NAD+ supplements: When lifestyle products have criminal consequences

NAD+ supplements are increasingly being touted as anti-ageing and longevity treatments. In Switzerland, however, all products for injection or infusion are subject to therapeutic products legislation. Swissmedic has initiated a number of administrative criminal proceedings concerning the import, distribution and use of unauthorised NAD+ supplements. Fines and financial penalties have been imposed, and courts have ordered the seizure of unlawfully obtained financial benefits.

A cantonal pharmacy office in French-speaking Switzerland informed Swissmedic that a pharmacy was suspected to have imported large quantities of NAD+ solutions for injection from abroad and distributed them to healthcare professionals and healthcare institutions throughout Switzerland. Swissmedic subsequently initiated administrative criminal proceedings against the person responsible for the pharmacy and conducted house searches.

Investigations revealed that numerous healthcare professionals and healthcare institutions had procured substantial quantities of these preparations over a prolonged period. Administrative criminal proceedings were also initiated against several of those involved. After Swissmedic blocked the distribution channel, some of these individuals procured the products directly from other countries. Several suppliers promoted NAD+ treatments with sweeping claims of efficacy, and charged between 300 and 800 Swiss francs per treatment.

NAD+ supplements are subject to therapeutic products legislation

NAD+ (nicotinamide adenine dinucleotide) is a naturally occurring coenzyme in the body that is involved in numerous metabolic processes and is increasingly being offered in the anti-ageing and longevity sectors as infusions or injections.

Many consumers are unaware that such preparations are not considered to be either cosmetic products or food supplements in Switzerland. All products intended for injection or infusion and possessing pharmacologically active properties are classified as medicinal products and are subject to therapeutic products legislation. Swiss legislation explicitly states that products for injection cannot be deemed to be cosmetic products (Art. 53 FUAO).

The fact that a product is legally marketed or used in another country does not mean that it also satisfies the requirements of Swiss law. The Swiss legislation takes precedence.

Protecting health is the priority

Medicinal products may only be placed on the market in Switzerland if they have been authorised by Swissmedic. During the authorisation procedure, manufacturers must prove that their products are effective, safe and of high quality.

Medicinal products that are not authorised by Swissmedic have not passed this official review process. Particularly as regards injections and infusions, quality defects, impurities or contamination can have serious health consequences. Even minor deviations from the sterility requirements can cause serious infections. This is why the manufacture of such preparations is subject to particularly stringent quality requirements.

Moreover, all medicinal products for injection or infusion are available only on prescription (Art. 42 let. e TPO). Their safe use requires corresponding specialist knowledge, and they may only be administered by appropriately qualified healthcare professionals.

Breaches can have criminal consequences

Swissmedic monitors compliance with the provisions of therapeutic products legislation. In the event of breaches it can, for example, seize products, ban their distribution or initiate administrative criminal proceedings.

In the present case, Swissmedic has initiated a number of administrative criminal proceedings as a result of suspected breaches of the provisions of therapeutic products legislation. Specifically, these involved the import, distribution, advertising and use of NAD+ supplements that had been placed on the market illegally in Switzerland. That fact that comparable treatments were legally available in another country or were administered under medical supervision did not change the assessment according to therapeutic products legislation.

During the proceedings, convictions were handed down and fines or financial penalties of up to 20,000 Swiss francs were imposed. Swissmedic further ordered the seizure of unlawfully obtained financial benefits of up to 40,000 Swiss francs.

This case shows that what may be marketed as a lifestyle or longevity treatment does not automatically fall outside the scope of therapeutic products legislation. In particular, quality defects in products for injection or infusion can pose considerable health risks. The illegal import, distribution, advertising or use of such preparations can also have criminal consequences.

Since not all the criminal proceedings have been legally concluded, the presumption of innocence still applies to the individuals concerned.