Health · Healthcare & Policy · 5 hrs ago
São Paulo court allows Urupês to resume compounded tirzepatide program
A São Paulo court temporarily allowed Urupês to restart its obesity treatment program using compounded tirzepatide, the active ingredient in Mounjaro.
The program in the town of Urupês provides injections to patients with obesity through Brazil’s public health system.
Eli Lilly, which makes Mounjaro and holds the Brazilian patent for tirzepatide until 2032, challenged the town’s program, arguing that the medicine could be compounded on an industrial scale.
The court said there was not enough evidence so far that the medicine was being produced in advance or at industrial scale, and cited an Anvisa review that found no evidence of sanitary irregularities in the documents it examined.
About 280 patients had active treatment when the program was suspended, and the court considered the risk that stopping treatment could harm their progress.
The town says doses are prescribed individually and given by health professionals, rather than supplied for patients to use at home.
The restart is temporary while the court considers the appeal, and Anvisa may act if new evidence shows the rules have been breached.
A São Paulo court has temporarily allowed Urupês to resume its municipal program providing compounded tirzepatide to patients with obesity.
The decision, issued on November 6, suspended an earlier injunction that had halted the program after a lawsuit by Eli Lilly.
The court found insufficient evidence at this stage that the medicine was being produced in advance or on an industrial scale.
The program had about 280 patients actively receiving treatment when it was suspended.
The court also considered a technical note from Anvisa that found no documented signs of sanitary irregularities warranting intervention at that time.
- Who
- Urupês city government and patients in its obesity-treatment program; Eli Lilly brought the lawsuit.
- What
- A São Paulo court temporarily allowed the city to resume providing compounded tirzepatide.
- When
- The decision was issued on November 6, 2026. Applications were expected to resume on November 10.
- Where
- Urupês, in São Paulo state, Brazil.
- Why
- The court found insufficient evidence of advance or industrial-scale production and considered the potential harm of interrupting treatment.
Eli Lilly
Urupês city government
Production model
Eli Lilly
Eli Lilly argued the municipal supply model could involve large-scale compounding contrary to Anvisa rules.
Urupês city government
The city said the quantity listed in its procurement plan was for budgeting and planning, and that each supply was based on an individual prescription.
Program status
Eli Lilly
Eli Lilly’s lawsuit led to an injunction halting the program.
Urupês city government
The city appealed, arguing that treatment was administered by health professionals and that interruption could harm patients.
Urupês launched its Tirzepatodos obesity-treatment program.
A first-instance court granted Eli Lilly’s request and ordered the program’s commitments and deliveries to stop.
A São Paulo court suspended the injunction and temporarily allowed the program to resume.
Applications were expected to resume, according to Folha.
- Active patients at suspension
- About 280
- Patients served since launch
- About 400
- Adult population with overweight or obesity
- 78%, according to the municipal health department
- Medicine supplier
- Terapêutica Farmácia de Manipulação Ltda.
- Anvisa technical note
- Found no documented signs of sanitary irregularities warranting intervention at that time.