Ozempic Lawsuit Update 2026

The litigation over Ozempic and the broader class of GLP-1 receptor agonist drugs entered the second half of 2026 as one of the fastest-growing mass torts in the country, and also one of the slowest to reach a jury. The federal docket keeps climbing, a European regulator has added a vision-loss warning that plaintiffs are already leaning on, and a single evidentiary ruling from the presiding judge is quietly reshaping which cases can move forward. Here is where things stand at mid-year.

The state of the docket: two separate MDLs

Federal GLP-1 cases are now split across two multidistrict litigations, both in the U.S. District Court for the Eastern District of Pennsylvania and both overseen by Judge Karen Spencer Marston, who inherited the litigation after the original presiding judge, Gene E.K. Pratter, died in May 2024.

The main proceeding, In re: Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) Products Liability Litigation (MDL-3094), covers gastrointestinal injuries. Plaintiffs allege the drugs cause gastroparesis, or stomach paralysis, along with ileus, intestinal obstruction, gallbladder injury, and pancreatitis, and that Novo Nordisk and Eli Lilly failed to adequately warn patients and physicians. The drugs named include Novo Nordisk's Ozempic, Wegovy, Rybelsus, Victoza, and Saxenda, and Eli Lilly's Mounjaro, Trulicity, and Zepbound. As of mid-2026, the gastrointestinal MDL held roughly 3,800 pending cases and had grown by more than 1,500 actions since August 2025, per the Judicial Panel on Multidistrict Litigation's monthly reports. These remain unproven allegations, and no court has found the manufacturers liable.

A second, much newer docket was created in December 2025. The JPML declined Eli Lilly's request to fold vision-loss claims into the existing gastrointestinal MDL and instead established a standalone proceeding, MDL-3163, for claims alleging that semaglutide causes non-arteritic anterior ischemic optic neuropathy (NAION), a form of sudden and often permanent vision loss. That docket is small so far, in the low hundreds of cases, and is also assigned to Judge Marston.

The most consequential ruling so far: proof of diagnosis

The single most important development in the gastrointestinal MDL is not a verdict but an evidentiary gate. On August 15, 2025, Judge Marston largely denied the drugmakers' motion to dismiss and allowed the central failure-to-warn claims to proceed, while striking design-defect and medical-monitoring theories she found preempted by federal law. Days later, she entered the order that now governs the shape of the docket: any plaintiff alleging drug-induced gastroparesis must support the diagnosis with a properly performed gastric emptying study, whether by scintigraphy, breath testing, or a wireless motility capsule, confirming delayed emptying at the time of diagnosis.

The practical effect is a meaningful filter. Before that order, a plaintiff could allege gastroparesis based on symptoms alone. After it, the claim needs objective diagnostic proof, which narrows the pool of viable cases. The ruling grew out of what Judge Marston called the litigation's "cross cutting issues," and as trade outlet BioSpace reported, she sided with Novo Nordisk and Eli Lilly in prioritizing the questions of diagnostic testing and warning adequacy before reaching the broader question of whether the drugs actually cause the injuries alleged. In 2026, the parties moved into expert discovery and Daubert briefing, with Eli Lilly moving to exclude the plaintiffs' causation experts. No bellwether trial date has been set, and trials are not expected until late 2026 at the earliest, and more likely 2027.

The regulatory backdrop driving the vision-loss claims

The vision-loss docket has a regulatory tailwind the gastrointestinal cases lack. In June 2025, the European Medicines Agency's safety committee (PRAC) concluded that NAION is a "very rare" side effect of semaglutide, potentially affecting up to 1 in 10,000 users, and recommended that the product information for Ozempic, Rybelsus, and Wegovy be updated to reflect it. The agency noted that several large epidemiological studies suggested roughly a two-fold increase in NAION risk among adults with type 2 diabetes taking semaglutide. The World Health Organization issued its own medical product alert later that month, urging regulators to revise semaglutide risk-management plans.

The signal was not confined to regulators. In November 2025, Reuters reported that Denmark's patient-compensation body had granted compensation to four patients who experienced vision loss after using Wegovy and Ozempic. For U.S. plaintiffs, the argument is straightforward: European and international authorities have acknowledged a labeled risk that, they contend, was not adequately disclosed on the American label at the time they were injured. Novo Nordisk disputes the causal link, having said the totality of evidence did not suggest a reasonable possibility of a causal relationship between semaglutide and NAION and that the drug's benefit-risk profile remains favorable.

The corporate fight is escalating on a separate front

The litigation is also unfolding against a backdrop of open commercial warfare between the two defendants. On July 21, 2026, Novo Nordisk sued Eli Lilly in New Jersey federal court, alleging that Lilly's advertising campaigns use outdated clinical trials to mislead consumers about the comparative efficacy of the rival drugs, and asking the court to halt the ads and order corrective advertising, as CNBC reported. The suit is not part of the injury MDLs, but it underscores how high the stakes are in a market where Lilly's Zepbound sales reached nearly $4.2 billion in the first quarter of 2026, an 80 percent jump year over year, according to Yahoo Finance. A market that large is a large litigation target.

The science remains genuinely contested

Underlying everything is a scientific dispute that is far from settled. On the vision side, a widely cited 2024 study from Massachusetts Eye and Ear, published in JAMA Ophthalmology, found that patients prescribed semaglutide had a substantially elevated risk of NAION compared with patients on other medications. On the gastrointestinal side, the two sides offered sharply different accounts at the MDL's "Science Day." Plaintiffs' experts argued that sustained GLP-1 use causes gastric dysfunction meeting the clinical definition of gastroparesis, while defense experts countered that the drugs temporarily slow gastric emptying without producing a true diagnosable disease, and may unmask pre-existing problems rather than create new ones. That disagreement is exactly what the coming Daubert rulings, and eventually a jury, will have to sort out.

What to watch in the second half of 2026

Three things will define the rest of the year. First, watch Judge Marston's rulings on the pending expert challenges. Because the litigation was structured to resolve diagnostic testing, warnings, and preemption before general causation, these evidentiary decisions will do more than the raw case count to determine whether MDL-3094 heads toward bellwether trials or contracts sharply. Second, watch the NAION docket mature. It is early, but the EMA label change, the WHO alert, and the Danish compensation awards give those plaintiffs a regulatory record the gastrointestinal claimants never had, and the MDL will hold its own Science Day on the vision science. Third, watch whether the filing surge continues now that the gastric-emptying-study requirement has raised the bar for entry. A litigation this large will not resolve quickly, and on the current schedule, the first jury will not hear a GLP-1 injury case until late 2026 or 2027.

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