by ahstilde | 2025-04-23 17:15:53+00:00
I run a YC-backed tech-superpowered healthcare company, Wyndly [1]. I wanted to cure allergies, but then I realized that permanent allergy relief was already possible with allergy immunotherapy, which is compounded.

A compounded medicine is one which is made to order for the specific patient, versus being packaged in a factory en mass. It's almost like "making your own generic". In allergy, compounding is used to create custom allergy trigger mixes which are then used to build tolerance through allergy shots or under-the-tongue allergy drops. Compounding is also used a ton in skincare.

I've been following the GLP-1 and compounding conversation very closely, as the marketing and the operations have had secondary effects on Wyndly.

This specific action by Eli Lilly is a different tact then before. I suspect it may be more successful, too, because it's focused on protecting patients instead of protecting profits.

Look, Eli Lilly wants to defend their patent. They want to be the only people who can sell the drug they developed, its tirzepatide medications (Mounjaro and Zepbound).

In 2023 [2], EL went after providers who were selling compounded versions of their drugs, by going after deceptive marketing that was misusing their brand name. That's understandable. If a patient thinks they're getting Mounjaro, and they're not, that's fraud.

In 2024 [3], EL started going after the compounding pharmacies by sending hundreds of cease-and-desists. This was in sync with the FDA declaring the tirzepatide shortage over, allowing EL to defend its patent.

Now (2025), we're seeing a new evolution of the strategy. Here, EL is claiming that 4 companies, Mochi Health, Fella & Delilah Health (YC), Willow Health, and Henry Meds, are effectively practicing medicine incorrectly. This is what took down Cerebral [4] and Done ADHD [5].

In short, EL is saying "the businesses, not individual doctors, are changing the medicine, which is means the business is practicing medicine en masse, instead of through personalized provider-patient relationships."

Mochi: EL “switched dosages and prescriptions for patients en masse at least five times—with corporate interests, rather than doctor decisionmaking—driving the changes.”

Fella & Delilah: EL claims that Fella & Delilah Health switched all of its patients from a compounded tirzepatide product with no additives to a version containing untested amino acid additives late last year.

Henry Meds: EL accuses the company of “creating the false impression” that clinical trials have confirmed the effectiveness of its drugs, “materially omitting that no such clinical trial data exists.”

Willow Health: EL alleges false marketing of “custom-prepared” for patients despite being mass-produced.

All in all, this would be a violation Corporate Practice of Medicine Doctrine, which is a patchwork of laws that basically says: providers practice medicine and make the final calls on patient needs, not businesses.

Interesting stuff, honestly.

[1] https://www.wyndly.com/ [2] https://www.fiercepharma.com/pharma/lilly-expands-its-clampd... [3] https://www.wired.com/story/crackdown-compounded-glp-1-lilly... [4] https://www.justice.gov/usao-edny/pr/telehealth-company-cere... [5] https://www.additudemag.com/done-adhd-stimulant-medication-s...