Denmark has paid 27 GLP-1 vision-loss claims at about $56,000 each

Denmark's paid claims come to about $56,000 each, dividing more than $1.5 million among 27 patients ^[1]. Another 38 cases sit with the same body, and at that average they would take the Danish total to roughly $3.6 million ^[2]. Novo Nordisk's Dr. Tine Bilsboell said the payments are not an indicator of a causal relationship ^[19]. The distinction matters to Novo, because the Danish body assesses medical claims administratively while the American cases are in state and federal court ^[18][10][11].

The suits filed in federal court in Philadelphia claim both companies' GLP-1 drugs caused vision loss and that the companies failed to adequately warn patients ^[11]. Four other jurisdictions have already written a warning. The European Medicines Agency concluded in June last year that NAION is a very rare side effect of semaglutide and recommended adding it to the European labels for Novo's drugs ^[13]. Britain, Japan and Australia carry warnings or related information ^[14], and in Australia and New Zealand the information appears on other GLP-1 labels too, including Lilly's Mounjaro, which uses tirzepatide, as Zepbound does ^[15]. Aaron Kesselheim, a Harvard Medical School professor who studies FDA regulation, said the agency "is fairly conservative about what warnings it puts on a label," and that it is assessing whether the drugs actually cause the side effect ^[17].

The Wall Street Journal's account of the litigation, published on the 20th, did not give a total for the American claims ^[4]. Weitz & Luxenberg's New Jersey filings alone come to more than seven dozen, so one firm may account for all of the dozens of suits attributed to Novo Nordisk ^[3]. At the Danish average, more than 90 claims would be about $5 million ^[4].

Both companies are contesting the suits, saying there is not enough evidence that their drugs are responsible ^[12], and on the science they have material to work with: doctors and researchers said the evidence is mixed and not clear enough to determine whether the drugs cause the condition, or how ^[7]. Research shows the condition often appears within six to 18 months of starting a GLP-1 drug ^[5]. It usually affects one eye, sometimes both, and there is no approved treatment ^[8]. Michelle Fennell, who had started Ozempic six months earlier to treat type 2 diabetes, was diagnosed two weeks after her vision blurred ^[1][3]. "The doctor told me to stop taking Ozempic immediately," Fennell said ^[2].

The FDA could end its review with a warning, which would put an official date on the risk and close the period the plaintiffs are describing. It could decline, and then the failure-to-warn theory has to carry causation on its own. Or the epidemiology firms up, and the claim pool grows with the number of people taking these drugs. In my view the label decision moves the exposure more than any individual verdict will. The American Optometric Association recommended last year that anyone beginning a GLP-1 drug undergo an eye examination to check the health of the optic nerve ^[6]. That exam is also a dated record of an optic nerve before treatment, useful to both sides.

Dr. John Chen, a Mayo Clinic professor who specializes in optic nerve disorders, said doctors should help patients weigh the risks and benefits themselves, and that for patients who need the drugs to control diabetes or heart disease the benefits are likely to outweigh the risks ^[20]. "If you want to lose five pounds, it's not worth that kind of risk," Chen said ^[21].