GLP-1 Drug Market Faces Legal Battles and AI-Powered Alternatives

Novo Nordisk sued telehealth company Hims & Hers on Feb. 9, alleging patent infringement over the sale of compounded versions of Wegovy. The lawsuit came less than one week after Hims & Hers announced plans to sell a compounded version of Wegovy at an introductory price of $49 per month. Days later, after the FDA threatened action against Hims & Hers, the company dropped its plans.

About 1 in 8 Americans take a GLP-1 drug for weight loss, diabetes or other conditions, according to KFF, a health policy nonprofit. Many customers whose insurance plans don't cover the medications struggle to afford these drugs, which carry list prices of more than $1,000 per month.

Compounded drugs were only supposed to be broadly offered while the popular brand-name drugs were in shortage. The Food and Drug Administration declared the shortage over in 2025, yet telehealth companies still sell compounded versions of the anti-obesity drugs, tailoring the medications to different dosages and often selling them for less than what pharmaceutical companies charge for the brand-name drugs.

"We expect all compounders who are engaged in mass compounding to take note of this legal action," said the group general counsel. "We expect all of them to take note of what could be the potential consequences of their continued behavior."

Unlike the injectable versions, there was never a shortage of the Wegovy pill and no need to market a compounded version. "There's no excuse. There's no claim that it's arising out of a shortage," the counsel said. "And frankly, it was outrageous. Not only is it violating our patents, which we take very seriously, but it's really a direct challenge to the entire drug approval framework in the United States."

Hims & Hers said it has about 2.5 million subscribers across all of its health offerings. GLP-1 customers represent a "small minority" of its subscriber base, the company said. The company still sells injectable GLP-1 medications.

Novo is the only company to gain FDA approval for a GLP-1 weight loss pill. That gives Novo an exclusive window to sell the pill to consumers who want to lose weight without using an injectable version of the medication. During an earnings conference call with investors in February, executives stressed the importance of a fast launch for the company's oral medications. They said more than 50,000 weekly prescriptions of oral Wegovy were being filled. And 9 in 10 consumers who filled prescriptions in the opening weeks paid with cash.

The starting price for the Wegovy pill is $149, or about $200 less than the injectable version of the medication. Novo won't have this exclusive sales opportunity forever. Eli Lilly's weight-loss pill, orforglipron, could gain FDA approval in April.

Novo Nordisk and Eli Lilly have cut prices for consumers whose insurance plans don't cover these medications. These cash-paying customers can buy Wegovy or Zepbound from the pharmaceutical companies, telehealth portals, retailers such as Costco and Sam's Club or TrumpRx, the Trump administration's direct-to-consumer drug sales website.

A survey by benefits consultant Mercer found 49% of large employers covered GLP-1 medications in 2025, up from 41% in 2023.

With demand for Ozempic and other GLP-1 drugs soaring, employers are grappling with their high costs. At around $1,000 to $1,500 a month per person, these medications represent a rapidly increasing health care expense. It's why some employers are turning to non-medication alternatives to help people go off, reduce, or avoid GLP-1s entirely.

Mountain View, California–based Twin Health's approach uses a combination of wearables, AI, and on-demand health coaching to help manage diabetes, prediabetes, and obesity. The company sends users a kit with a continuous glucose monitor, blood pressure cuff, smart scale, and fitness tracker. Together, the devices collect data points on blood sugar, weight, stress, blood pressure, sleep, and activity and feed them into a single app. Using a predictive AI model, the app analyzes all this information to generate a virtual replica of the user's metabolism—the digital twin.

A clinical trial found that Twin can help people with type 2 diabetes control their blood sugar with fewer medications and lose weight. The program has led to medication savings for asset manager Blackstone, which has been using Twin Health for several years, while helping employees there lose weight.

The company has enrolled tens of thousands of people across nearly 200 employers. Twin gets paid only when users achieve certain clinical outcomes, such as lower blood sugar, weight loss, or the reduction of metabolic medications.

Users log what they're eating throughout the day by scanning food labels, taking pictures of their meals, or recording meals via voice. The app uses AI to analyze nutritional content and identifies foods as "green," "yellow," or "red"—green being the healthiest options and red being foods to avoid. Those colors can change as a person's metabolic health improves. A food that was once red might eventually turn yellow or green.

Based on logged meals, the app predicts a person's blood sugar response to those foods. It also makes personalized recommendations throughout the day, such as adjusting portion size, choosing a different food combination, or taking a walk after eating. Users can accept or ignore these suggestions—maybe broccoli isn't their favorite food, or they prefer to exercise during a particular time of the day. The app uses AI to adapt to their preferences over time. Users can also chat with human coaches if they have specific health questions.