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Key points

• The TGA is investigating whether a telehealth start-up is advertising a popular drug.
• The start-up, Eucalyptus, emailed customers on its contact list about the drug Ozempic.
• Ozempic is in demand for its weight loss properties but is only approved here for type 2 diabetes.
• Advertising of prescription medicines to the public is illegal in Australia.

The medicines watchdog will investigate whether an Australian telehealth start-up spruiking the blockbuster drug Ozempic to its online weight loss clients has fallen foul of medical advertising laws.

Eucalyptus, a $560 million Australian company backed by Woolworths and the Mike Cannon Brookes-chaired Blackbird Ventures investment fund, started emailing people on its contact list last month through its brand Juniper, which caters specifically to women who want to lose weight.

There has been a global shortage of Ozempic since early 2022 because of an unexpected increase in demand due to use of the drug for weight loss.Credit: Alex Ellinghausen

It presented Ozempic as a medication that “suppresses appetite and increases the feeling of being full”, that only needs to be administered once a week and is more affordable than Saxenda, the product the company was distributing previously. It advised patients to request a doctor consultation “as soon as possible”.

A spokesperson for the Therapeutics Goods Administration said it was aware of the email and was making inquiries.

“In Australia, the advertising of prescription medicines, such as Ozempic, to the public is illegal … and fines and civil and criminal penalties can apply,” they said.

“Appropriate treatment options involving prescription medicines should be determined between a doctor and their patient in consultation, rather than on the basis of commercial advertising.”

Eucalyptus’ clinical director, Dr Matt Vickers, defended the email as an “essential” way to inform patients that an alternative medicine was newly available to them, given Saxenda had been subject to a shortage and was temporarily unavailable.

“The TGA rules allow for communications about medications to existing patients from their clinical teams. Everyone who received the email was an existing patient with an established treatment relationship with the clinical team,” he said.

However, this masthead has seen correspondence to an email address linked to an account that had been cancelled. Vickers did not respond to questions about how the company defined “existing patients”.

Ozempic has grabbed global headlines for its weight loss properties but is only approved in Australia for type 2 diabetes treatment while it is in short supply.

Its manufacturer, Danish pharmaceutical giant Novo Nordisk, has also distanced itself from Eucalyptus by saying it does not support the drug being used outside its stated purpose.

‘The advertising of prescription medicines … is illegal … fines and civil and criminal penalties can apply.’

“Novo Nordisk is governed by a strong set of business ethics principles and takes its obligations under Australian law and the Medicines Australia Code of Conduct very seriously. We do not support any type of non-indicated (off-label) use of a Novo Nordisk product at any time,” a spokesman said.

The Eucalyptus email told customers that Ozempic was due to be removed from the TGA shortage list on June 30. “Juniper has secured supply of the medication ahead of this date as a result of the shortage easing,” it said.

But the Therapeutics Goods Administration says Ozempic supply has not stabilised and it should only be prescribed for type 2 diabetes until the end of December 2023.

“We are asking health professionals to continue limiting Ozempic prescriptions to the TGA-registered indication of the management of type 2 diabetes as there may not be adequate supply to support off-label use for other conditions,” the TGA website says.

However, Vickers said doctors prescribed off-label medications in Australia “every day” according to their clinical judgment.

“Just because medication is submitted for TGA approval for one condition doesn’t mean it isn’t highly effective and appropriate to treat others. This is why off-label prescription is left to the clinical decisions of doctors,” he said.

Eucalyptus’ Juniper website previously said it only sold medication approved for weight loss in Australia – a sentence that has since been removed.

Juniper artwork of its weight loss ads, which don’t specifically name the drugs it sells, published to its Facebook page.

The Royal Australian College of GPs’ obesity management group chair, Dr Terri-Lynne South, said the doctor’s college and the Australian Diabetes Society were also asking prescribers not to recommend Ozempic off-label because of the continuing supply issues.

She said doing so would “compound an already tenuous situation” that meant diabetics missed out. South was also concerned about consumer targeting and advertising, which she said went against medical ethics.

“Some people’s motivation for weight loss may not necessarily be health-driven. We’re talking about a pretty significant medication that comes with risks and potential side effects. My concern is it being used in a way that is not sound medical practice,” she said.

Online telehealth companies, which both prescribe and supply drugs to patients, have seen a major commercial opportunity in the hyped weight loss drug.

But they are also facing tougher oversight from the Medical Board of Australia, which announced it will crack down on text-based prescribing practices from September, citing a series of cases in which patients got the wrong medicine or dose after a digital consultation.

This masthead has previously reported that Eucalyptus was not holding video calls or checking people’s identity prior to sending out weight-loss medication that can lead to serious side effects. The company has since said it would implement required changes within the given timeframe.

A spokesman for Woolworths Group, a Eucalyptus investor, said it and other investors expected the business to abide by all health regulations. “We understand the company is in discussions with the TGA,” he said.

A spokeswoman for Blackbird Ventures backed the company. “We support Eucalyptus’ vision to build a suite of digital healthcare services for customers with specific conditions,” she said. “We include relevant regulatory considerations as part of our investment due diligence process, and monitor updates accordingly.”

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