Foundayo vs the Wegovy Pill: What a Year of Each Costs

Paying cash, Foundayo™ and the Wegovy® pill cost the same once you reach a maintenance dose: $299 a month each, or $3,588 for twelve 30-day fills. The difference is in year one. Escalating on each label's schedule, a first year of Foundayo costs $3,188 at Lilly's current prices against $3,338 for the Wegovy pill, a $150 gap that exists only because two of Foundayo's starter doses are temporarily reduced through December 31, 2026.

The two are different drugs. Foundayo is orforglipron, a small-molecule GLP-1 pill from Eli Lilly approved in April 2026. The Wegovy pill is oral semaglutide from Novo Nordisk. This page compares what they cost, not how well they work.

Year-one cost on each dose ladder

Both labels escalate the dose in 30-day steps. Foundayo starts at 0.8 mg, moves to 2.5 mg and then 5.5 mg, and can step up to 9, 14.5 or 17.2 mg after at least 30 days on each.⁵ The Wegovy pill starts at 1.5 mg once daily for 30 days and titrates every 30 days to its 25 mg maintenance dose.⁶

Lilly sells Foundayo through LillyDirect at $149 a month at 0.8 mg, $149 at 2.5 mg, $199 at 5.5 mg and $299 at 9 mg and above. The 2.5 and 5.5 mg prices are "temporarily reduced through December 31, 2026."¹ TrumpRx lists the regular prices behind them: $199 at 2.5 mg and $299 at 5.5 mg.² Novo sells the Wegovy pill at $149 a month at 1.5 mg, $199 at 4 mg and $299 at 9 and 25 mg.³

At Lilly's regular prices the two first years come out identical, to the dollar. Anyone starting Foundayo late in 2026 will cross into 2027 partway through the ladder, so their year one lands between the two Foundayo rows.

Both manufacturers print list prices on TrumpRx that no self-pay patient on these programs pays: $649 a month for Foundayo and $1,349.02 for the Wegovy pill.²⁴ The gap between those numbers says more about how each company sets list prices than about what you will spend.

Maintenance cost

From the maintenance dose onward, both pills cost $299 a month, which is $3,588 for twelve 30-day fills. There is one condition on the Foundayo side. At 14.5 and 17.2 mg, the $299 price holds only "when you refill within 45 days."¹ TrumpRx shows the price if you miss a fill: $349 a month.² A year of late refills at those doses is $4,188, $600 more than the on-time year.

Novo's pill pricing carries no refill window. Costco's price list adds one date of its own: its 1.5 mg Wegovy tablet price of $149 becomes $199 a month after December 31, 2026.⁷ That only touches the first month of a new start.

For how these compare with injections at maintenance, see what GLP-1 maintenance doses cost.

Savings cards

Both manufacturers publish a price for commercially insured patients whose plan covers the drug, and both exclude government beneficiaries.

Lilly says eligible, commercially insured patients with coverage for Foundayo "could pay as low as $25 a month," with a month defined as 30 days.¹ Novo's Wegovy offer lets commercially insured patients "pay as little as $25" a month, "subject to a maximum savings of $100/month," and defines a month of the pill as one bottle of 30 tablets.³

The $100 ceiling is the difference that matters. If your plan leaves you with a copay above $125 for the Wegovy pill, the card cannot bring it down to $25. Lilly's page states no cap for Foundayo; read the terms before assuming there is none. Manufacturer copay cards explains how these ceilings work.

Medicare GLP-1 Bridge

Since July 1, 2026, Medicare covers both pills for eligible Part D enrollees under a temporary program called the Medicare GLP-1 Bridge. Medicare.gov lists "Foundayo® (tablet)" and "Wegovy® (injection or tablet)" among the covered drugs, with a $50 monthly copayment.⁸ That is $600 a year for either pill.

Eligibility has conditions: a Part D plan, a qualifying weight-related condition, and not already being eligible for the drug through your own Part D benefit. Medicare.gov states that an approved prior authorization stays valid through December 31, 2027, unless you change GLP-1s.⁸ Switching from one pill to the other mid-program is therefore not free of paperwork. Cash pay vs insurance covers how the Bridge interacts with the rest of Part D.

Food and timing rules as a cost of adherence

The labels set very different daily routines, and a routine that is hard to keep has a cost of its own. This is a description of the labels, not advice about which to take.

Foundayo is taken once daily "with or without food."⁵ The Wegovy pill must be taken on an empty stomach in the morning with no more than 4 ounces of water, and you then wait at least 30 minutes before eating, drinking anything else or taking other oral medicines.⁶

Missed doses have a price on the Foundayo side. If seven or more consecutive doses are missed, the label says to restart the escalation at a lower dose.⁵ Lilly prices the lower doses below maintenance, so a restart costs little in cash. The real cost is time: weeks spent climbing back to the dose you had reached.

Buying either pill through a telehealth company

LillyDirect, NovoCare Pharmacy and TrumpRx fill a prescription; none of them writes one. A telehealth company can supply the prescription and the drug together, and charges for doing so.

Among the telehealth companies we track, one company publishes a Foundayo price ($248 a month at the no-commitment rate), and 4 companies publish a Wegovy pill price ($248 to $448 a month). Set each against the manufacturer's own $299 at maintenance, and check what the company's figure covers: some bundle the pill with the visit, and some bill the pill separately at the manufacturer's price.

The best oral GLP-1 providers board ranks them by what a year actually costs, and what oral semaglutide costs shows the full spread for semaglutide you swallow, compounded tablets included.

Foundayo™ and Zepbound® are trademarks of Eli Lilly and Company. Wegovy® is a registered trademark of Novo Nordisk A/S. Doseworth is not affiliated with either.