AUTH/3421/11/20 - Complainant v Novartis

Alleged promotion of Cosentyx on LinkedIn

  • Received
    13 November 2020
  • Case number
    AUTH/3421/11/20
  • Applicable Code year
    2019
  • Completed
    22 July 2021
  • No breach Clause(s)
  • Breach Clause(s)
  • Sanctions applied
    Undertaking received
  • Additional sanctions
  • Appeal
    Respondent appeal

Case Summary

A complainant who described him/herself as a concerned UK health professional, complained about the promotion of Cosentyx (secukinumab) by Novartis Pharmaceuticals UK on LinkedIn.

Cosentyx was indicated for certain patients with plaque psoriasis, psoriatic arthritis or axial spondyloarthritis.

The complainant provided a screenshot of a named Novartis employee’s LinkedIn profile which stated that he/she had ‘liked’ a news story that mentioned Novartis. The information on the employee’s profile featured the Novartis corporate logo and the statement ‘Novartis’ Cosentyx reduces synovitis in new psoriatic arthritis study’. The post appeared to be linked to a Pharma Times article, but a copy of the article was not provided by either party.

The complainant noted that information regarding Cosentyx appeared on LinkedIn and had been ‘liked’ by a member of the medical staff at Novartis.

The complainant noted that this was not the first time that staff at Novartis had undertaken this activity and, in that regard, he/she referred to Case AUTH/3038/4/18.

The complainant stated that there was no evidence that the LinkedIn post had been certified, there was no mention of the generic name and the post promoted to the public. The complainant alleged a breach of undertaking which surely demonstrated both a failure to maintain high standards and brought discredit to the industry (Clause 2).

The detailed response from Novartis is given below.

The Panel noted Novartis’ submission that its employee ‘liked’ the Pharma Times post which mentioned a Novartis medicine and an indication entirely of his/her own volition using his/her own LinkedIn account; the employee’s conduct was not associated with any activity supported by Novartis. It appeared from the screenshot provided by the complainant that the statement ‘Novartis’ Cosentyx reduces synovitis in new psoriatic arthritis study’ and link to the Pharma Times article appeared on the employee’s LinkedIn profile and was, on the balance of probabilities, highlighted to his/her connections which in the Panel’s view would likely include both health professionals and other relevant decision makers and members of the public.

The Panel further noted from Novartis’ submission that the post at issue was not limited to the employee’s direct connections on LinkedIn.

The Panel considered that the statement ‘Novartis’ Cosentyx reduces synovitis in new psoriatic arthritis study’ which appeared on the Novartis’ employee’s LinkedIn profile and, on the balance of probabilities, its proactive dissemination to the employee’s connections constituted promotion of a prescription only medicine to the public. A breach of the Code was ruled as acknowledged by Novartis.

Furthermore, the Panel considered that the positive statement that Cosentyx reduced synovitis in a new psoriatic arthritis study could have, on the balance of probabilities, encouraged members of the public to ask their health professional to prescribe Cosentyx and therefore a breach of the Code was ruled.

The Panel noted that the Code required a side effect reporting statement to be included on material which related to a medicine and which was intended for patients taking that medicine. The Panel did not consider that the LinkedIn post about Cosentyx was created as material intended for patients taking the medicine and therefore it ruled no breach of the Code.

The Panel considered that the Novartis employee’s post which, in the Panel’s view, promoted Cosentyx would have, on the balance of probabilities, also been seen by or been proactively disseminated to health professionals and/or other relevant decision makers without the non-proprietary name adjacent to the brand name at its first appearance and a breach of the Code was ruled. With the statement ‘Novartis’ Cosentyx reduces synovitis in new psoriatic arthritis study’ the employee had effectively created his/her own piece of promotional material which should have been certified for such use. A breach of the Code was ruled.

The Panel noted that Novartis had a UK policy document covering the personal use of social media by its employees. That document had been in place since 2018 and stated that employees must not post, re-tweet, ‘like’ or share any content that referred to a specific medicine either directly or indirectly, including Novartis and non-Novartis products, licensed or not licensed. That included product-specific information emanating from Novartis corporate social media feeds, such as those run by the global organisation. The policy further stated that ‘likes’ could be viewed as endorsements and reminded readers that a post did not have to contain a product claim to make it promotional. It stated that if the product name and the indication/therapeutic area were mentioned, it could deem it to be promotional and, therefore, not suitable for being shared with the general public. The policy stated that as a general rule, if a medicine was mentioned in a post, not to engage with it. The Panel considered that the instructions to staff not to refer to company products on social media or ‘like’ posts that made any reference to a specific medicine either directly or indirectly were clear and unambiguous. The employee in question had been trained on the company’s social media policy in summer 2020 but had acted in contravention of it in this instance.

The Panel noted its comments and rulings above and considered that high standards had not been maintained. A breach of the Code was ruled.

Nonetheless, the Panel did not consider that this case warranted a ruling of a breach of Clause 2 which was a sign of particular censure and reserved for such use. Novartis had the requisite policies in place but had been badly let down by one of its relatively junior employees not following the company guidelines upon which he/she had been trained. No breach of the Code was ruled.

With regard to the alleged breach of undertaking, the Panel noted that Case AUTH/3038/4/18 involved, among other things, a press release about Cosentyx data, initiated by Novartis’ Swiss based headquarters, which was ‘liked’ by an employee. In Case AUTH/3038/4/18, the complainant had considered it inappropriate for employees to use LinkedIn to promote information, including studies, about their companies’ products. The Panel considered that the activity now in question in Case AUTH/3421/11/20 was similar to the previous case ie an employee had ‘liked’ material about a Cosentyx study on LinkedIn. The Panel considered in that regard that the undertaking given in Case AUTH/3038/4/18 had been breached. A breach of the Code was ruled. This ruling was appealed by Novartis.

The Panel noted the importance of complying with undertakings; the supplementary information to Clause 2 listed inadequate action leading to a breach of undertaking as an example of an activity likely to lead to a breach of Clause 2. The Panel considered that failure to comply with its undertaking brought discredit upon and reduced confidence in the industry. A breach of the Code was ruled. This ruling was appealed by Novartis.

The Appeal Board agreed that the reference to ‘all possible steps’ as set out in Paragraph 7.1 of the Constitution and Procedure and included on the form of undertaking to be signed by respondent pharmaceutical companies following a Code of Practice Panel ruling of a breach of the Code should, in general, be interpreted to mean all reasonable, proportionate and lawful steps.

The Appeal Board noted Novartis’ submission that its employee had ‘liked’ the Pharma Times post which mentioned a Novartis medicine and an indication entirely of his/her own volition using his/her own LinkedIn account in a momentary lapse in judgement; the employee’s conduct was not associated with any activity supported by Novartis.

The Appeal Board noted from Novartis that its employees completed mandatory interactive online social media training and were sent regular email reminders on the appropriate personal use of social media. Training records were provided. Employees who did not complete the training were followed up. The Appeal Board considered that Novartis had social media policies in place but it had been badly let down by one of its relatively junior employees not following the company guidelines upon which he/she had been trained. The Appeal Board noted that Novartis had accepted the Panel’s rulings in relation to advertising a prescription only medicine on LinkedIn.

The Appeal Board queried whether there were sufficient checks in place including validation to ensure that the social media training was fully understood and embedded and considered that it would in addition be prudent to clearly state the consequences of breaching the social media policy when communicating with employees about it rather than the general reference to the employee handbook. It would be more helpful if Novartis used more consistent language in its policies, training and emails. Whilst the Appeal Board noted these general concerns and the similarities between the activities at issue in Case AUTH/3421/11/20 and Case AUTH/3038/4/18, it considered that, on balance, in the particular circumstances of this case, it had not been established that Novartis had failed to comply with its undertaking given in Case AUTH/3038/4/18. No breaches of the Code were ruled including Clause 2. The appeal on both points was successful.