Mochi Health sold cheap compounded GLP-1s in the FDA shortage window, until Lilly sued

Subscription telehealth clinic for obesity and metabolic health that prescribes compounded GLP-1 medications shipped from partner pharmacies

That 503A/503B compounding during an official FDA shortage was a durable legal channel to sell GLP-1s at a fraction of list price to patients priced out of brands

Eli Lilly's Mounjaro was approved for diabetes in May 2022 and the FDA declared doses in shortage by year-end; Zepbound followed in November 2023 and went short months later. Brand GLP-1s cost about $1,000 a month and most insurers refused obesity coverage. Mochi Health launched into that gap, pairing online visits with compounded medication from partner pharmacies. WIRED describes startups that 'sprang up specifically to cash in' on this niche; by November 2024 a compounder trade group counted about 2 million Americans on compounded GLP-1s

Lilly says Mounjaro and Zepbound brought in over $16.4 billion in 2024, and it moved to shut the grey channel. The FDA declared the tirzepatide shortage over in December 2024 and semaglutide in February 2025, giving compounders wind-down deadlines into spring 2025. According to Lilly's complaint, Mochi switched dosages and prescriptions 'en masse at least five times,' formulating products with vitamin additives like niacinamide and pyridoxine to argue the copies were customized. Washington state regulators ordered Mochi's compounder Aequita Pharmacy to stop production in March 2025. On April 23, 2025, Lilly sued Mochi, Henry Meds, Fella & Delilah, and Willow Health; Novo Nordisk later filed its own suit against Mochi

The FDA shortage declarations converted an expensively patented drug into something pharmacies could legally copy, collapsing the price for uninsured patients

The bet depended on a shortage the manufacturer had every incentive to fix; once supply caught up, the legal channel closed within months

Lilly and Novo used courts, not Congress, to enforce the boundary: the same compounding flexibility that built the clinic also made its recipes legally attackable

The 2-million-patient market proved demand was real; the fight is over whether that demand can legally be served off-label of the brand system

A regulatory window can mint an industry overnight and close it just as fast. If your product exists only while a rule is in force, the rule is your real exposure — pivot before it shuts

Mochi Health is still operating as of June 2026 and has been repositioning beyond compounded GLP-1s: it relaunched its platform in June 2025, added 15 new care categories in November 2025, launched a Spanish-language app experience in June 2026, and was marketing virtual care starting at $39 in a USA Today shopping feature. The Lilly and Novo suits remain pending, and regulatory pressure on non-FDA-approved GLP-1s continued into 2026