik, Associate Professor of Pharmacy Practice and Policy at University College London’s School of Pharmacy.
“Patients see ‘weight-loss jab deal’ and interpret these promotions as discount offers for Wegovy or Mounjaro, which effectively sidestep regulations and put profit above patient safety.”
## The Rise of ‘Service’ Advertisements
A common workaround has emerged in the form of marketing a “weight-loss service,” or offering deals on “consultations,” rather than overtly promoting medications.
However, critics say that many of these offerings feature high-profile images of jabs and reference the specific brands in close proximity to discounted prices.
Superdrug Online Doctor, for instance, recently ran a webpage advertising a 33% discount on its weight-loss service—while listing the costs of prescription-only weight-loss jabs (Wegovy and Mounjaro) below.
A spokesperson for Superdrug said it complies fully with ASA guidance, insisting that the code covers the overall medical consultation rather than the cost of any specific medication.
But some industry professionals remain unconvinced.
“Pharmacies should not create or use discount codes for prescription-only medicines,” says Roz Gittins, Chief Pharmacy Officer at the General Pharmaceutical Council (GPhC).
“This includes the creation of codes for use in advertising, including on social media.” The GPhC also stresses that the final prescribing decision—particularly for weight-loss injections—must hinge on patient history, clinical appropriateness, and professional judgement.
## Regulatory Tensions and Loopholes
When the MHRA does intervene, its enforcement often relies on contacting violators and urging voluntary compliance.
Though it has the legal ability to impose fines and pursue criminal charges, the agency says it has not yet been required to use these statutory powers, as most companies amend their advertisements after being contacted.
Since 2019, the number of MHRA complaints involving POM advertising specifically for weight loss has escalated from zero, to four in 2020, to at least 27 breaches in 2023 alone.
According to the agency, not a month has gone by since April 2023 without a website being asked to amend or remove content that contravenes the regulations.
Julian Beach, MHRA’s interim Executive Director of Healthcare Quality and Access, acknowledges these concerns.
“We take complaints about the illegal promotion of prescription weight-loss medicines to the public very seriously,” he says.
“Where appropriate, we work with other regulators.
A failure to comply with these rules can result in fines or even imprisonment.”
## Mounting Pressure for Clearer Rules
Critics argue that inconsistent enforcement makes it easier for some providers to operate in grey areas.
Dr Piotr Ozieranski, Reader in the Department of Social and Policy Sciences at the University of Bath, believes a more proactive approach is needed: “The current system is based on reputational damage, naming and shaming, rather than significant financial penalties or legal action.
In the US, regulators impose large fines and act more adversarially to deter unethical practices.”
The ASA acknowledges the growing problem, announcing that it plans to launch at least eight investigations into questionable weight-loss jab advertisements—some involving the use of discount offers—in a bid to establish clearer precedents.
The Committee of Advertising Practice (CAP) also issued an enforcement notice in 2021 focusing on prescription-only weight-loss treatments.
Yet, as the market for Wegovy, Mounjaro, and similar medications continues to balloon, experts warn that these measures may not go far enough.
“The line between promoting health services and selling prescription drugs has grown blurry,” says Pyzik.
“We need an updated regulatory strategy that addresses these marketing tactics more directly and, ultimately, keeps patient well-being front and centre.”
## Upholding Professional Standards
Novo Nordisk, whose medicines are heavily in demand, states that it does not condone direct promotion of its prescription-only drugs.
“We make providers aware of their legal obligations, including regulation around the promotion of POMs. When we are made aware of providers promoting our medicines to the public, we address this with them directly and, in many cases, report them to relevant authorities,” the company says.
Ultimately, the weight-loss medication boom in the UK may bring transformational benefits to many struggling with obesity.
Yet as the incentives to sell these products intensify, the tension between industry growth and consumer safeguards seems likely to heighten.
Regulators have vowed to crack down on those breaching the rules, but as experts warn, meaningful progress will require not only robust enforcement, but also clarity in how ‘services’ and ‘consultations’ are marketed.
For now, Britain’s appetite for weight-loss jabs continues to expand, in what some describe as an increasingly volatile marketplace.
Experts warn that a ‘wild west’ mentality has overtaken parts of the booming industry, with some online pharmacies apparently defying rules intended to protect consumers from the hard sell of prescription-only medicines.
## A Burgeoning Market
Novo Nordisk, the Danish pharmaceutical giant behind Saxenda and Wegovy, revealed that global sales of its weight-loss therapies surged to £1.94bn in the third quarter of this year alone—a 48% increase from the previous quarter.
Retailers, including both high-street chains and online pharmacies, are clamouring to meet the soaring demand for what many see as the newest frontier in combating obesity.
The injections, containing active ingredients like semaglutide (Wegovy) and tirzepatide (Mounjaro), help patients control their appetite and manage blood sugar levels, leading to significant weight loss for some users.
With the potential for these medications to be as transformative as statins were for cholesterol, the weight-loss jab market has become a lucrative opportunity, especially as Britain grapples with rising obesity rates.
## Cracks in the Regulatory Framework
Yet the legal framework around promoting prescription-only medicines (POMs) in the UK is strict: direct-to-consumer advertising of POMs is prohibited.
Under existing guidelines from the Advertising Standards Authority (ASA), pharmacies and other healthcare providers may only advertise a “weight-loss service” or “consultation,” and may not refer explicitly to prescription medications outside of a consultation context.
Even then, pricing details must be carefully positioned away from a homepage to avoid encouraging consumers to choose a product based on discounts.
Regulators say a growing number of online providers have flouted these rules, sometimes boldly.
Investigations by the Medicines and Healthcare products Regulatory Agency (MHRA) reveal that dozens of websites and online pharmacies are using discount codes, multibuy deals, and promotional content that showcase brand names and imagery of weight-loss injections.
In response, the MHRA regularly sends letters to reprimand these firms, reminding them that eligibility for weight-loss medication must be determined by a qualified professional.
“While technically not direct-to-consumer drug advertising, the distinction is lost on most consumers,” observes Oksana Pyzik, Associate Professor of Pharmacy Practice and Policy at University College London’s School of Pharmacy.
“Patients see ‘weight-loss jab deal’ and interpret these promotions as discount offers for Wegovy or Mounjaro, which effectively sidestep regulations and put profit above patient safety.”
## The Rise of ‘Service’ Advertisements
A common workaround has emerged in the form of marketing a “weight-loss service,” or offering deals on “consultations,” rather than overtly promoting medications.
However, critics say that many of these offerings feature high-profile images of jabs and reference the specific brands in close proximity to discounted prices.
Superdrug Online Doctor, for instance, recently ran a webpage advertising a 33% discount on its weight-loss service—while listing the costs of prescription-only weight-loss jabs (Wegovy and Mounjaro) below.
A spokesperson for Superdrug said it complies fully with ASA guidance, insisting that the code covers the overall medical consultation rather than the cost of any specific medication.
But some industry professionals remain unconvinced.
“Pharmacies should not create or use discount codes for prescription-only medicines,” says Roz Gittins, Chief Pharmacy Officer at the General Pharmaceutical Council (GPhC).
“This includes the creation of codes for use in advertising, including on social media.” The GPhC also stresses that the final prescribing decision—particularly for weight-loss injections—must hinge on patient history, clinical appropriateness, and professional judgement.
## Regulatory Tensions and Loopholes
When the MHRA does intervene, its enforcement often relies on contacting violators and urging voluntary compliance.
Though it has the legal ability to impose fines and pursue criminal charges, the agency says it has not yet been required to use these statutory powers, as most companies amend their advertisements after being contacted.
Since 2019, the number of MHRA complaints involving POM advertising specifically for weight loss has escalated from zero, to four in 2020, to at least 27 breaches in 2023 alone.
According to the agency, not a month has gone by since April 2023 without a website being asked to amend or remove content that contravenes the regulations.
Julian Beach, MHRA’s interim Executive Director of Healthcare Quality and Access, acknowledges these concerns.
“We take complaints about the illegal promotion of prescription weight-loss medicines to the public very seriously,” he says.
“Where appropriate, we work with other regulators.
A failure to comply with these rules can result in fines or even imprisonment.”
## Mounting Pressure for Clearer Rules
Critics argue that inconsistent enforcement makes it easier for some providers to operate in grey areas.
Dr Piotr Ozieranski, Reader in the Department of Social and Policy Sciences at the University of Bath, believes a more proactive approach is needed: “The current system is based on reputational damage, naming and shaming, rather than significant financial penalties or legal action.
In the US, regulators impose large fines and act more adversarially to deter unethical practices.”
The ASA acknowledges the growing problem, announcing that it plans to launch at least eight investigations into questionable weight-loss jab advertisements—some involving the use of discount offers—in a bid to establish clearer precedents.
The Committee of Advertising Practice (CAP) also issued an enforcement notice in 2021 focusing on prescription-only weight-loss treatments.
Yet, as the market for Wegovy, Mounjaro, and similar medications continues to balloon, experts warn that these measures may not go far enough.
“The line between promoting health services and selling prescription drugs has grown blurry,” says Pyzik.
“We need an updated regulatory strategy that addresses these marketing tactics more directly and, ultimately, keeps patient well-being front and centre.”
## Upholding Professional Standards
Novo Nordisk, whose medicines are heavily in demand, states that it does not condone direct promotion of its prescription-only drugs.
“We make providers aware of their legal obligations, including regulation around the promotion of POMs. When we are made aware of providers promoting our medicines to the public, we address this with them directly and, in many cases, report them to relevant authorities,” the company says.
Ultimately, the weight-loss medication boom in the UK may bring transformational benefits to many struggling with obesity.
Yet as the incentives to sell these products intensify, the tension between industry growth and consumer safeguards seems likely to heighten.
Regulators have vowed to crack down on those breaching the rules, but as experts warn, meaningful progress will require not only robust enforcement, but also clarity in how ‘services’ and ‘consultations’ are marketed.
For now, Britain’s appetite for weight-loss jabs continues to expand, in what some describe as an increasingly volatile marketplace.
