Danish reporting puts Novo Nordisk's knockoff litigation at 132 companies sued

Novo Nordisk has filed suit against 132 companies for marketing products as semaglutide, the Danish business paper Børsen reported, describing the damages sought as running into the billions ^[1]. That figure matches the company's own count of 132 federal complaints filed across roughly 40 U.S. states, targeting compounding pharmacies, telehealth providers and medical spas ^[2].

According to Børsen's review of court filings, half of the sued U.S. companies are medical or beauty spas, and 55 of the 132 cases have already reached a first-instance ruling, with Novo Nordisk winning the large majority ^[1]. Novo Nordisk says its legal strategy has two main targets: pharmacies that make unapproved compounded semaglutide while claiming it is "personalized," and telehealth companies that steer patients toward those products in ways the company says violate state laws on the corporate practice of medicine ^[2].

Courts have granted 44 permanent injunctions in related cases, barring companies from compounding semaglutide illegally or falsely marketing products as FDA-approved or equivalent to Wegovy and Ozempic, and some defendants have been ordered to give up profits ^[2]. In June, Novo Nordisk ended its partnership with Hims & Hers, saying the company had engaged in "illegal mass compounding" and deceptive marketing ^[2].

The FDA has separately warned about counterfeit and unapproved compounded products, and Novo Nordisk cites reports of patients who were hospitalized after taking five to 20 times the intended dose ^[2]. The company also points to a Brookings Institution report stating that many compounded semaglutide products use synthetic active ingredient imported from China, and that 60% of the Chinese manufacturers exporting that ingredient are not legally allowed to sell it for use in human drugs within China itself ^[2].

Not every compounder has stopped selling. Noom has said it will keep offering compounded semaglutide, at a 0.6-milligram dose compared with Novo's standard 2.4-milligram dose, through what it calls its Microdose GLP-1Rx Program ^[2].

Why it matters for patients

The scale of this litigation, 132 companies across dozens of states, signals how widely products marketed as semaglutide have spread outside FDA-approved channels ^[1][2]. For patients who have used compounding pharmacies, telehealth clinics or med spas for these medications, the lawsuits and injunctions mean some suppliers may be forced to stop selling or change how they operate, which could affect access or pricing for people who turned to compounded options ^[2]. The FDA's warnings about overdoses tied to unapproved products underscore a safety concern separate from the legal fight: dosing errors have sent patients to the hospital ^[2]. The dispute also shows disagreement over how big a threat these products pose, with Børsen emphasizing the billions in damages Novo is seeking and Novo's own materials focusing on the number of injunctions already won ^[1][2].

What happens next

Of the 132 cases identified in the Børsen review, 55 had already reached a first-instance court decision, mostly in Novo Nordisk's favor, with the remainder still pending ^[1]. Novo Nordisk has said it will continue pursuing legal action and public education campaigns such as "Check Before You Inject" and "Choose The Real Thing" ^[2]. Meanwhile, at least one major compounder, Noom, has said it plans to keep selling a lower-dose compounded product, meaning the legal and marketplace picture for patients is likely to keep shifting as more cases are resolved ^[2].