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Irish Times
3 days ago
- Business
- Irish Times
Should the maker of Ozempic be funding children's playgrounds in Ireland?
Last Monday Taoiseach Micheál Martin posted on social media about his delight at attending the unveiling of a primary school's new playground equipment that is 'part of Novo Nordisk Ireland's ongoing Play at Primary School Initiative'. The initiative by the manufacturer of Ozempic and Wegovy involved providing nine Deis schools with equipment, with plans to expand to more schools during 2025. On the face of it, new playground equipment seems a commendable and worthwhile initiative. But the question has to be asked: what's in it for Novo Nordisk, which has a track record in sophisticated public relations campaigning? Fundamentally, there are potential ethical considerations with any company or industry paying for children's playground equipment. But Novo Nordisk deserves additional scrutiny given its marketing practices. READ MORE In 2023, the Danish drug manufacturer was suspended by its own industry body in the UK for two years over its sponsorship of weight management courses for health professionals. This is the most severe punishment that the Association of the British Pharmaceutical Industry has issued and was only the eighth occasion in the past 40 years the ABPI board has issued such a significant sanction. It led to the Royal College of Physicians and the Royal College of General Practitioners ending their partnerships with Novo Nordisk. The suspension occurred because Novo Nordisk paid for a 'large scale Saxenda [a weight-loss drug] promotional campaign […] which was disguised' and included 'heavily biased' information. The ruling outlined 'serious concerns about Novo Nordisk's culture' and raised further concerns about Novo Nordisk at the global level. In March 2025, the ABPI voted to readmit Novo Nordisk as a full member on the basis that it 'now had the systems and culture in place' to resume self-regulation. But Novo Nordisk was since found to be in breach of UK marketing regulations on several more occasions . In Ireland, issues have also emerged. Through a freedom of information request, I obtained an inspection report by the medicines watchdog, the HPRA, of Novo Nordisk's advertising-related activities for the period January 2021 to May 2023. My findings that the pharma company broke rules around the advertising and marketing of its medication to healthcare workers over three years were reported in The Irish Times on Friday. The HPRA found 'a significant number of non-compliances' with Novo Nordisk's advertising and 'educational' activities. [ Maker of Ozempic and Wegovy broke advertising rules, regulator finds Opens in new window ] They outlined that the 'level of control and governance that was in place for educational activities, promotional and non-promotional meetings with healthcare professionals, advisory boards and medicinal product advertising were deficient'. Issues outlined included presentations to healthcare professionals that were 'unbalanced' in nature. It also found the omission of important and legally required drug information relating to adverse reactions, precautions and contraindications in materials intended for use with patients and in a promotion to healthcare professionals. A teaching guide intended for use with patients included advertising for a prescription-only product, which is not legally permitted. The HPRA also observed compliances with requirements. In response to the HPRA review, Novo Nordisk outlined a range of procedural changes. This includes extensive reviews of slides presented by third parties for work affiliated to Novo Nordisk; the removal of materials in breach of regulations; updates to internal guidance; and the introduction of relevant training processes. A spokeswoman told The Irish Times that the company 'addressed the findings to ensure compliance with industry regulation and this was completed to the HPRA's satisfaction immediately following the inspection' and that its focus 'remains on meeting the needs of patients, healthcare professionals and partners'. Between 2016 and 2023, Novo Nordisk has reported making payments valued at over €6.6 million to healthcare organisations, a patient organisation and healthcare professionals, based on my analysis of Novo Nordisk's disclosures on – the pharmaceutical industry's record of direct or indirect financial support or 'transfers of value' to healthcare professionals – and the disclosures of patient organisation payments Novo Nordisk makes on its website. It's not clear whether this is the full picture: research I was involved with has highlighted significant shortcomings with the Irish payment declaration system. In the UK, Novo Nordisk has been found to be underreporting payments to the value of almost £8 million (€9.5 million) to 150 doctors, patients, journalists and healthcare organisations. One might ask why €6.6 million in payments to individuals and organisations in our health system would be problematic? The pharmaceutical industry describes these payments as being for education, research and healthcare. But payments such as these have well-recorded effects on prescribing practices, and are linked to recipient organisations favouring the positions of the funder. Novo Nordisk has made payments to help set up patient organisations, to pay senior decision makers in the Irish health system consultancy fees, and to help fund clinical guidelines on obesity in Ireland. Guidelines and patient organisations are important endeavours, but there are valid concerns about industry funding, as international evidence shows that it can influence important organisations and initiatives. When it comes to Novo Nordisk paying senior health system decision makers as consultants, significant scrutiny is necessary given the influence they have over our health system. Nothing here is intended to question the benefits of Novo Nordisk's approved medicines – if a medicine is approved for use in Ireland then the evidence shows that it meets the required standards for benefits and risk. What we should question is whether the drug maker's marketing efforts are affecting the decision making of our politicians, policymakers, prescribers and healthcare organisations. These decisions should be based on evidence only, not who has paid for our playgrounds, our conferences or our lunches. Novo Nordisk is applying to the State to reimburse its weight loss drugs for a much larger group of people. This decision has the potential to put unprecedented pressure on the State's health budget, potentially more than doubling state expenditure on medicines to €10 billion. The drugs are so expensive that US researchers have suggested it would be less expensive for the United States to just buy Novo Nordisk than to reimburse its weight loss drugs. There's a reason that the College of Psychiatrists of Ireland ended pharmaceutical industry partnerships in 2010 and the Irish College of General Practitioners last year voted to phase out pharmaceutical industry partnerships. It's because, as the College of Psychiatrists put it, the college's aims do not always align with the industry's aims and there is a need for the college to be able to provide 'independent appraisal of the value of specific drugs'. Our health and education systems struggle for funding for important initiatives. Pharmaceutical companies and other industries sometimes step into this void. But we need to ask if there are hidden costs to this funding, costs that may not be worth paying for. James Larkin is a senior postdoctoral fellow in the department of General Practice at RCSI
BBC News
16-05-2025
- Health
- BBC News
'No compensation route' for Jersey rheumatology patients
Jersey's health department has said there is no compensation route available to patients of the island's rheumatology service, after an independent report found serious failings.A "significant number" of patients are said by lawyers to be seeking legal some cases, patients were wrongly diagnosed and got the wrong medication. The report was conducted after the deaths of 182 rheumatology patients in Jersey since health department said it had been looking into a compensation scheme but no such route was currently available and it had advised anyone wishing to make a claim to contact the Citizens Advice Bureau. A Royal College of Physicians report found the standard of care provided by the service in 2023 to be "well below" an acceptable April 2024, Deputy Tom Binet, minister for health and social services, said he was committed to publishing an action plan by the end of June that year to ensure the completion of recommendations included within the Jonathan Renouf has since tabled a written question to the States, requesting an update and asking if the department was still considering a group compensation department said it had been exploring the possibility of a compensation scheme in relation to rheumatology complaints and claims, but "currently there is no such route available". "Patients and relatives are being advised to seek independent on-Island legal advice should they wish to consider making a claim," the department response went on to say that Citizens Advice Jersey might be able to provide further information on how to do health department said 12 of the recommendations made in the review had now been implemented, with a further five nearing were four outstanding recommendations that still needed to be actioned, including a full rollout of electronic prescribing and medicines administration across all outpatient licensing and full functionality of this was dependent on future funding and digital service capacity and "this remains a strategic priority for 2026", the response added. A spokesperson for Viberts law firm, which represents a "significant number" of patients, said: "This news has been disappointing and continues our concern that individuals may be effectively prohibited from obtaining compensation which we do not consider is a just or fair position."Where this affects our clients or people that have made inquiries with Viberts we will be considering alternative action on a case-by-case basis."Viberts remained committed to assisting individuals with claims through the standard Royal Court process, they added. Analysis By Ammar Ebrahim, BBC Jersey political reporter The news that there won't be a compensation scheme will come as a huge blow to those impacted by failings in patient who was given wrong medication that damaged her liver told me that "having them insist that those affected go to the expense of suing them is denying those who cant afford to do that any recourse. It adds insult to injury".What will make this more uncomfortable for the government is that the law firm representing some of the people impacted by the failings in rheumatology say this decision is neither "just or fair".Health leaders have said rheumatology is a different department now but for those patients who have found out a compensation scheme is no longer an option, that will be of little comfort.
Telegraph
16-05-2025
- Health
- Telegraph
Medics criticise assisted dying Bill ahead of MP debate
Another leading medical body has raised concerns about the risks of the assisted dying Bill 'failing to protect vulnerable patients' as the landmark legislation returns to Parliament today. The Royal College of Physicians said it believed there were 'concerning deficiencies' with the proposed Bill as it stands. Its statement followed one earlier this week from the Royal College of Psychiatrists which said it had 'serious concerns' and could not support the Bill in its current form. The Terminally Ill Adults (End of Life) Bill, which relates to England and Wales, returns to the House of Commons today for the first time since MPs supported the legislation in principle back in November. The legislation was backed by 330 votes to 275 at second reading and MPs are now going to debate and vote on amendments during its report stage which is expected to run into a second day next month ahead of a crunch final vote. The Government is neutral on the Bill, which was tabled by Labour MP Kim Leadbeater, and any votes MPs make are according to their own conscience rather than along party lines. It is far from certain that the Bill will make it onto the statute book, with all eyes currently on how many MPs could change their minds on the issue.
Daily Mail
16-05-2025
- Health
- Daily Mail
Doctors join chorus of opposition to assisted dying law with warning over 'concerning deficiencies' in legislation as it returns to Commons
Doctors have become the latest professionals to voice their concern about plans to legalise assisted dying, as the legislation returns to the Commons. The Royal College of Physicians (RCP) has said it believes there are 'concerning deficiencies' with the proposed Terminally Ill Adults (End of Life) Bill. Its intervention came after the Royal College of Psychiatrists (RCPsych) said it has 'serious concerns' and cannot support it. MPs will take part in a five-hour session today during which various amendments to the law will be debated and voted on. But the final vote on whether to bring it into law has been delayed until late next month due to the amount of changes that are wanted. Concerns have been raised over the speed at which the law is being taken through and fears over safeguards for vulnerable people. Several MPs who backed it in an initial vote in November have now said they will oppose it. But PM Sir Keir Starmer, who will miss the votes on a trip to Albania, has indicated he remains supportive of the proposed legislation. And TV presenter Dame Esther Rantzen, credited for her efforts in bringing the conversation on assisted dying to the fore in recent years, said she remains a strong backer of the Bill. New Reform MP Sarah Pochin has also confirmed she will support it, while Nigel Farage is opposed. Last night the Mail revealed the Government had quietly admitted it had got key figures related to the legislation wrong. On the eve of the controversial legislation returning to Parliament, the official forecast of how many people are likely to seek to end their own lives was corrected – but MPs were not alerted. The final page of the Impact Assessment carried out by the Department of Health and Ministry of Justice, which was controversially published late on the day of the local election results, was updated to state: 'Since publication on 02 May 2025, two errors have been identified and corrected.' It explained that the wrong period of time was used to collate figures of recent assisted deaths in Oregon and so the prediction for England and Wales was incorrect. Under the revised figures, up to 647 deaths are expected in the first half-year of the scheme rather than 787 and 1,078 applicants are expected instead of 1,311. Campaigners told the Mail the that error highlighted the 'chaotic' nature of the legislation, which is being led by backbench Labour MP Kim Leadbeater in a Private Members' Bill rather than by the Government. She has repeatedly made major changes to the plan, such as removing the role of High Court judges to approve applications, and has continued to table amendments to it until this week. In their position statement on Thursday, the RCP said despite changes to the Bill in recent months which supporters argue have strengthened it, the college believes 'there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals'. It said there are 'key factors' which must be in place should assisted dying be legalised. But MPs with a medical background have urged a law change. A statement, signed by supportive MPs including doctors Neil Shastri-Hurst, Simon Opher and Peter Prinsley, insisted 'most healthcare professionals understand that the current law is not working', that it 'criminalises compassion', places clinicians 'in an impossible position' and cannot be tolerated or defended. Expressing continued hope that her Bill can keep making progress through Parliament, Labour MP Ms Leadbeater said proceedings in the Commons will be watched by terminally ill people and bereaved family members 'who are counting on us to make our law better, safer and kinder – not just for them but for all of us, whatever we might choose'. In a comment piece in the Mirror newspaper, she said: 'We are closer than ever to achieving the change the British public have long been calling for.' She insisted the Bill is 'even stronger' than it was back in November, and 'goes further than any other around the world in its safeguards, oversight and regulation'. Assisted dying law change - key points: What is being proposed? The proposed legislation would allow terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death. This would be subject to approval by two doctors and a panel featuring a social worker, senior legal figure and psychiatrist. The terminally ill person would take an approved substance, provided by a doctor but administered only by the person themselves. When would it come into effect? The implementation period has been doubled to a maximum of four years from royal assent, rather than the initially-suggested two years. If the Bill was to pass later this year that would mean it might not be until 2029, potentially coinciding with the end of this Government's parliament, that assisted dying was being offered. The extended implementation period was one of a number of changes made since the Bill was first introduced to the Commons back in October. What other changes have there been? The plan to have a High Court judge sign off cases has been dropped and replaced by expert panels. It is a change much-criticised by opponents who said it weakened the Bill. Changes were also made to ensure the establishment of independent advocates to support people with learning disabilities, autism or mental health conditions and to set up a disability advisory board to advise on legal implementation and impact on disabled people. How many are expected to use it? A Government impact assessment published earlier this month, estimated that between 164 and 787 assisted deaths could potentially take place in the first year of the service, rising to between 1,042 and 4,559 in year 10. What will is cost? The establishment of a Voluntary Assisted Dying Commissioner and three-member expert panels would cost an estimated average of between £10.9 million to £13.6 million per year, the document said. It had 'not been possible' to estimate the overall implementation costs at this stage of the process, it added. While noting that cutting end-of-life care costs 'is not stated as an objective of the policy', the assessment estimated that such costs could be reduced by as much as an estimated £10 million in the first year and almost £60 million after 10 years. Do medical staff have to take part? It was already the case that doctors would not have to take part, but Ms Leadbeater has also confirmed she will propose a clause to ensure 'anybody who does not want to be involved in the assisted dying process should not be forced to do so', meaning pharmacists and others will have the right not to participate. What about the rest of the British Isles? The Isle of Man looks likely to become the first part of the British Isles to legalise assisted dying, after its proposed legislation passed through a final vote of the parliament's upper chamber in March. In what was hailed a 'landmark moment', members of the Scottish Parliament (MSPs) on Tuesday voted in favour of the Assisted Dying for Terminally Ill Adults (Scotland) Bill, backing its general principles. It will now go forward for further scrutiny and amendments but will only become law if MSPs approve it in a final vote, which should take place later this year. Any move to legalise assisted dying in Northern Ireland would have to be passed by politicians in the devolved Assembly at Stormont. Jersey's parliament is expected to debate a draft law for an assisted dying service on the island for terminally ill people later this year.
The Independent
15-05-2025
- Health
- The Independent
MP behind assisted dying Bill defends it as medical body adds voice of concern
The MP behind the assisted dying Bill has defended it as another leading medical body raised concerns about the risks of it 'failing to protect vulnerable patients'. The Royal College of Physicians (RCP) said it believes there are 'concerning deficiencies' with the proposed legislation as it stands. Its statement follows one earlier this week from the Royal College of Psychiatrists (RCPsych), which said it has 'serious concerns' and cannot support the Bill in its current form. That statement was branded by one opponent of the Bill as a 'blow to its foundations'. Kim Leadbeater, the Labour MP behind the Bill, said it was coming back 'even stronger' when it returns to the House of Commons on Friday for the first time since a historic yes vote in November. She said the Terminally Ill Adults (End of Life) Bill, which relates to England and Wales, goes 'further than any other around the world in its safeguards, oversight and regulation' and that the Government's impact assessment has confirmed this. 'The law as it stands is not working for dying people or their loved ones; that much is clear,' Ms Leadbeater wrote in The Mirror. 'A majority of MPs recognised this when they backed my Bill in November. 'When they come to debate it once again today, they can be confident that it returns even stronger.' Prime Minister Sir Keir Starmer, who voted for the Bill last year, has indicated he remains supportive of the proposed legislation and that it has 'sufficient time' in Parliament amid claims from some it is being rushed through. In a boost for the Bill, new Reform MP Sarah Pochin has confirmed she will support it. Mike Amesbury, who she replaced in the Runcorn and Helsby constituency earlier this month, had voted no last year. Reports speculating on the numbers of MPs who had supported the Bill last year but are now considering voting against it have been dismissed by the Bill's backers who reject the idea the proposed legislation is at risk of collapse. But the RCPsych statement prompted MPs, some with medical and clinical backgrounds, who back the Bill, to urge their colleagues in Parliament to support it. A statement, signed by supportive MPs including doctors Neil Shastri-Hurst, Simon Opher and Peter Prinsley, insisted 'most healthcare professionals understand that the current law is not working', that it 'criminalises compassion', places clinicians 'in an impossible position' and cannot be tolerated or defended. In their position statement on Thursday, the RCP said despite changes to the Bill in recent months which supporters argue have strengthened it, the college believes 'there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals'. It said there are 'key factors' which must be in place should assisted dying be legalised. These include decisions around a patient's prognosis to be informed by 'expert clinical professionals including those who know the patient', decisions on capacity, and safeguards around coercion to be informed by face-to-face assessments of 'relevant and appropriately skilled health and care professionals', regulations of medicines and a guarantee resources will not be diverted from other end-of-life care. Their concerns follow those from RCPsych which said it has 'unanswered questions' about the safeguarding of people with mental illness, and warned of a shortage of consultant psychiatrists to meet the demands of the Bill. Both colleges said they remain neutral on the principle of assisted dying. The RCP's clinical vice president, Dr John Dean, said: 'The ultimate decision on assisted dying rests with society through Parliament, but professional and clinical issues are integral to legislation, regulation, guidance and safe and effective implementation. 'Our members and fellows who we represent have a wide range of views on assisted dying. While the RCP neither supports or opposes a change in the law on this matter, the Bill in its current form has concerning deficiencies. 'Notably, the proposed mechanisms of decision making are not in line with good clinical and professional practice. Further statutory guidance is also required to ensure effective regulation of drugs, providers, and the involvement of clinicians. 'Parliament must address these critical issues in the legislation or risk failing to protect vulnerable patients and uphold the integrity of clinical practice.' The chairwoman of the Royal College of GPs, Professor Kamila Hawthorne, also told the BBC this week that doctors have 'real concerns about the practical and legal implications of a change in the law on assisted dying', which she said 'must be acknowledged and addressed, so that any legislation is watertight'. Speaking during a visit to Albania, Sir Keir was asked if his views on assisted dying had changed during the passage of the Bill. He told broadcasters: 'My views have been consistent throughout.' In a later interview he reiterated the Government's neutrality on the Bill and said it was facing 'a lot of scrutiny, both inside Parliament and outside Parliament', adding that he was 'satisfied' it had 'sufficient time' in Parliament. Some opponents have claimed proposals are being rushed through as a private member's bill and that it has not had the same level of scrutiny had it been a Government Bill. Dozens of amendments have been tabled and many could be debated and voted on during a five-hour sitting in the Commons on Friday. It is not yet clear whether time will allow for a third reading vote, with the possibility that the report stage could instead run into a second day next month because of the large number of further amendments proposed. As it stands, the Bill would allow only terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death – subject to approval by two doctors and the three-member expert panel featuring a psychiatrist, social worker and senior legal figure. Ms Leadbeater has defended the scrapping of the High Court judge safeguard which has been replaced by the expert panel. She told LBC Radio this was a 'more holistic approach, a more patient-centred approach' and is 'much, much stronger' as a result.
