Eli Lilly sues four telehealth companies over compounded tirzepatide
Lilly's new lawsuits target telehealth sellers of compounded tirzepatide, the cheap alternative many patients turned to when the brand-name drug was in shortage and priced above $1,086 a month.
Eli Lilly sued four telehealth companies on April 23, 2025, accusing them of selling illegal compounded copies of tirzepatide, the active ingredient in its weight-loss drug Zepbound and its diabetes drug Mounjaro [1]. The complaints name Mochi Health, Willow Health, Fella Health and Delilah, and Henry Meds [1].
The lawsuits land on a price gap that built the compounded market. Zepbound carries a sticker price of more than $1,086.37 a month, while compounded tirzepatide sells for as little as $99 a month [1].
What the complaints allege
Compounded drugs are not generics. They are essentially copies that special pharmacies were allowed to make during drug shortages [1]. Tirzepatide was in shortage for two years until Dec. 19, 2024. The U.S. Food and Drug Administration required an end to making the copies by mid-March, though pharmacies could sell stock already produced until it ran out or expired [1].
According to one complaint, Mochi allegedly switched its patients to compounded tirzepatide with different additives, such as niacinamide, and to doses different from those Lilly offers. The complaint alleges these changes were made "at least five times in just eight months" to keep selling compounded tirzepatide [1]. Existing law prohibits compounders from making what is "essentially" a copy of a commercially available drug [1].
Lilly's complaint against Henry Meds alleges the company improperly referenced Lilly's approved drugs and clinical trials on its website to sell more compounded versions. Henry Meds and Fella Health are also accused of selling tirzepatide in pill form, which the FDA has never approved [1]. "Fella even tells patients that its untested oral drug is better than Lilly's approved medicines," Lilly's complaint against Fella alleges [1].
The complaint against Willow Health asserts it falsely claimed to have developed the first "cosmetic" GLP-1. "FDA has never approved any form of tirzepatide for cosmetic weight loss," Lilly's complaint alleges, adding that Lilly makes the only FDA-approved tirzepatide [1].
Mochi, Henry Meds, Fella Health and Willow Health did not respond to NPR's requests for comment [1].
Earlier this month, Lilly sued two compounding pharmacies, Strive and Empower [1]. Strive told NPR it will fight back, and Empower said in a statement posted to its website, "We stand by our mission, and the patients and providers who depend on it" [1].
Lilly said in a statement to NPR: "Anyone continuing to sell mass compounded tirzepatide is breaking the law and deceiving patients. We will continue to take action to stop those who threaten patient safety and urgently call on regulators and law enforcement to do the same" [1].
Scott Brunner, chief executive of the Alliance for Pharmacy Compounding, declined to comment on the specific suits or companies. In an email to NPR, he said compounders only produce drugs when a prescriber sends a prescription. "I fear there is not a bright line on this issue of corporate practice of medicine vs. legitimate customization of a drug based on the judgment of a prescriber who has actually interacted with a patient," he wrote. "FDA guidance clearly authorizes the latter, but the former is to a certain degree in the eye of the beholder. In these new Lilly lawsuits, [it] looks like the beholder will be a Federal judge" [1].
Why it matters for patients
The gap between roughly $99 a month and more than $1,086.37 a month is why many patients without insurance coverage for Zepbound turned to compounded tirzepatide during the shortage [1]. That route is narrowing. The shortage ended, production deadlines passed, and Lilly is now pursuing sellers in court [1].
Compounding pharmacies can still generally make custom drugs for patients with a doctor's prescription, as they do for patients with allergies to certain preservatives in medications, for example [1]. What is disputed is where legitimate customization ends and copying begins, and Brunner says that question may now be decided by a judge [1].
Patients should also note that tirzepatide in pill form has never been approved by the FDA, and that no form of tirzepatide is FDA-approved for cosmetic weight loss [1].
What happens next
Lilly filed the compounding pharmacy suits on April 1 and the telehealth suits on April 23 [1]. No court dates or rulings have been reported, and it is not yet known how the cases will be resolved or whether they will change how compounded tirzepatide is sold.
Sources
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