Foundayo vs Wegovy pill: both $149 (Oct 2026)

Where the two pills differ

Foundayo and the Wegovy pill are both once-daily oral GLP-1 receptor agonists for weight reduction in adults, and they are not the same drug. FDA approved the Wegovy pill on December 22, 2025, and approved Foundayo on April 1, 2026. The Wegovy pill was the first oral GLP-1 for obesity in the United States. Foundayo was the first new molecular entity approved under FDA's Commissioner's National Priority Voucher pilot, 50 days after filing.

The useful comparison is the daily routine, the molecule, the dose ladder, the labeled use, and the published price. The table puts those differences in one place. Trial averages come later, from separate studies, and a live Wegovy pill catalog sits under this section because Foundayo has no treatment row of its own.

Food, water, and the molecule

Lilly describes Foundayo as a once-daily small-molecule, non-peptide oral GLP-1 receptor agonist that can be taken any time of day without food or water restrictions. The July 2026 prescribing information says to take it orally once daily, with or without food, swallow the tablet whole, and take no more than one tablet a day. Lilly's April 9, 2026 announcement says it is available through LillyDirect, telehealth providers, and U.S. retail pharmacies.

The June 2026 Wegovy label says to take one tablet once daily on an empty stomach in the morning with water, up to 4 ounces, and no other liquids, then wait at least 30 minutes before eating, drinking, or taking other oral medicines. The tablet is swallowed whole. Semaglutide is the active ingredient. That fasting window is a daily difference from Foundayo's with-or-without-food instruction, and the two active ingredients are not interchangeable names for one product.

Dose ladder and missed-dose rules on each label

The Foundayo label starts at 0.8 mg once daily. After at least 30 days the listed step is 2.5 mg, then 5.5 mg after at least 30 more days. Later steps are 9 mg, 14.5 mg, or 17.2 mg, each after at least 30 days, based on response and tolerability, with a maximum of 17.2 mg. Tablets come in those six strengths, in bottles of 30. If a dose is missed, the label says to take it as soon as possible and not to double the dose. If 7 or more consecutive doses are missed, the label calls for re-escalation at a lower dosage. Lilly's approval announcement says oral birth control may work less well, and that a provider may recommend another birth control method for 30 days after starting and after each dose increase.

The Wegovy tablet label uses a fixed calendar: 1.5 mg on days 1 through 30, 4 mg on days 31 through 60, 9 mg on days 61 through 90, and 25 mg from day 91 onward as the maintenance dosage. Tablet strengths are 1.5, 4, 9, and 25 mg. If a tablet is missed, the label says to skip it and take the next dose the following day. The same label allows a switch from the 2.4 mg injection to the 25 mg tablet one week after the last injection. That switch sentence is label information for a prescriber. These schedules describe the products. They are not instructions to choose, raise, skip, or restart a dose.

Missed doses, dose changes, birth control, and a switch from the Wegovy injection belong with the current label and the prescriber.

Indications, including cardiovascular risk reduction

Foundayo's approval is for use with a reduced-calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in adults with obesity, or in adults with overweight and at least one weight-related comorbid condition. The sources in this packet give Foundayo that weight indication. They do not add a cardiovascular risk-reduction indication for Foundayo.

Wegovy tablets are indicated for weight reduction and maintenance and to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and either obesity or overweight. That second indication is a label difference, not a claim that one obesity trial beat the other. The July 2026 Foundayo label carries a boxed warning for thyroid C-cell tumors and says the drug is not for patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. The June 2026 Wegovy label also carries a boxed warning about thyroid C-cell tumors seen in rodents and says it is unknown whether Wegovy causes those tumors, including medullary thyroid carcinoma, in people.

Self-pay price, list price, and savings cards

At the lowest labeled dose, both self-pay offers start at $149 a month: Foundayo 0.8 mg and Wegovy 1.5 mg. At the top labeled maintenance doses, Foundayo 17.2 mg is $299 a month when each refill is completed within 45 days, and $349 otherwise, while Wegovy 25 mg is $299 a month. Wegovy 9 mg is also $299. Novo Nordisk defines one month as one bottle of 30 tablets and can modify or cancel its offer at any time. Lilly defines a month as 30 days. On those terms, 12 on-time Foundayo 17.2 mg fills and 12 Wegovy 25 mg fills are each 12 x $299 = $3,588. Foundayo fills outside the 45-day window are 12 x $349 = $4,188.

List price is farther apart. Foundayo's wholesale acquisition cost is $649.00 for a 30-day supply. The Wegovy pill list price is $1,349.02 per package, one bottle of 30 tablets. The arithmetic is $1,349.02 - $649.00 = $700.02 between those published list figures. With commercial insurance that covers Foundayo, Lilly's card can bring a fill to as little as $25, with maximum savings of $100, $200, or $300 by fill length, $1,000 per calendar year, and up to 10 fills, ending December 31, 2026. Government beneficiaries are excluded. Novo Nordisk's Wegovy card also says as little as $25 per month, with maximum savings of $100 per month, government beneficiaries excluded, and pricing to be updated after December 31, 2026. When commercial insurance does not cover Foundayo, Lilly lists as low as $149, $149, $199, or $299 by dose, with maximum monthly savings of $520, $520, $470, or $370. The dose-by-dose Foundayo walkthrough, including the temporary 2.5 mg and 5.5 mg prices, is in the companion cost note.

Medicare Bridge coverage for both tablets

Starting July 1, 2026, Medicare's temporary GLP-1 Bridge covers Foundayo tablets and Wegovy tablets, along with Wegovy injection and Zepbound KwikPen only. For an eligible Part D enrollee the copayment is $50 for a one-month supply of 28 or 30 days. The same eligibility rules apply to the listed drugs: age 18 or older, and a BMI of 35 or higher, or a BMI of 30 or higher with diastolic heart failure, uncontrolled hypertension, or chronic kidney disease stage 3a or higher, or a BMI of 27 or higher with prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease.

The Bridge excludes someone who already gets GLP-1s through a Part D plan, or who has type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease. The provider sends the prescription and prior authorization and certifies a lifestyle program focused on diet and exercise. Prior authorization is valid through December 31, 2027 unless the GLP-1 changes. The $50 does not count toward the Part D deductible or out-of-pocket limit, and Extra Help cannot lower it.

Obesity trial results from two different studies

There is no head-to-head obesity trial of Foundayo versus the Wegovy pill in this source packet. The numbers below come from different trials, with different lengths, estimands, and placebo results. They are not a ranking.

Foundayo Trial 1, ATTAIN-1, enrolled adults without diabetes for 72 weeks. On the intention-to-treat analysis, mean body weight change was -11.1% on 17.2 mg, -8.3% on 9 mg, and -7.4% on 5.5 mg, versus -2.1% on placebo. On 17.2 mg, 54.5% of participants lost at least 10% of body weight, versus 13% on placebo. Lilly's April 1, 2026 announcement adds the efficacy estimand for people on the highest dose who stayed on treatment: an average 27.3 lb (12.4%) versus 2.2 lb (0.9%) on placebo, and, regardless of completion, 25 lb (11.1%) versus 5.3 lb (2.1%). Trial 2, in adults with type 2 diabetes over 72 weeks, reported -9.6% on 17.2 mg versus -2.5% on placebo. The same announcement lists the most common side effects as nausea, constipation, diarrhea, vomiting, indigestion, stomach pain, headache, swollen belly, feeling tired, belching, heartburn, gas, and hair loss.

OASIS 4, the Wegovy pill trial in the December 22, 2025 approval announcement, lasted 64 weeks and enrolled 307 adults with obesity or overweight plus a comorbidity, without diabetes. On 25 mg, mean weight loss was 13.6% versus 2.4% on placebo regardless of staying on treatment (treatment-policy estimand), and 16.6% versus 2.7% if everyone stayed on treatment. Seventy-six percent lost at least 5% of body weight, versus 31% on placebo. A 72-week Foundayo percentage and a 64-week Wegovy percentage answer different protocols.

Lilly's September 29, 2026 analysis was in type 2 diabetes

On September 29, 2026, at the European Association for the Study of Diabetes meeting in Milan, Lilly presented an indirect treatment comparison using ACHIEVE-3 and PIONEER PLUS data in adults with type 2 diabetes. Under the efficacy estimand, Foundayo 17.2 mg was associated with 1.5% greater weight loss (95% confidence interval -2.7% to -0.2%) and a 0.3% greater A1C reduction than oral semaglutide 25 mg at 52 weeks. Lilly's release says oral semaglutide 25 mg is not approved in the United States for type 2 diabetes. This was a company-presented indirect analysis in a diabetes population. It was not an obesity head-to-head trial, and it was not a trial of the Wegovy pill.

The same release describes ACHIEVE-3, a separate head-to-head, open-label, 52-week trial in 1,698 adults with type 2 diabetes. Weight loss was 6.7% on Foundayo 9 mg and 9.2% on Foundayo 17.2 mg, versus 3.7% on oral semaglutide 7 mg and 5.3% on oral semaglutide 14 mg. Those comparator doses are 7 mg and 14 mg, not the Wegovy tablet's 25 mg maintenance dose. Sesame Care has a Wegovy pill offer in the live catalog under this section. Shed Rx sells Foundayo and bills that medication separately from its membership; Foundayo itself has no catalog treatment slug.