Strive Compounding Pharmacy alleged in its lawsuit that Eli Lilly and Novo Nordisk have worked to lock telehealth providers in exclusive partnerships, disallowing them from offering compounded versions of GLP-1 medicines.
Arizona-based Strive Compounding Pharmacy has filed a lawsuit against Eli Lilly and Novo Nordisk, alleging that the companies are engaging in a “coordinated effort to suppress competition” for their weight-loss drugs, according to a Wednesday news release.
The complaint, filed with the United States District Court for the Western District of Texas, pointed to Lilly and Novo’s efforts to forge alliances with telehealth companies, with agreements that bar these providers from working with compounders. The effect, Strive alleged, is “cutting off an essential channel between patients with prescriptions for personalized medicines and the pharmacies that could fill those prescriptions.”
The pharmas, which have not responded publicly to the lawsuit, have lamented the market share they’re losing to compounders. At the J.P. Morgan Healthcare Conference this week, for example, Novo CEO Mike Doustdar estimated that around 1.5 million U.S. patients are using compounded versions of the company’s GLP-1s and accused compounders of “grabb[ing] a part of the consumers that simply were price sensitive.”
In its lawsuit, Strive additionally singled out Lilly, saying it tried to disrupt business relationships between the compounder and technology platforms and payment processors “in an effort to censor all statements about compounded medicines’ potential benefits.”
Lilly and Novo’s actions expressly violate U.S. antitrust laws, Strive alleged. “It is meant to preserve their supracompetitive prices by forestalling all competition, no matter how small.”
These pharma companies, the compounder said, “would have the world believe that without the potential of reaping hundreds of billions of dollars in profits for the sale of GLP1 drugs, incentives to innovate and compete would be lost, and that exclusivity in the market for GLP-1 medicines serves the greater good.”
“These assertions are false,” the lawsuit read.
Strive is asking the court to prevent what it characterizes as Lilly and Novo’s antitrust practices, “restore competitive conditions” in the market and enact additional relief as the court deems fit.
Wednesday’s lawsuit is the latest salvo in what has become a heated legal landscape saga the practice of producing remixed, unapproved versions of GLP-1 therapies.
The tensions began in December 2024, when the FDA formally ended the shortage for Lilly’s GLP-1 drugs, giving compounders 60 to 90 days to stop producing their own versions of these products. In April, almost immediately after this window passed, Lilly filed the first round of lawsuits against four telehealth providers for promoting and selling compounded GLP-1s.
These providers, the pharma said at the time, were “putting patients at risk by engaging in dangerous, deceptive, and unlawful practices.”
For their part, compounders bristled at the declaration of the end of the GLP-1 shortage. In February 2025, the Outsourcing Facilities Association hit the FDA with the lawsuit over this decision, calling it “reckless and arbitrary.” Ending the shortage, the group said at the time, serves to “benefit special interests, raise drug prices, and deprive[s] much of the public access to a needed medicine.”
It is unclear exactly how Strive is able to legally sell its compounded GLP-1 products, though the company in its lawsuit insisted that its medicines are “personalized for individual patients according to a medical practitioner’s prescription—medicines that Eli Lilly and Novo Nordisk did not offer.”
