Eli Lilly sues four telehealth sellers over compounded tirzepatide

Eli Lilly filed four lawsuits on April 23, 2025 against telehealth sellers of compounded tirzepatide, claiming they mislead customers about products that have not gone through clinical testing ^[1][3][4]. Named in the complaints are Mochi Health; Fella Health, which also runs the Delilah brand; Willow Health Services; and Henry Meds ^[1][3][4].

Tirzepatide is the molecule in Lilly's diabetes drug Mounjaro and its weight-loss drug Zepbound ^[1][4]. Both ran short — Mounjaro starting in late 2022 — and Novo Nordisk's Wegovy was also scarce, which let compounding pharmacies fill the gap ^[1][3]. Online sellers sold those copies far below brand prices to people who could not find or afford the approved products ^[1][3]. Once the FDA declared the tirzepatide shortage over, large-scale compounding was supposed to end ^[1]. Mochi's chief executive, Myra Ahmad, told CNBC in March that her company would keep selling compounded tirzepatide, wagering that personalized formulations would keep it clear of regulators ^[1].

The complaints get specific about what is being sold. Henry Meds offers what it describes as an oral form of the drug. Lilly told the court that version "is an untested knockoff that exposes patients to safety risks," noting that no study has established that swallowing tirzepatide is safe or works ^[3]. "Lilly's tirzepatide medicines are only tested and approved for under-the-skin injections— not for administration in any oral form," the company wrote ^[3]. Tablets and drops also appear in the filings ^[1][3].

In the Fella complaint, Lilly says Fella and Delilah marketed both oral and injectable tirzepatide as "safe, effective and backed by science" — claims, Lilly argues, that lean on Lilly's own research ^[4]. The company says its 37 clinical trials covered neither an oral version nor tirzepatide blended with additives such as glycine or l-arginine, and that it knows of no trials that did ^[4]. Mounjaro and Zepbound are cleared only as injections placed under the skin, with no additives ^[4]. Lilly further alleges Fella shifted patients "en masse from one tirzepatide formulation to another with additives" ^[1][3], while Mochi moved patients to lower doses "that have never been studied" ^[3].

Two of the cases raise a different argument. Lilly contends Mochi and Fella illegally practice medicine, saying no physician owns either company and that both direct the prescribing choices of the medical groups they work with — Mochi Medical and Fella Medical Group ^[1][3][4]. The filing says Ahmad is not a licensed physician ^[1][3]. Ahmad responded that she holds a doctor of medicine degree but does not practice in her CEO role, and that use of compounded drugs "remains appropriate and legal when tailored to individual patient needs and prescribed by a licensed medical provider" ^[1]. Mochi also said its physicians alone pick treatments and its model "remains compliant with FDA guidance and pharmacy regulations" ^[1][4]. Fella, Willow and Henry Meds did not immediately answer CNBC's questions ^[1].

Accounts of where the cases landed differ slightly. MobiHealthNews reported that the Mochi, Fella and Henry Meds complaints went to the Northern District of California, San Francisco Division, and the Willow complaint to the Central District of California ^[4]. The Hill described the filings as being in the Northern District of California ^[3]. Lilly wants the courts to bar the companies from marketing or selling tirzepatide, a request that could take months or longer to resolve ^[1]. It filed a separate suit against two compounding pharmacies earlier in April, and Reuters reported action against more than two dozen medical spas, wellness centers and compounding pharmacies ^[1][4].

Why it matters for patients

The FDA does not review compounded drugs for safety, effectiveness or quality before they are sold, and the agency says compounded products can pose risks even though they can serve a medical need for some patients ^[4].

Form matters here. The approved tirzepatide medicines are injections under the skin, without additives ^[4]. Lilly says oral tirzepatide, and tirzepatide combined with glycine or l-arginine, have no clinical trial behind them ^[3][4]. Whether patients have been harmed by the specific products named has not been reported, and no recall has been announced in connection with the suits.

Filing a lawsuit does not change what can legally be sold, and these products remain available while the cases proceed ^[1].

What happens next

The complaints were filed April 23, 2025 ^[1][3][4]. No hearing dates, rulings or settlements have been reported. If granted, the injunctions Lilly seeks would stop the four companies from marketing or selling tirzepatide ^[1]. How Lilly's earlier compounding suits have resolved has not been reported ^[1][4].