Welcome to another week of Type 2 diabetes frivolity, news, and opinions! Here, we give you the unfiltered truth about the wonderful world of Mounjaro and other related issues through the lens of someone, namely me, who has been injecting this GLP-1 receptor agonist for just short of a damn year.
I’m 78 years-old with a typical variety of chronic conditions, one of which is Type 2 diabetes, which is under control thanks to Mounjaro and my willpower. (The latter is necessary because there is no such thing as a wonder drug to cure diabetes or obesity, no matter what “they” say). I write this update weekly for no other reason than to share my thoughts and progress with you. I am not “monetized” in any way, I do not receive kickbacks from Big or Little Pharma, your friendly Indian telehealth facility, or YouTube. Nope, not even Google Ads befoul this little blog.
My arrogant air might lead you to regard me as an authority on the subject, but I am not. I’m just your average retired engineer with an opinion. My results might not be the same as yours. If you want medical advice, this isn’t the place for it. Consult your local, live, non-tele-health doctor for the best advice and knowledge of your condition.
In This Week’s Edition
This week, we’ll be leading into GLP-1 RA lawsuits and deals with my rant about how today’s journalists are royally screwing up the English language by lacing their commentary with vogue crap that leads to ambiguous interpretations. Why is that? Because they’re lazy, impressionable, and easily influenced by pop culture. These former paragons of literary excellence are now nothing more than wannabe writers. Pisses me off! But I digress…
Later, I’ll comment on the news that the FDA has approved tirzepatide (Mounjaro and Zepbound) for treatment of obstructive sleep apnea, another triumph for Big Pharma. And last, but certainly not least, I’ll present this week’s progress or lack of same. Now, sit back and listen to an old man going off on idiots.
Bonus Snark: The Mounjaro Lawsuit That Got Dropped (But Not Really)
Before we dive into Eli Lilly’s latest crusade to ensure that only their gold-plated, FDA-blessed vials of tirzepatide reach the masses, I need to vent about a linguistic travesty that’s been gnawing at my cerebrum like a caffeinated termite.
So, there I was, perusing the digital fishwraps, when I stumbled upon a headline declaring, “Eli Lilly dropped lawsuits against compounding pharmacies.” For a fleeting moment, I thought, “Well, isn’t that magnanimous of them?” But alas, the article proceeded to detail how Lilly had, in fact, filed lawsuits against these pharmacies. Apparently, in today’s journalistic lexicon, “drop” has been repurposed to mean “initiate,” “announce,” or “unleash the hounds.” I suppose next we’ll hear that the Pentagon “dropped” a peace treaty.
This semantic contortion is the bastard child of pop culture and lazy reporting. In the halcyon days of yore, “dropping” a lawsuit meant you were backing off, retreating, perhaps even admitting you were wrong. Now, it’s a declaration of war, a linguistic Molotov cocktail hurled into the fray. It’s as if words no longer have fixed meanings, but are instead fluid, like the contents of a politician’s promises.
But I digress. Let’s pivot from this lexical lunacy to the actual legal shenanigans at hand.
Eli Lilly’s Legal Blitzkrieg: Protecting the Golden Goose
Eli Lilly, the pharmaceutical behemoth behind the blockbuster weight-loss drug Zepbound and its diabetic cousin Mounjaro, has embarked on a legal rampage against compounding pharmacies and telehealth startups. Their crime? Offering more affordable, albeit unapproved, versions of tirzepatide—the active ingredient in Lilly’s cash cows.
During the pandemic-induced shortages, the FDA allowed compounding pharmacies to produce tirzepatide to meet demand. Patients, desperate for treatment and unable to afford Lilly’s $1,000-a-month price tag, turned to these compounders, who offered the drug for as little as $99 a month. But now that the shortage is officially over, Lilly is wielding its legal cudgel to squash these upstarts.
In April, Lilly filed lawsuits against two compounding pharmacies—Strive Pharmacy LLC and Empower Clinic Services LLC—accusing them of selling unapproved tirzepatide products with added vitamins like B12 and glycine, suggesting these concoctions were safer and more effective than Lilly’s own offerings. In particular, Lilly has accused Empower of repackaging Lilly’s own products, breaking sterile seals, and selling them as personalized treatments.
Get the Teledocs, Too!
Not content with targeting pharmacies, Lilly has also set its sights on telehealth companies. They’ve sued Mochi Health, Fella Health, Willow Health Services, and Henry Meds for allegedly selling compounded tirzepatide with untested additives and making dubious claims about their efficacy. For instance, Lilly accused Mochi Health of switching patients between different formulations at least five times in eight months, driven by corporate interests rather than medical necessity.
Lilly’s stance is clear: any entity selling compounded tirzepatide is “breaking the law and deceiving patients.” They’ve already sued over two dozen entities and sent approximately fifty cease-and-desist letters to others. Meanwhile, the compounding industry argues that they’re filling a crucial gap in the market, providing affordable treatments to patients who would otherwise go without.
As this legal battle unfolds, one thing is certain: the war over tirzepatide is far from over. And in the midst of it all, the semantics of “dropping” lawsuits continues to confound and amuse.
Novo Nordisk Fires Back: Hims, CVS, and a Danish Uppercut to the Jaw
While Lilly was busy suing every compounder this side of the Rio Grande, Novo Nordisk was sharpening its elbows. This week, they hit the gas with two strategic salvos designed to wedge Wegovy into America’s arteries faster than you can say “insurance prior authorization.”
First, Novo inked a deal with Hims & Hers, the telehealth platform best known for making erectile dysfunction as easy to treat as acne. This move lets Novo sidestep the compounder drama entirely by pushing branded Wegovy directly to the masses via the click-happy millennial crowd that believes healthcare should happen in between DoorDash deliveries. Second, and more significantly, Novo cut a deal with CVS Caremark, a large pharmacy benefit manager with tentacles in many employer plans in America. The deal includes significant price concessions for Wegovy in exchange for preferred placement—translation: CVS will steer its patients toward Novo’s incretin over Lilly’s. Unsurprisingly, Eli Lilly’s stock took a modest but symbolic hit, dropping over 2% on the day of the CVS announcement, as Wall Street investors clutched their spreadsheets and wondered if maybe Novo had outflanked their golden goose.
But here’s the twist in this pharma soap opera: while Novo may have won this week’s headline war, the long game still favors Lilly. Tirzepatide continues to outperform semaglutide in trials across both diabetes and obesity, and Lilly has something Novo doesn’t: a once-weekly GLP-1 weight loss pill currently in Phase 3 trials (see my Week 46 update). So yes, Novo landed a flashy combo—but Lilly’s the one training for the championship rounds.
Tirzepatide’s New Role in Sleep Apnea Treatment
Well, it seems Big Pharma has found another avenue to expand its reach. The FDA has approved Zepbound (tirzepatide) for treating moderate to severe obstructive sleep apnea (OSA) in adults with obesity . This marks the first medication approved for OSA, a condition traditionally managed with CPAP machines or surgical interventions like uvulopalatopharyngoplasty (UPPP).
Tirzepatide, initially developed for type 2 diabetes and weight loss, has shown promise in reducing apnea events by up to 63% in clinical trials . While this is a significant development, it’s essential to recognize the underlying issue: obesity is a primary risk factor for OSA. Addressing weight through lifestyle changes remains a cornerstone of treatment.
The introduction of a pharmaceutical option may offer an alternative for those struggling with existing therapies. However, it’s crucial to approach this development with a balanced perspective, acknowledging both its potential benefits and the importance of comprehensive lifestyle management in treating OSA.
My Week on Mounjaro
The mundane week was a good respite, because I looked at my calendar for May and saw eight doctor, dentist, or lab appointments. That’s what happens when you get old! You spend your time going from doctor to doctor.
Today was the first doc appointment in May, as we celebrate Cinco de Mayo. Well, YOU do. I don’t drink tequila, Tecate, or any T-word stronger than herbal tea. Not even peyote. Anyhow, I saw my eye doc (who I have yet to bestow with a pseudonym), to set up a YAG laser treatment toward the end of the month. This is something many people need in the aftermath of cataract lens replacement. The capsule becomes cloudy. Zapping it with the laser cracks the coating off the back of the capsule. The cloudiness is mildly annoying, but they can fix it, so that’s what I’m doing.
The Numbers, Already!
Morning fasting glucose: 96 mg/dl (5.33 mmol/L)
Average glucose (Stelo biosensor): 117 (6.5 mmol/L) — but the damn thing has been reading about 20 mg/dL high, compared to finger stick glucometer, which makes this number highly suspect
Body Weight: Nominally unchanged at 181.4 lbs (82.5 kg) — desirable result, because I’m concentrating on muscle maintenance and growth instead of weight loss.
Conclusion: From Dropped Lawsuits to Pillow Talk Pharma
So where have we been this week, dear readers? We began by dissecting the tragic mutilation of the English language by today’s headline-chasing scribes, who apparently think that “drop” means “announce” and “accuracy” is optional. From there, we followed Eli Lilly into the courtroom as they waged a scorched-earth campaign against compounders and telehealth outfits, all in the name of “patient safety” — or as it’s known in corporate circles, revenue preservation.
Next, we turned our gaze to Novo Nordisk, who, rather than filing lawsuits, chose to file into bed with Hims & Hers and CVS Caremark, bypassing the compounding chaos entirely in favor of mass-market dominance. It was a bold move that caused Lilly’s stock to wobble ever so slightly — a paper cut in this billion-dollar knife fight, but a cut nonetheless.
Then came the real kicker: tirzepatide’s surprise approval for obstructive sleep apnea. Not content with cornering diabetes and obesity, Lilly now wants a slice of the apnea market too — traditionally dominated by hose merchants like ResMed and scalpel-happy surgeons. But let’s not kid ourselves: this isn’t about curing sleep apnea, it’s about monetizing it with the same injectable you’re already using for everything else. Weight loss reduces apnea. Who knew? (Spoiler: everyone with a functioning cerebrum.)
See You Next Week
In short, Week 48 was a parade of pharmaceutical overreach, corporate bed-hopping, legal theater, and snarky indignation — all lovingly wrapped in sarcasm and served without monetization. I’m not selling anything here but honesty, skepticism, and the occasional eye-roll. See you next week, unless I’m held in contempt by the grammar police, the FDA, or Eli Lilly’s legal department.
For an annotated catalog of all my Mounjaro updates, visit my Mounjaro Update Catalog page.
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