Novo Nordisk

Novo Nordisk is a global healthcare company focused on the discovery, development, manufacturing and marketing of pharmaceutical products for the treatment of diabetes, obesity and haemophilia. Within the company’s diabetes and obesity segment it concentrates on insulin, GLP-1 and other protein-related products as well as delivery systems and needles and oral anti-diabetic drugs. Within the biopharmaceuticals segment, it covers haemophilia care, growth hormone therapy and hormone replacement therapy.

Topic: Customer Health and Safety.

Our objective: Limiting material negative social or environmental impacts.

Company objective: Address off-label GLP-1 use, specifically for cosmetic purposes.

Desired outcome: Ensure Novo Nordisk understands its ability to manage the off-label cosmetic use of GLP-1s, safeguard patient safety, and maintain regulatory compliance and  protect the company’s reputation.

Background: In 2021, Novo Nordisk launched Wegovy, a revolutionary weight-loss drug based on a specific GLP-1 (Glucagon-Like Peptide-1) hormone called semaglutide. Derived from the gut, semaglutide sends satiety signals to the brain, whilst stimulating the secretion of insulin to lower blood sugar levels. Whilst other GLP-1s are available, Wegovy has been applauded for its superior effectiveness in treating obesity, as well as the numerous related co-morbidities.

There is no question that the proper use of these drugs, for those with obesity or related health conditions such as diabetes, can significantly enhance health and extend lifespan when used as part of a comprehensive treatment plan. However, concerns have been raised about the impacts of “off-label use” of GLP-1s, often by non-obese individuals seeking cosmetic weight loss. This can result in shortages, impacting affordability and exposes users to potentially serious adverse side effects unnecessarily. 

The implications of whether pharmaceutical companies can or should be held responsible for the potentially serious social risks associated with GLP-1s is a serious matter for their investors. 

Activity: In late 2024, we raised concerns with Novo Nordisk’s IR regarding the social risks of off-label GLP-1 use. The goal was to understand the company’s approach to mitigating these risks.

Engagement outcome: 

M2 - company shares or agrees to disclose information on the issue 

Novo Nordisk has demonstrated a proactive and responsible approach to managing potential ESG risks associated with its GLP-1 medications. The company provides robust data and prioritises educating healthcare practitioners to ensure prescriptions align with approved labelling. For example:

• Educating healthcare professionals to ensure proper prescription.
• Preventing misuse through clear communication with healthcare providers.
• Adhering to regulatory standards in advertising and marketing.
• Transparency around common side effects and the long-term safety of GLP-1s.

This comprehensive approach underscores Novo Nordisk’s commitment to responsible marketing, patient safety, and regulatory compliance, ensuring these transformative medications are used appropriately to address significant global health challenges. We nonetheless continue to monitor Novo Nordisk’s approach to this issue as off-label use of GLP-1s remains an area of concern.