Lilly Sues Four More Over Compounded Tirzepatide and the Fallout Has Just Begun

Eli Lilly has filed new lawsuits against four companies: Mochi Health, Fella and Delilah Health, Willow Health Services, and Henry Meds. The charge? Selling compounded versions of tirzepatide, the same active ingredient found in Mounjaro and Zepbound.

These are not mom and pop operations. They are national telehealth companies with strong branding, wide reach, and thousands of patients. During the tirzepatide shortage, they stepped into a vacuum, offering affordable alternatives when the FDA allowed compounders to fill the gap. But now that the shortage is over, Lilly is drawing a hard line.

The lawsuits, filed in California federal court, accuse the companies of marketing and distributing unapproved versions of tirzepatide. Some were oral. Others were mixed with amino acids or vitamins. None were evaluated or cleared by the FDA. Lilly is not alleging patent infringement in these cases. Instead, the company is framing this as a safety issue, warning that these compounded versions may be risky or ineffective.

Lilly also claims that these telehealth companies are not just selling unapproved versions of tirzepatide, they are actively shaping the prescribing process in ways that raise red flags. According to the filings, Lilly alleges that some of these platforms steer patients toward compounded medications without adequate medical evaluation, often relying on prefilled templates or quick online forms. The concern is that these companies may be prioritizing sales over safety, influencing doctors to prescribe in bulk or outside standard clinical judgment. This accusation adds a new layer to the battle, calling into question not just the product, but the entire process by which it reaches the patient.

This is part of a broader crackdown. Lilly has already sued more than two dozen spas, clinics, and pharmacies. They have sent cease and desist letters to dozens more. They are making it clear, if you are selling tirzepatide without a formal FDA approval process behind it, they are coming for you.

But legal battles like this take time. These cases will not be decided overnight. Months from now, the courts will still be sorting through the filings. And in the meantime, patients are left wondering what will happen to the only version of this medication they can afford.

It also remains to be seen how the rest of the market reacts. Will other telehealth platforms and prescribers back away from compounded versions to avoid getting sued? Will they pause marketing while their legal teams scramble? Or will they hold their ground and let the courts decide?

There is also an uncomfortable truth that rarely gets discussed. Major drugmakers have long had ways of shaping how doctors write prescriptions. Speaker fees, lunch programs, sponsored education, and rep visits are all part of the playbook. These are not illegal. But they do shape the conversation. And in a high-stakes, high-dollar category like GLP-1 medications, the pressure is real.

Compounded tirzepatide was never meant to be permanent. But for millions of patients, it was the only real option. They are now caught in a system that continues to treat access like a privilege, not a right. A system where affordability gets squeezed out once supply catches up.

We will keep covering this story from the patient side.

Because someone has to.

Stay tuned to OnThePen.com for more updates and in depth analysis on the latest developments in weight loss and diabetes treatments. Sharing this article is a powerful form of advocacy that brings us closer to our goal of educating the masses and reducing the stigma of obesity. If you found this article insightful, please share it within your networks, especially in Facebook groups and Reddit forums dedicated to GLP-1 medications and diabetes management. Together, we can make a difference.