Guide · litigation

The drugmakers are suing your pharmacy

Novo Nordisk has filed 132 lawsuits and won 44 permanent injunctions against sellers of compounded semaglutide. Eli Lilly has sued the telehealth companies directly. If you buy compounded, the risk to your supply is not clinical — it is legal.

Updated 2026-08-167 sources

The scale of it

Most coverage of compounded GLP-1s treats the risk as pharmacological — is the molecule what it claims to be, is the dose right. That is worth asking. But the thing most likely to interrupt a compounded prescription in the next year is not a bad batch. It is a court.

By August 2025 Novo Nordisk had filed 132 lawsuits across 40 federal courts against sellers of compounded semaglutide, and had obtained 44 permanent injunctions. A permanent injunction does not fine a company. It stops it selling. Whoever was mid-titration when it landed had to find another supplier at whatever dose they had reached.

Eli Lilly has gone at it from a different angle. Rather than only suing the pharmacies that compound the drug, it sued the telehealth companies that sell it — in April 2025, Mochi Health, Fella Health and Delilah, Willow Health Services and Henry Meds, having already sued the compounders Strive and Empower Pharmacy earlier that month. Three of those defendants are reviewed on this site, and each of those reviews says so.

What is actually alleged

The claims are not that the drug is fake. They are commercial and structural, and there are three recurring ones worth understanding because they describe how this industry is built.

That “personalised” compounding is a fiction. Compounding is lawful when a drug is tailored to an individual patient. Lilly alleges these services sell “mass-manufactured, untested, and unapproved one-size fits-all compounded drugs” and call the result personalised to fit inside the exemption. That is why so many sites add B12 or a slightly odd strength — it is the tailoring that makes it legal.
That the company is practising medicine. Most US states bar corporations from owning medical practice or steering clinical decisions. Novo alleges that telehealth firms improperly influence what physicians prescribe. If that holds, the affiliated-provider structure most of this market runs on is the problem, not any individual prescription.
That the marketing is false. Lilly alleges deceptive marketing of knockoff tirzepatide as safe and effective for cosmetic weight loss — brought under the Lanham Act, the federal false-advertising statute, which is a competitor’s tool rather than a regulator’s.

How courts have actually ruled

Two rulings a week apart in spring 2026 went opposite ways on similar theories, which is a fair picture of how unsettled this is.

Two rulings, two outcomes
Case	Court	Trademark claims
Lilly v. Mochi Health	N.D. Cal. (Corley, J.), 23 Apr 2026	Survived
Lilly v. Empower Pharmacy	S.D. Tex. (Lake, J.), 30 Apr 2026	Dismissed

Judge Corley let Lilly’s Lanham Act and Unfair Competition Law claims against Mochi proceed, dismissing only civil conspiracy with leave to amend, finding Lilly had alleged that Mochi “diverts potential customers — and concomitant sales — from Lilly’s FDA-approved medications”. A week later Judge Lake dismissed Lilly’s federal trademark claims against Empower for failure to show lost sales or irreparable harm, along with the Texas unfair-competition claims, while letting other states’ claims proceed.

Novo has not won everything either — it dropped its suit against Hims & Hers. But 44 permanent injunctions is a lot of wins, and the direction of travel for a small compounder facing a manufacturer’s litigation budget is not hard to read.

Why this compounds with the other thing

The lawsuits are one of two pressures on this tier, and the second is larger. In a notice published on 1 May 2026, FDA proposed not to include semaglutide, tirzepatide or liraglutide on the 503B Bulks List — the set of substances for which it has found a clinical need for outsourcing facilities to compound. If that is finalised, the legal basis for bulk compounding of all three goes away, and no litigation is required to end the supply.

Comments on that proposal closed on 30 July 2026 after an extension. Nothing has been decided. But read the two together and the picture is a tier being squeezed from both ends at once: sued case by case in the meantime, and possibly legislated out of existence at the end of it.

What to actually do about it

Do not prepay twelve months for compounded medication. That is the single practical conclusion. The discount on an annual plan is real, and so is the possibility that the supplier cannot lawfully ship month eight.

Before you prepay anything, ask the provider in writing what happens to your balance if it is enjoined or the rules change. A provider confident of its position will answer. Note that several services on this site state that all prescription sales are final.

Ask which pharmacy compounds your prescription, and check whether that pharmacy is a named defendant anywhere. Providers that will not name their pharmacy cannot be checked this way at all, which is one more reason the naming matters.

If continuity is what you care about most, the branded route through LillyDirect or NovoCare is not subject to any of this. It costs more. That is the trade.

Questions

Could my compounded prescription just stop?

Yes, and it has happened to other people. Novo Nordisk has obtained 44 permanent injunctions against sellers of compounded semaglutide, and an injunction stops sales rather than fining the seller. Separately, FDA has proposed removing semaglutide, tirzepatide and liraglutide from the 503B Bulks List, which would remove the legal basis for bulk compounding altogether.

Are the drugmakers suing because the copies are dangerous?

That is what they say, and Novo publishes testing claims about impurities and understrength product. It is also true that they are the two companies losing sales to the copies, and that these are civil suits brought by competitors rather than actions by a regulator. Both things are true at once; weigh the claims knowing who is making them.

Which providers on this site are being sued?

Mochi Health (by both Lilly and Novo), Henry Meds (by Lilly) and Empower Pharmacy (by Lilly). Each of those reviews carries the detail, the court and where the case has got to. Lilly also sued Fella Health and Delilah, Willow Health Services and Strive, which we do not review.

What does “personalised” compounding actually mean?

Compounding is lawful when a medicine is tailored to an individual patient — a different strength, a different form, an added ingredient. That is why compounded GLP-1s so often come with B12 or at unusual doses. Lilly alleges the tailoring is a pretext and the product is mass-produced. That question is central to several of these cases and has not been settled.

Is buying compounded illegal for me?

No. None of this litigation targets patients, and none of it makes possessing or using a lawfully dispensed compounded prescription an offence. The risk to you is that supply stops, not that you are exposed.

Sources

Everything on this page traces to one of the links below, retrieved on the date shown. Prices and programme terms in this market change without notice — confirm against the provider before you buy.