A second court lets Lilly's compounded tirzepatide advertising claims proceed

A federal judge in the Northern District of California largely denied a motion to dismiss Eli Lilly and Company's lawsuit against Mochi Health Corp., allowing Lanham Act false-advertising claims and a state unfair-competition claim to proceed ^[1][2]. The April 20, 2026 ruling means Lilly can continue pursuing allegations that Mochi Health misrepresented compounded tirzepatide as FDA-approved and as "personalized" medicine ^[1].

Lilly's suit centers on Mounjaro and Zepbound, its FDA-approved tirzepatide medications, and Mochi Health, a telehealth company that connects patients with physicians who can prescribe compounded versions of the drug ^[1]. According to the complaint, Mochi Health changed its compounded tirzepatide doses en masse multiple times between December 2024 and September 2025, including a shift tied to a new partnership with Lexington Compounding Pharmacy, without consulting patients or getting a clinical reason from a physician ^[1]. Lilly alleges these changes, along with varying additives like niacinamide, glycine, and pyridoxine depending on which pharmacy Mochi Health used, were driven by business relationships rather than medical need ^[1][2].

On the advertising claims, Lilly alleges Mochi Health cited Lilly's own clinical studies to support safety claims about its compounded product, told consumers tirzepatide "is a safe medication that has been approved by FDA," and marketed its compounded drug as "customized to the medical needs of the patient" ^[2]. The court found it plausible that these statements misled consumers into thinking Lilly's studies tested compounded formulations, and that Mochi's dosing changes based on pharmacy relationships rather than individual patient needs contradicted its "personalized" marketing claims ^[2]. Lilly also cited research finding that compounded medications carry higher rates of side effects such as abdominal pain, diarrhea, nausea, suicidality, and cholecystitis, arguing that blurring the line between compounded and FDA-approved drugs damages its reputation ^[1].

Notably, the court declined to follow a related California case, Eli Lilly & Co. v. Willow Health Services, in which a different judge found that the need for a doctor's prescription broke the chain of causation between advertising and any harm to Lilly ^[2]. Here, the court reasoned that a prescription requirement doesn't stop a consumer from asking a doctor for a specific product based on advertising, especially since both products contain tirzepatide ^[2].

Why it matters for patients

This ruling does not decide whether Mochi Health actually broke the law — it only lets the case continue toward further evidence-gathering ^[1][2]. But the allegations shine a light on how compounded GLP-1 doses and formulations can change for business reasons unrelated to a patient's individual treatment plan, according to Lilly's claims ^[1]. Patients using compounded tirzepatide may want to understand that, per these allegations, a "personalized" dose from a telehealth provider could actually be changed company-wide based on which pharmacy is supplying the product, not their own medical situation ^[1][2]. The case also underscores an unresolved public confusion issue: research cited in the litigation suggests some consumers may not clearly distinguish between compounded products and FDA-approved medications, including their differing safety data ^[2].

What happens next

The order was issued April 20, 2026, and allows Lilly's Lanham Act and UCL claims to move forward while dismissing the civil conspiracy claim ^[1][2]. The case, Eli Lilly & Co. v. Mochi Health Corp., No. 25-cv-03534-JSC, will proceed in the Northern District of California, likely into discovery ^[1][2]. The court noted that Mochi Health could renew certain legal arguments, including one involving federal preclusion, if discovery warrants it, meaning further rulings on the merits of Lilly's claims are still to come ^[2]. No trial date is mentioned in available records.