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A new lawsuit pits two pharmaceutical giants with large North Carolina campuses against each other in a fight over weight-loss drug advertisements.
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On Tuesday, Novo Nordisk sued Eli Lilly for allegedly misleading the public in direct-to-consumer ads that compare Eli Lilly’s GLP-1s Mounjaro and Zepbound to Novo Nordisk-made Ozempic and Wegovy.
“The ads are maliciously and deceptively false because Lilly knowingly cites outdated clinical trials that compare the highest doses of the Lilly medicines to lower doses of Novo Nordisk’s medicines,” states the lawsuit, which Novo Nordisk filed in the federal district court in New Jersey.
Eli Lilly rejected this claim in an email Tuesday to The News & Observer, arguing the companies’ respective treatments for weight loss were compared in a randomized clinical trial. “Novo is asking a court to stop Lilly from communicating the results of that trial,” Eli Lilly wrote. “We stand firmly behind our advertising.”
Each company makes its obesity treatments in North Carolina. Novo Nordisk is the largest private employer in Johnston County, where the Danish company opened its first foreign manufacturing site in the 1990s.
A relative newcomer to the Tar Heel State, Indiana-based Eli Lilly selected a former GlaxoSmithKline campus in Research Triangle Park for a $474 million factory in 2020 before opening an identical manufacturing site outside of Charlotte in 2024. It is one of the 25 biggest employers in Durham County.
No third major GLP-1 producer exists — the two rivals control the market for both injectable and newer oral treatments.
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“They’re two of the 800-pound gorillas that have been competing against each other for years, decades in the diabetes and metabolic space,” Michael DiFiore, an analyst at the New York City investment firm Evercore, told The N&O in 2025.
Both companies thrived earlier this decade as demand for their obesity treatments soared. However, Novo Nordisk has struggled over the past two years as Eli Lilly has eroded its market share. Since its stock peaked in 2024, Novo Nordisk has lost more than half its market value. In September, the company cut 9,000 jobs — including more than 200 workers at its North Carolina campus in the town of Clayton.
Eli Lilly’s share price has continued to rise. Today, it is the No. 15 most valuable publicly traded company in the world, while Novo Nordisk is No. 83.
Previous studies did in fact find Eli Lilly’s drugs more effective for weight loss. “People remember (Ozempic) on the TikTok shows, but they don’t know Zepbound is much better,” Dr. Sarah Ro, director of UNC Health Medical Group Weight Management Program, told The N&O last year.
Zepbound and Wegovy are specifically approved to treat obesity while Mounjaro and Ozempic are officially diabetes treatments.
In its lawsuit, Novo Nordisk wrote that the U.S. Food and Drug Administration had approved a higher Wegovy dosage for weight loss in March but that Eli Lilly debuted a nationwide Zepbound television ad the following month that ignored this new dosage. A separate Mounjaro ad, Novo Nordisk noted, didn’t use a higher dosage of Ozempic that the FDA approved four years ago.
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