Expedient Healthcare Marketing Private Limited - Healthians

Recommendation: Upheld | Medium: Suo Motu - NAMS (TAMS)

The ASCI had approached the advertiser for its response in addressing the objections raised in the complaint. The advertiser was offered an option to seek an Informal Resolution (IR) of the complaint by modifying or withdrawing the claims in the advertisement, or alternately to substantiate the claims with supporting data. The advertiser was also offered an opportunity for a telecon with the ASCI Secretariat, which they did not avail and replied seeking for an extension of time to submit their response. The deadlines stipulated by Consumer Complaints Council (CCC) procedure exist keeping in mind the immediate and widespread impact that advertisements have on the public. Consequently, any action which is needed to be taken with respect to the same is required to be prompt and urgent. It is for this purpose that the deadlines, as stipulated, are set for advertisers/broadcasters etc., and the CCC itself makes it a priority to deal with every complaint before it as expeditiously as possible. However, as a special gesture, the advertiser was granted an extension of additional five business days to respond. The advertiser in their response stated that, “Expedient Healthcare Marketing Private Limited ("Healthians") substantiates this claim based on a comprehensive analysis of cholesterol test data conducted by the Company from 2019 to 2022-2024. The data shows that the proportion of individuals with deranged LDL levels (bad cholesterol) has more than doubled post-COVID period that is during 2022-2024. The statement refers to increased risk factors rather than definitive disease incidents, with "POST COVID" being used as a timeline reference. The claim is supported by the data analysis of 2 million datasets of the Company over the period of years”. As claim support data, the advertiser submitted the following documents – (1) Excel sheet containing the raw data of the data sets for the years 2019 and 2022-2024, (2) Study indicating that deranged LDL levels (bad cholesterol) is a known risk factor for heart disease, (3) Copy of advertisement The advertiser’s response along with the claim support data was referred to an Independent technical expert of ASCI for an opinion in the matter. The expert’s opinion was then shared with the advertiser for making additional submissions. The advertiser had a telecon/meeting with the ASCI Secretariat and the technical expert via zoom video conference to discuss their submissions. Post this meeting, the advertiser submitted cholesterol data 27-09-24 The additional submissions made by the advertiser were shared with the technical expert for final opinion. The CCC viewed the print advertisement, considered the complaint, the advertiser’s response along with the claim support data, and the expert’s final opinion presented at the meeting. The CCC observed that the advertisement claims, “Indian’s are at a 2x higher Risk of heart disease post COVID". The disclaimer says, “Based on a comprehensive health survey of 2 million datasets over 3 years”. The advertiser has provided internal data which consists of cholesterol related findings from blood test reports of their customers. The data set has not been sourced from any independent organization. The CCC discussed that the data set includes blood test results from individuals who visited the advertiser’s labs in India from 2022 to 2024, but it does not show any data linking Covid-19 to LDL cholesterol levels. The percentage of Indians with high LDL cholesterol increased from 34% in 2019 (pre-covid) to 79% in 2024 (post covid) is based on the advertiser’s data, which only includes information for 2022, 2023, and 2024. Since there is no data available for 2019, the 34% figure from that year cannot be independently verified. The percentage of 79% for 2024 appears to have been calculated by dividing the number of people with 'out of range' LDL cholesterol levels (57 individuals) by the total number tested in 2024 (72 people). However, this sample size of 72 individuals is too small to accurately represent the entire population of India. The CCC further discussed that the data from 2022, which involved 16,335 individuals tested for LDL cholesterol, is considered a sufficient sample size to represent a large country like India. However, the number of individuals tested in 2023 and 2024 is significantly lower. The sample size for these two years is so small that it is inadequate to draw reliable conclusions about the health of India's population as a whole. The CCC discussed that the data set is limited to customers of the advertiser's company, it only reflects the health information of individuals who have engaged with the advertiser. Additionally, the fact that these individuals chose to undergo a blood test suggests that they may have been prompted to do so by their doctors. This indicates that these individuals have pre-existing health concerns as compared to the general population of India. As a result, this sample group is not representative of the broader Indian population. The CCC observed that post the meeting with the technical expert, the advertiser has submitted another excel data having much larger data points. This new data not only has data for the year 2019 but also has additional data for other years from 2020 to 2024. The CCC discussed that the claim suggests that Covid-19 has caused an increase in LDL cholesterol (bad cholesterol) levels. However, the advertiser has also stated that, “the fact “post Covid” is used as a timeline for reference and not the suffering of Covid by an individual”. This could mislead readers into concluding that, as a result of the Covid-19 pandemic, people's LDL cholesterol levels have risen, thereby increasing their risk of heart disease. Both the previous and current data fail to establish any causal relationship between Covid-19 and LDL cholesterol levels. Hence the claim is not supported by the new data. The CCC further discussed that the advertiser’s old data showed LDL (bad) cholesterol levels for 2019 and 2024. An analysis of the new data, shows different percentages for the years 2019 and 2024. It states that ‘the percent of Indians with high LDL (bad cholesterol)’ has gone up from 57.3 in 2019 (pre-covid) to 81.4 in 2024 (post covid). The claim is not supported because of the major difference between the old and new data. The data does not accurately reflect the demographic profile of the Indian population. For instance, the percentage of individuals under age 15 in the old data was reported as 3.2%, while the actual percentage in India is 25.3%. The new data shows 4.6% for the same age group, which is still significantly lower than the actual figure. Due to this discrepancy in representativeness of the Indian population in the sample of persons in the old and new data, the claim is not supported. Based on this assessment, the CCC concluded that the claim, “Indian’s are at a 2x higher risk of heart disease post COVID", was inadequately substantiated. The source and date for the claim is not indicated in the advertisement. The claim is misleading by exaggeration and is likely to lead to widespread disappointment in the minds of consumers. The said claim contravened Chapter I, Clauses 1.1, 1.2, 1.4 and 1.5 of the ASCI Code. This complaint was UPHELD