Obesity, politics, money and a company called Novo Nordisk

In April this year, a landmark study, supervised by world-leading obesity specialists, was unveiled by the grandly titled World Obesity Federation addressing a question that’s created waves throughout the medical world: is obesity a disease? 

The study surveyed more than 14,000 patients and around 3000 doctors from a dozen different countries. Released amid the pomp at the European Congress on Obesity in Glasgow, the study purported to show that 68% of patients and 88% of doctors consider obesity to be a “chronic disease”.

So who’s on the expert committee for the study? And, crucially, what is its relationship with a $164 billion Danish pharmaceutical company called Novo Nordisk?

Here are some clues:

• The study was funded by Novo Nordisk.
• Novo Nordisk arranged for specialist medical communicators to write the survey report.
• The 17 members of the study’s steering committee included eminent specialists associated with the World Obesity Federation. All were paid by Novo Nordisk — and 10 of the specialists had already been paid by Novo Nordisk for other work.
• Three panel members were Novo Nordisk employees and two of them held shares in the company.
• Novo Nordisk was lead sponsor of the European Congress which showcased the research.
• Novo Nordisk provides significant financial support to the World Obesity Federation.

Welcome to the conflicted world of obesity politics, obesity jargon and obesity economics. And welcome to the world of Novo Nordisk, a huge multinational Danish-headquartered pharmaceutical corporation with a hunger to change the way Australians think about obesity and an appetite to convince the Australian government that obesity is a disease that should be treated by a taxpayer-subsidised drug.

And for whoever finally cracks the obesity drug market, a fortune awaits. Almost a third of Australians are classified as obese with that number set to grow as we become obese at a younger age.

No one can put an exact figure on the value of the market, but the amount of money tied up in cardiovascular medicines is a decent guide. A 2017 federal government study calculated that 100 million prescriptions were issued to treat cholesterol, hypertension and cardiac heart disease. Total value? $1.8 billion (with taxpayers subsidising that to the tune of $1.3 billion through the Pharmaceutical Benefits Scheme).

Enter Novo Nordisk, historically a world leader in the treatment of diabetes with the scientific credentials and medical contacts that translate easily to the world of obesity. It’s also a company that knows how to build a market.

According to the most recent federal government figures, 28% of adults in Australia are classified as obese, meaning they have a BMI of 30 or greater. This is roughly 6.8 million people.

If only one in 10 of those people took Novo Nordisk’s obesity drug Saxenda, at a cost of $400 a month, the company stands to make $272 million a month or $3.2 billion a year. It’s a back-of-the-envelope calculation but it gives you an idea of the sums at stake.

Novo Nordisk isn’t the only company with its eyes on the obesity prize. Roche and iNova are among other big pharma companies working on solutions. But Novo Nordisk has made its intention clear: to dominate the market.

If the company can get it right with an obesity drug, if it can convince doctors to back its product and if it can get governments on board with taxpayer subsidies then there is a fortune to be made.

As Inq has discovered, these are the precise steps the company is taking. A company presentation we’ve unearthed is utterly candid about its strategy.

The company is setting out to “create legitimacy and urgency” for “the medical management of obesity” and it wants to “grow and evolve that medical management”.

The presentation states in bold typeface that while obesity is a national health priority it is “not recognised as a chronic disease”.

It argues that there is “significant unmet medical educational need”. It points out that weight loss management is largely “unreimbursed”. Its fix is to “generate and disseminate evidence” to, again, further the recognition of obesity as a chronic disease.

Inq’s investigation shines a light on just how the Novo Nordisk company is setting out to build a market for its drugs. The company has enmeshed itself in the public discussion on obesity. It has worked assiduously to change public perceptions of the obese. It has funded reports that paint a dire picture of obesity’s impact on society and its cost to nations. The company is a prolific funder of academics and obesity specialists, and it gives money to cash-strapped anti-obesity organisations. Yet ultimately it wants to sell more drugs.

Science. Drugs. Profit. It’s a potent cocktail — a potentially dangerous one for medical professionals.

Tomorrow: What’s in a word?