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Ozempic ads seem to be everywhere, doctors and ethics experts are worried

Increased attention on diabetes drug turned weight loss treatment has watchdogs on alert
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An advertisement for Ozempic is seen on a billboard in Toronto on Friday, June 16, 2023. THE CANADIAN PRESS/Cole Burston

With ads popping up on TV, social media, giant billboards and at professional sports games, Canadians may be feeling bombarded by marketing for Ozempic and sister drug Rybelsus.

Some have taken to social media to document their most remarkable sightings, including Ozempic and Rybelsus ads wrapping entire streetcars and encircling the field at Toronto Blue Jays baseball games.

Both medications are semaglutide drugs manufactured by Novo Nordisk B次元官网网址 Ozempic is the injectable form and Rybelsus is the pill form. TheyB次元官网网址檙e approved in Canada for treating Type 2 diabetes and often prescribed off-label to treat obesity.

But some doctors and medical ethics experts say the marketing campaign is too aggressive. They worry that such intense saturation of advertising could lead to pressure on doctors to prescribe Ozempic to patients who donB次元官网网址檛 actually need it, leading to shortages for those who do.

They also worry that serious potential side-effects such as pancreatitis and gallbladder inflammation, although rare, could start to appear due to the sheer volume of people taking the drug.

B次元官网网址淲hat the (company is) trying to do is to put the ads in so many places that itB次元官网网址檚 very difficult to avoid seeing them,B次元官网网址 said Dr. Joel Lexchin, a professor emeritus at York University who studies pharmaceutical policy.

Health Canada allows pharmaceutical companies to run B次元官网网址渞eminder ads,B次元官网网址 Lexchin said. Advertisements can say the name of the drug but they canB次元官网网址檛 say what conditions it treats. Instead, they urge people to ask their doctors about the drug.

Kate Hanna, a spokeswoman for Novo NordiskB次元官网网址檚 Canadian arm, told The Canadian Press on Monday that the national marketing campaign is aimed at people with Type 2 diabetes.

B次元官网网址淒iabetes is not being effectively managed and this is not a niche market. Diabetes is a public health crisis,B次元官网网址 Hanna said.

B次元官网网址淭here really is a need to educate Canadians on Type 2 diabetes risk and support those living with the condition to engage their health-care professional for optimal disease care.B次元官网网址

But themarketing influx comes on the heels of an explosion of unofficial Ozempic promotion for weight loss from social media influencers and celebrities. Canadian doctors and pharmacists have already confirmed an enormous increase in patients asking for the drug for that purpose.

The ever-present reminder ads are likely to prompt more people wanting to lose weight to put pressure on their doctors to prescribe Ozempic, even though they donB次元官网网址檛 have diabetes or meet the clinical criteria for obesity, Lexchin said.

B次元官网网址淚tB次元官网网址檚 not approved for treating somebody who wants to lose 10 or 15 pounds so that they can fit into a bathing suit or a tuxedo or what have you. But the ads that youB次元官网网址檙e seeing donB次元官网网址檛 tell you that,B次元官网网址 he said.

B次元官网网址淵ouB次元官网网址檝e tried to lose weight, you figure if you can get from 180 to 160 (pounds) youB次元官网网址檒l be in much better shape,B次元官网网址 Lexchin said. B次元官网网址淵ou see one of these ads and you go see your doctor. And thatB次元官网网址檚 what this kind of advertising is designed to do.B次元官网网址

Even diabetes and obesity specialists who praise Ozempic for its effectiveness in treating those conditions are worried about Novo NordiskB次元官网网址檚 marketing strategy.

B次元官网网址淚B次元官网网址檓 not impressed,B次元官网网址 said Dr. Ehud Ur, an endocrinologist at St. PaulB次元官网网址檚 Hospital and Vancouver General Hospital.

Ur noted that he has been involved with Novo Nordisk for B次元官网网址渕any different drugsB次元官网网址 and that heB次元官网网址檚 personally found the companyB次元官网网址檚 practices to be ethical.

But B次元官网网址渢he push to get everybody and their dog on OzempicB次元官网网址 is problematic, he said.

B次元官网网址淲eB次元官网网址檝e never had a drug as good as Ozempic. But on the other hand weB次元官网网址檝e never had so much interest and so much pressure on people to prescribe it,B次元官网网址 Ur said.

Like with all prescribed medications, doctors need to do a risk versus benefit assessment, he said.

According to the manufacturerB次元官网网址檚 website, minor side-effects include nausea, vomiting, diarrhea, constipation and abdominal pain. More serious but rare risks include inflammation of the pancreas, gallbladder problems, kidney issues and low blood sugar. Animal studies found an association between Ozempic and thyroid tumours in rats, but itB次元官网网址檚 not clear whether thatB次元官网网址檚 a real risk in humans.

For someone with diabetes or obesity, the risks of not getting effective treatment often outweigh the rare potential risks associated with Ozempic, Ur said.

But for someone who wants to lose 10 to 20 pounds for B次元官网网址渃osmeticB次元官网网址 reasons, the medical benefit may not be worth the risk.

B次元官网网址淲here you are placed in that continuum of risk is really an important calculation for a physician,B次元官网网址 Ur said.

The problem with the mass Ozempic advertising campaign is that it cultivates an impression among people that itB次元官网网址檚 a B次元官网网址渨onder drug thatB次元官网网址檚 going to help them lose weight,B次元官网网址 he said.

If they convince their doctor to prescribe it, those patients B次元官网网址渁re now going to expose themselves to the risk of a medical intervention without a huge amount of medical benefit.B次元官网网址

Huge demand for Ozempic could also create shortages for patients who rely on it for diabetes control, Ur said, noting he has patients who have already had trouble with the drug being on back order.

When asked to respond to that concern, Hanna of Novo Nordisk said the company is B次元官网网址渞amping up our production to meet the demands.B次元官网网址 She also said there are no current shortages in Canada.

Another issue, Ur said, is that mathematically, the more people who take the drug, the more likely it is that someone will suffer one of the rare side-effects.

B次元官网网址淚 think ultimately (Novo Nordisk) may be shooting themselves in the foot by this strategy,B次元官网网址 Ur said.

Despite the criticisms, the companyB次元官网网址檚 Ozempic marketing campaign complies with Canadian law, Health Canada said in an email on Monday.

B次元官网网址淭o date, (Health Canada) has assessed 30 complaints. The current advertisements of Ozempic that have been reviewed are deemed compliant with the current advertising provisions in Canada,B次元官网网址 the email said.

Both Lexchin and Ur said Canada should not allow any direct-to-consumer advertising for prescription drugs, similar to regulations in the U.K. and Europe.

Kerry Bowman, a bioethicist at the University of Toronto, said he finds the companyB次元官网网址檚 advertising blitz B次元官网网址渄isturbing.B次元官网网址

B次元官网网址淭heyB次元官网网址檙e taking advantage of Canadian law because theyB次元官网网址檙e staying within the parameters of it, but not the spirit of it because, you know, the saturation of these ads is incredible,B次元官网网址 Bowman said.

B次元官网网址淭his is not about public health, this is not about well-being. This is about marketing and it is very, very much for profit. And so thereB次元官网网址檚 no question about that.B次元官网网址

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