Two Instagram posts from the accounts of Cosmetic Medical Advice employees, seen on 17 March 2020:
a. The first post, from drritarakus_, featured an image of Dr Rakus receiving an IV drip, with the text “DR RITA HAVING HER SUPER IMMUNE SYSTEM BOOSTER DRIP AT THE CLINIC”. The body text of the post began “Dr Rita Raku Clinic is now offering the 250mg Nad+ High potency B vitamins and Vit C in a 500ml saline solution is[sic] super immune booster drip … Why boost NAD+ to improve your immunity? March 13, 2020 When a virus infects your body, it must enter your cells in order to survive”.
It continued by describing the role NAD+ was thought to have in the immune system, and ended with the claim “Boosting your cellular NAD+ levels and sirtuin activity may therefore be a good way to boost your immune system and protect yourself from viral infections”.
b. The second post, an Instagram story from dr_galyna, also stated “Why boost NAD+ to improve your immunity?” and continued with a description of the role NAD+ was thought to have in the immune system, ending with the claim “Boosting your cellular NAD+ levels and sirtuin activity may therefore be a good way to boost your immune system and protect yourself from viral infections”.
Further text included “Dr Rita Rakus clinic is a medical clinic! We carefuly [sic] monitor Government and The World Health Organisation advice and at the moment only one thing is very clear! Strong Immune System Is key and we are very determined to help our patients with #immunityboost”.
The complainant challenged whether the implied claims that the advertiser’s IV drip could help to prevent coronavirus/COVID-19 were medicinal claims for a product which was not licensed as a medicine by the MHRA.
Cosmetic Medical Advice UK Ltd t/a Dr Rita Rakus Clinic said they had removed all posts about their IV drips from their advertising. They said they had not intended to claim that the IV drips could prevent people from catching coronavirus/COVID-19 or have any direct medicinal effect.
The CAP Code required that medicinal claims and indications could be made only for a medicinal product that was licensed by the MHRA or under the auspices of the European Medicines Agency (EMA). A product could be rendered medicinal by its functional effect on the body, or by presenting itself as having properties for treating or preventing disease. A medicinal claim was a claim that a product or its constituents could be used with a view to making a medical diagnosis or could treat or prevent disease, including an injury, ailment or adverse condition.
Both ads (a) and (b) were posted in mid-March 2020 shortly after the World Health Organisation (WHO) had declared that coronavirus was a pandemic. Both ads stated that the clinic was offering an NAD+ IV drip, described the role NAD+ was thought to have on the immune system and stated that “Boosting your cellular NAD+ levels … may be a good way to boost your immune system and protect yourself from viral infections”. Ad (b) also stated “We carefuly[sic] monitor Government and The World Health Organisation advice and at the moment only one thing is very clear! Strong Immune System is key …”.
The ASA sought the view of the MHRA regarding the claims. The MHRA said that any mention of coronavirus/COVID-19 in the promotion of an IV drip product would bring the product under medicines regulations, as would any claim that implied treatment of, or protection from, the virus. We considered that in the context of the dates when the ads were published, references to government and WHO advice and boosting the immune system, the claim “protect yourself from viral infections” in both ads was an implied medicinal claim that the IV drip offered by the advertiser could help to prevent people from catching coronavirus/COVID-19. We understood that the IV drip offered by the advertiser was not licensed as a medicinal product and because of that, no medicinal or medical claims could be made for it.
We therefore concluded the ad breached the Code. The ad breached CAP Code (Edition 12) rules
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease. and 12.11 12.11 Medicines must have a licence from the MHRA, VMD or under the auspices of the EMA before they are marketed. Marketing communications for medicines must conform with the licence and the product's summary of product characteristics. For the avoidance of doubt, by conforming with the product's indicated use, a marketing communication would not breach rule 12.2.
Marketing communications must not suggest that a product is "special" or "different" because it has been granted a licence by the MHRA, VMD or under the auspices of the EMA. (Medicines, medical devices, health-related products and beauty products).
The ad must not appear again in the form complained of. We told Cosmetic Medical Advice UK Ltd t/a Dr Rita Rakus Clinic to ensure that their ads did not contain medicinal claims for unlicensed products, including stated or implied claims that their IV drips could help to prevent or treat coronavirus/COVID-19 or other viruses.