Judge refuses to block Lilly's Zepbound ads in Novo's lawsuit

A federal judge in New Jersey has refused to stop Eli Lilly from running ads that compare its tirzepatide drugs, Zepbound and Mounjaro, with Novo Nordisk’s semaglutide drugs, Wegovy and Ozempic. In a 25-page opinion dated Oct 26, 2026, U.S. District Judge Zahid N. Quraishi denied Novo’s motion for a preliminary injunction. He concluded that Novo’s showing of irreparable harm “is inadequate to warrant the extraordinary relief it seeks.”

A separate order entered the same day, listed on the case docket, lifts a stay of Lilly’s deadline to respond to the complaint. The lawsuit itself goes on.

What Novo claimed

Novo filed suit on July 21, 2026, against Eli Lilly and Company and Lilly USA, LLC. According to the opinion, it brought claims for false advertising and unfair competition under the Lanham Act, the federal law that covers misleading commercial claims, and for unfair competition under New Jersey law. Three days later it asked the court to halt the ads and to order Lilly to run “corrective advertising.”

The dispute centers on two Lilly-sponsored head-to-head trials. The opinion describes SURMOUNT-5, an open-label study comparing Zepbound with Wegovy in adults with obesity or overweight, and SURPASS-2, which compared Mounjaro with Ozempic in adults with type 2 diabetes. In SURMOUNT-5, people on Zepbound lost an average of 20.2% of their body weight, against 13.7% for those on Wegovy.

Novo’s core argument, as Reuters reported, is that the ads pit higher doses of Lilly’s drugs against lower doses of Novo’s. The opinion notes that SURMOUNT-5 did not test a higher Wegovy dose because the FDA had not approved it when the trial ran. Lilly later added a disclaimer to its Zepbound ad saying that dose was not evaluated, the opinion says.

Lilly has denied wrongdoing. When Novo filed its motion in July, a Lilly spokesperson told MobiHealthNews that “SURMOUNT-5 and SURPASS-2 are the only head-to-head, randomized clinical trials directly comparing tirzepatide and semaglutide” and added, “We stand behind the science and our advertising.”

Why the judge said no

The court held an evidentiary hearing on August 27 and 28, 2026, and heard twelve witnesses. In the opinion, Quraishi found that Novo offered “only speculative claims of harm” to its reputation. He cited testimony from Lilly’s chief financial officer, Mark Stempel, summarizing prescription data that showed Novo’s products “remained stable” between April and July. Even if Novo suffered some harm, the judge wrote, it had not shown that money damages could not fix it.

The judge also said that, even assuming Novo was entitled to a legal presumption of irreparable harm, Lilly had produced enough evidence to rebut it. In a footnote, he gave a short preliminary view of the merits at Novo’s request. He called Novo’s case “less than persuasive” on the current record. Among his reasons: Novo concedes the ads contain no actual misrepresentations, the ads disclose that the newer Wegovy dose exists and was not studied, Lilly’s challenges to Novo’s consumer-confusion studies left doubts about their value, and Novo’s theory downplays the role of the prescribing doctor.

Novo’s own ads counted against it

Lilly also argued that Novo came to court with unclean hands, and the judge agreed. The opinion says Novo kept making superiority claims based on its SUSTAIN-7 trial after the FDA approved higher doses of Lilly’s Trulicity, without saying those doses were not tested. Novo conceded it stopped those ads days before it sued, according to the opinion. The judge wrote that he would also deny the injunction on this basis.

The ads at issue are aimed at patients. Reuters noted that the United States is one of only a handful of countries that allow drugmakers to advertise prescription medicines directly to consumers.

What is not known

• Whether Novo will appeal. The docket does not show an appeal, and Novo’s response to the ruling was not available at publication.
• How the merits will come out. The judge’s comments on the merits were preliminary, and the false advertising claims have not been tried.
• Whether the ads will change. Nothing in the ruling requires Lilly to alter or pull its campaign.

We will update this story if either company comments or the case moves to a new stage.