An American compounding pharmacy has sued Eli Lilly and Novo Nordisk for allegedly stifling patient access to compounded weight loss medications.
Strive Compounding Pharmacy said that the drugmakers, who dominate the glucagon-like peptide-1 receptor agonist (GLP-1RA) market, are engaging in a “coordinated effort to suppress competition and limit patient access to lawful compounded GLP-1RA medications”.
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The lawsuit, filed in the United States District Court for the Western District of Texas, alleges that Lilly and Novo used their dominant market positions to undermine the compounding pharmacy industry. The document highlights exclusive partnerships that the pharma companies signed with telehealth providers in efforts to compete with the compounding sector. It also points to Lilly and Novo establishing their own online pharmacies in the past year, which offer branded GLP-1RAs via direct-to-consumer (DTC) cash channels at a discounted price.
Through these alliances, online DTC platforms, and apparent marketing strategies, Strive alleges that Lilly and Novo’s conduct “unlawfully restricted competition and directly harmed GLP-1RA patients in the United States.”
A Novo spokesperson told Pharmaceutical Technology: “The claims in this litigation are without merit, and we will vigorously defend against them in court. Novo Nordisk remains committed to working alongside regulators and law enforcement to ensure that patients have access to safe, effective, and FDA-approved treatment options and to protect patients from unapproved knockoff drugs that pose significant risks to patient safety.”
A Lilly spokesperson told Pharmaceutical Technology: “Strive’s lawsuit is wrong, on both the facts and law, and an attempt to shift focus away from its own conduct. Lilly sued Strive for advertising its unapproved, mass-compounded products as clinically proven and “personalized,” and both FDA and a federal court have now said that those kinds of statements are false and misleading. We look forward to responding to Strive in court.”
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By GlobalDataStrive’s lawsuit is the latest in a fierce battle between the pharma industry and compounding pharmacies. Compounded drugs are custom-made and unbranded medications that contain the same active ingredient as a marketed drug, such as Novo’s semaglutide or Lilly’s tirzepatide, pursuant to a prescription. A shortage of a commercially available drug is one of the criteria that allows compounded production, as per US Food and Drug Administration (FDA) regulation.
The use of compounded GLP-1RAs surged during shortages of Lilly’s Mounjaro/Zepbound and Novo’s Wegovy/Ozempic in 2024. An added benefit for many patients was that these versions were far cheaper than the branded counterparts at the time. However, with supply chains now stabilised, the FDA no longer allows compounded GLP-1RA production. This was despite a lawsuit by the Outsourcing Facilities Association, which ultimately ended up being dismissed by a US district judge. FDA commissioner Marty Makary announced a clamp down on illegal GLP-1RA compounders in October 2025.
Novo entered into a partnership with Hims & Hers in mid-2025 but terminated it just days later after accusing the telehealth platform of “failing to adhere to the law”.
Lilly and Novo have already taken several online vendors, wellness spas, and telehealth platforms to court for making compounded versions of their branded GLP-1RAs.
Speaking at the J.P. Morgan Healthcare Conference this week, Novo’s CEO, Maziar Mike Doustdar, estimated that around 1.5 million US patients are using compounded versions of its GLP-1RAs. He accused compounders of targeting consumers who prioritised price. The compounded sector exists to provide personalised versions of drugs, rather than cheaper alternatives.
