Judge lets Lilly's false-advertising claims against Mochi Health proceed
The ruling means a court will examine advertising claims that compounded tirzepatide is FDA-approved and personalized, though it does not decide whether any of that is true.
A federal judge in California has allowed most of Eli Lilly's lawsuit against the telehealth company Mochi Health to move forward, ruling that Lilly's claims about misleading advertising for compounded tirzepatide can proceed [1][2].
The order came April 20, 2026, in the U.S. District Court for the Northern District of California [1][2]. Lilly makes Mounjaro and Zepbound, two FDA-approved weight-loss medications containing tirzepatide [1]. Mochi Health connects consumers with physicians who can prescribe weight-loss medications, including compounded versions of tirzepatide [1]. Lilly sued Mochi Health Corp., Mochi Medical CA, P.C., Mochi Medical P.A. and Aequita Pharmacy LLC [1].
The court allowed Lilly's claims under California's Unfair Competition Law and the Lanham Act, the federal false-advertising law, to go forward. It dismissed a civil conspiracy claim [2]. An earlier version of the complaint was dismissed in October 2025 for failing to plausibly allege standing, after which Lilly filed an amended complaint [1][2]. The ruling does not decide whether Mochi broke the law. It decides that Lilly's allegations are enough to continue.
What Lilly alleges
According to Lilly's complaint, Mochi prescribed compounded tirzepatide in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg doses before December 2024 [1]. Lilly alleges Mochi then changed patient doses en masse without consulting patients or getting a clinical indication from a physician; changed them back in March 2025; and changed doses and formulation again in September 2025 under a new partnership with Lexington Compounding Pharmacy [1].
Lilly also alleges that compounded medications contained niacinamide, glycine or pyridoxine depending on which pharmacy Mochi used, and that those additives reflected Mochi's financial considerations rather than a therapeutic aim [1][2].
On advertising, the court found Lilly plausibly alleged three misleading claims: that compounded tirzepatide is safe and effective based on studies of Lilly's drugs; that the compounded products are FDA-approved; and that they are "personalized" [1][2]. The court noted that the FDA approves specific formulations of an ingredient, not the ingredient itself [2]. On the "personalized" claim, the court said the question is whether Mochi changed formulations based on business interests and pharmacy relationships rather than patient needs [2].
Lilly cited studies indicating a higher risk of adverse events from compounded tirzepatide, including "abdominal pain, diarrhea, nausea, suicidality, and cholecystitis," along with National Consumers League research on consumer confusion between compounded and FDA-approved medicines [1][2].
The court declined to follow a different ruling, Eli Lilly & Co. v. Willow Health Servs., Inc., which had found that a prescriber's conduct defeated proximate cause [2]. Here, the court reasoned that requiring a prescription does not by itself break the link between advertising and a patient's request, since both products contain tirzepatide [2].
Why it matters for patients
The dispute is about advertising and business practices, not about whether compounded tirzepatide works. The court said it would not have to decide the scientific validity of citing Lilly's trials; it would only weigh whether Mochi misled consumers into thinking those trials tested compounded formulations [2].
People comparing GLP-1 options may see compounded products described with the same words used for brand-name drugs, including "FDA-approved" and "personalized." The order describes how one court evaluates those words when they appear in compounded-drug marketing [1][2].
Another practical point is that compounded products can vary. Lilly's allegations say the additives and doses in Mochi's compounded tirzepatide shifted over time depending on which pharmacy Mochi worked with [1][2].
The order also shows courts are not uniform on these cases. A different California court found a prescriber's role defeated similar claims, and this court disagreed [2]. No finding has been made that compounded tirzepatide caused harm to any specific patient in this case, and the lawsuit has not been resolved.
What happens next
The case continues in the Northern District of California [1][2]. No trial date has been reported, and it has not been disclosed whether the parties will settle. Defendants could renew arguments that FDA law precludes Lilly's claims if discovery warrants it, the order states [2].
Sources
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