Code for health product promotion (CAG)
In this Code the following is understood to mean:
Food supplements and other products covered by the Dutch Commodities Act in a pharmaceutical form and a pharmaceutical presentation and/or for which a health-related primary function is claimed.
This first category concerns liquids, capsules, tablets, ointments, sprays, powders, etc. The latter category, the “other products covered by the Dutch Commodities Act for which a health-related primary function is claimed” mainly concerns products to be used externally which distinguish from cosmetics by such health-related primary function. To ordinary food products the Advertising Code for Food Products applies.
A claim which states, suggests or implies that there is a link between a health product or an element thereof and health without using any medical claim or allusion to this .
There is a link, inter alia, in case it concerns care, support, aid, preservation, maintenance, enhancement, protection, etc. of the normal operation of a bodily function.
Advertising within the meaning of Article 1 of the Dutch Advertising Code of a health product as defined in this code which apparently, by reason of its content and the manner in which it is expressed, is (also) intended for other persons than professionals, i.e. doctors, pharmacists, dentists, obstetricians, nurses and chemists, as also paramedics such as physical therapists, dieticians and therapists.
The scope of this Code does not cover the data in labelling and instructions of use as laid down by law.
The labelling, instructions of use and exterior packaging are advertisement carriers. And so, the Code applies to this. The law requires specific data to be stated on it. That is why, within the context of this Code or its supervision, they can never be questioned.
The Advertising Code Committee presumes a valid approval number issued by the Dutch Advertising Control Board of Health Product Advertising (Keuringsraad Aanprijzing Gezondheidsproducten (KAG)), by virtue of its bylaws.
All communications for health products (including packaging and instructions of use) may obtain an approval number.
Advertising of health products is prohibited, if it is not allowed to produce or trade them.
5.1 Advertising of health products that are consumed (including food supplements) shall be in conformity with the guideline document in Annex 2 to this Code.(This Annex can be consulted at www.reclamecode.nl/nrc/cag).
The conditions of use of health claims laid down in the Regulation on nutrition and health claims made on food have been specified in the Dutch Guideline Document for the Claims Regulation. A database with alternative example wording for the allowed health claims is part of it (Database Claims Regulation).
5.2 Advertising of health products which involve recommendations of a medical content or allusion to this is not allowed.
By definition, health products are not medicinal products. That is why no medical indications shall be advertised. The suggestion of a medical effect shall not be made either. For claims that have not been established under the Nutrition and Health Claims Regulation, such as external health products, an Indicative List of health recommendations has been added to this Code as Annex 1. For health products that are consumed a database with health recommendations has been included in the Guideline Document for the Claims Regulation which has been added to this Code as Annex 2. By way of explanation of the delimitation of (allowed) health recommendations the lists state what recommendations are indeed of a medical content. In the event of merely stating a target group having a stronger need for a nutrient, there is no suggestion towards recommendation with a medical indication.
Advertising shall not be contrary to the information on the packaging and in the enclosed instructions of use.
Advertising has a purpose different from instructions of use. That is why both are of a different nature. However, they shall not be contradictory, because in that case false expectations might be raised on the part of consumers, or they might otherwise conflict with Article 4 of this Code.
It is prohibited to state the degree and/or rate of weight loss with health products intended for weight control and/or weight loss. Nor shall it involve a competitive element.
8.1 Advertising must include at least:
a. the name of the health product;
b. the data indispensable for the purchase decision of the health product.
An example of data indispensable for the purchase decision is the specification of what persons shall not use the health product.
8.2 In derogation from paragraph 1(b) it is allowed to refer in media that are limited as to space or time to the information on the packaging, if consumers are not misled by this.
Media that are limited are understood to mean for instance all radio and television commercials. Information about use and restrictions of use of a health product is in general stated on the packaging.
8.3 In derogation from paragraph 1 – advertising only has to include the name of the health product, if the only purpose is to remind of the name or brand of the health product.
Reminder advertising has as sole purpose to remind of the name and usually exclusively consists of mentioning the name in the communication. Indications which may reinforce the reminder values, such as for instance “this is familiar” are fully in line with such purpose. However, as soon as options of use or any other product characteristics are stated, it no longer concerns reminder advertising. This also excludes reminder advertising of products that have their use included in their name.
Advertising of a health product shall not make any misrepresentation and shall not mislead. The advertised effect with the recommended daily dose shall be plausible for the target group.
Advertising of a health product shall be truthful, shall not exaggerate its characteristics and shall not, directly or indirectly, incite unnecessary or excessive use of that health product.
Advertising shall not use in a deterrent or misleading manner pictures or descriptions of changes of the human body as a result of illness or injury, nor of the effect of the health product in the human body.
Advertising shall be represented in such manner that the message is perceived as advertising by the public, and shall be such as to form and content that the product is clearly not positioned as medicine or self-care medical product. Nor shall the health product be equalled to a medicine or self-care medical product.
Upon simultaneous recommendation of a health product and a medicine or self-care medical product they shall be positioned individually and it shall be clear what claim relates to what product. Seeing that it is not allowed to make medical claims for health products, but on the contrary this is allowed for medicines and self-care medical products, it is important to make an adequate distinction between them. For instance, upon simultaneous recommendation in a general introduction no medical claims or allusions shall be used. Furthermore, with the medicine it shall be stated explicitly that it concerns a “medicine”, with the health product that it concerns a “health product” and with a self-care medical product a “self-care medical product”.
Advertising of health products shall not state that the costs of health products can be reimbursed on doctor’s prescription.
Should the reimbursement status be advertised, it might stimulate people not to buy the product themselves, but to request prescription.
Advertising shall neither state nor suggest by its phrasing or pictures that use of the health product renders a medical examination or medical treatment unnecessary, or discourage it.
Therefore, the following is prohibited:
• Suggestions that medical examination or surgical intervention is not necessary;
• Offering a personal diagnosis, advice, prescription, or distant healing.
It is prohibited to make any suggestions that normal good health can be prejudiced, if the health product is not used, save the authorities (e.g. the Health Council of the Netherlands) issued an official recommendation in this respect.
Advertising shall not include any statements which due to the description or detailed presentation of organs or bodily functions might lead to misinterpretation of a person’s own health condition.
Testimonials shall correctly represent the view of users and shall not suggest any medical effect.
Describing and/or illustrating a health condition in detail, both before and after use may suggest that the product has a medical effect and thus lead to violation of Article 5.2. Any user experiences which imply a change in health condition shall only be reproduced, if they fit within the range of normal good health. This applies for instance to “I feel fit”.
Advertising shall not comprise, directly or indirectly, a recommendation of scientists, health care professionals or persons known to the public who could promote the use of health products by means of their renown and reputation.
Health care professionals in this respect are physicians, pharmacists, chemists, obstetricians, nurses and dentists, but also paramedics. The background of this provision is that the public has a special confidence in independent scientists and health care professionals, which causes their commendations to carry disproportionally great weight, whereas this will not readily be the case for scientists employed by the advertiser. An indirect recommendation may be the mention or depiction of items that are strongly associated with them (such as doctors’ white coats or the Aesculapius staff), the name of the instituttions they work for (university, clinic, institute, laboratory, etc.) or the kind of work they perform (research, diagnosis). This does not mean that such matters related to scientists and health care professionals shall never occur in public advertising. After all, it concerns reference to a recommendation. For instance, there is no such reference if it is stated that “research” showed that X% of the population tried product Y at some moment, if a chemist states that a products sells well, or it is stated that nutritional information can be retrieved from the dietician. Reference in a general sense to publications on research with the product in reputed magazines is allowed, save this is done within the context of quality, but not in relation to the effect of the product.
‘Persons known to the public’ concern persons who although they are no scientists or healthcare professionals themselves, do enjoy some trust of the public, for instance actors known for a specific part as a doctor, or persons of much authority and prestige.
Advertising shall neither state nor suggest that health products are safe. However, it is allowed within a relevant context to use the word ‘safe’ and comment on the safety of the product, if such relevant context is clearly stated.
For instance, it is allowed to state “safe if used in conformity with the instructions of use”.
Advertising shall neither state nor suggest that the safety or effectiveness of the health product is due to the fact that it is “natural” or of “natural origin”, unless this is proven to be correct and relevantly distinct from similar products.
Advertising shall neither state nor suggest by its phrasing or pictures that the health product does not have any additional effects or restrictions. The lack of a specific additional effect or restriction recognizable by the user can be stated. The notion “side-effect” shall not be used for health products.
Side-effects are associated with medicines. Stating the notion “side-effects” is therefore not allowed for health products. This goes in particular for their lack, also seeing that the health product is implicitly compared with the medicine in that case, as is contrary to Article 11. However, if the health product does not have a specific additional effect or restriction relevant to the users, this can be stated. Such additional effect or restriction (e.g. “does not make drowsy”, “does not lead to dependency” or “can be used for a long time”) then should be a distinctive argument and demonstrable with objective data.
Advertising may not be exclusively or primarily directed at children.
|Directed at children’ is defined as: encourage children to buy or to use the health product, or cause children to persuade their parents/ caretakers to purchase the health product. Advertising for the use of health products for children shall exclusively be directed at their parents/ caretakers. Children are defined as persons of the age of 12 or younger. This provision does therefore not refer to teenagers. Nonetheless, the provisions in the Code for Advertising directed at Children and Young People remain in full force.
If a use can be claimed, then this shall appear in health product advertising as primary reason of use. Any secondary properties of the health product shall not be used as primary reason of purchase.
Secondary properties are understood to mean properties other than the health-related primary function (health recommendation). Preserving good health shall therefore be the primary reason of use. Any other product characteristics are secondary to this, but may have importance to users. The taste of the health product is an example. Stating the taste as product benefit, however, shall be made in a way which distinguishes this from a health recommendation. If not, there is a risk of misuse or misunderstanding regarding the nature of the product.
Advertising may not contain any guarantee with regard to the therapeutic efficacy.
Use of expressions as “permanent result” and “efficacy guaranteed” is not allowed.
Advertising shall not comprise any derogatory comments on other products, services or concepts, or suggest so by its phrasing or pictures.
Any implicit or explicit comparison with other health products shall be demonstrably correct and shall not denigrate the value of other products. Furthermore, the following conditions apply to comparisons:
• no use of brand names;
• it shall concern similar products;
• the comparison must relate to all relevant characteristics.
The condition that it should concern similar products also applies to comparison with products that have not been composed in such manner that they can carry a (nutrition and/or health) claim.
In health product advertising to the public, health products shall no longer than 2 years after introduction be depicted as ‘new’.
This code of conduct is part of the Dutch Advertising Code since 1 February 2019.