For most of the GLP-1 era the only way to take one of these medicines was to inject it. That is no longer true. Two tablets are now approved in the United States for weight management: the Wegovy pill, approved on 2025-12-22, and Foundayo, approved on 2026-04-01. Both are taken once a day.
This page prices every dose of both, reports the trials behind them, and clears up the one thing that confuses almost every article on the subject — the dose printed on a Foundayo bottle is not the dose printed in the trial that got it approved, and there is a documented reason for that.
We report prices and published results. We do not say which medicine anyone should take; that is a prescriber's job, as our editorial standards explain. The cost hub carries the injections and the insurance and Medicare terms, and our tirzepatide vs semaglutide page covers the two injected drugs against each other.
The two pills, priced
| Wegovy pill (oral semaglutide) | Foundayo (orforglipron) | |
|---|---|---|
| Maker | Novo Nordisk | Eli Lilly |
| FDA approval | 2025-12-22, NDA 218316 | 2026-04-01, NDA 220934 |
| How taken | Once daily | Once daily, with or without food, swallowed whole |
| Labelled doses | 1.5, 4, 9, 25 mg | 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg |
| Self-pay, low dose | $149 (1.5 mg) | $149 (0.8 mg) |
| Self-pay, mid dose | $199 (4 mg) | $199 (2.5 mg), $299 (5.5 mg and 9 mg) |
| Self-pay, top dose | $299 (9 mg and 25 mg) | $349 (14.5 mg and 17.2 mg) |
Wegovy pill prices were read from NovoCare on 2026-09-06. Foundayo prices are as reported from Lilly's own Foundayo coverage-and-savings page; that page would not load for us on 2026-09-06, so these figures come from summaries of it rather than from the page itself, and they include two temporary reductions — the 2.5 mg dose at $149 and the 5.5 mg dose at $199 — described as running to 2026-12-31. Treat the Foundayo column as needing a re-check against Lilly's page before anyone relies on it.
For comparison, from the cost hub: the Wegovy pen is $349 a month at most doses, $199 for a new patient's first two fills, and Zepbound is $299 to $449 depending on dose.
The dose mystery, solved by the label
Search for orforglipron's results and you will find "36 mg" everywhere, because that is the top dose in the New England Journal of Medicine paper. Then you look at the prescribing information and the maximum dose is 17.2 mg. Neither number is wrong.
The label explains it directly. Its clinical-studies section says the effectiveness of Foundayo was established "based on adequate and well-controlled trials of an investigational orforglipron formulation," and that it "presents efficacy data from administration of the investigational orforglipron formulation shown as equivalent dosages of once daily FOUNDAYO." Trial 1 in the label is NCT05869903 — the same registration number as the published ATTAIN-1 paper — and the label describes its arms as 5.5 mg, 9 mg and 17.2 mg where the paper describes them as 6 mg, 12 mg and 36 mg.
So the mapping is:
| In the published trial | On the pharmacy label |
|---|---|
| 6 mg | 5.5 mg |
| 12 mg | 9 mg |
| 36 mg | 17.2 mg |
The commercial tablet is a different, more efficiently absorbed formulation. A reader comparing "36 mg gave 11% weight loss" against a bottle labelled 17.2 mg is looking at one trial described twice.
What each pill did in its trial
Foundayo, label Trial 1: 3,127 adults with obesity or overweight with a weight-related condition, no diabetes, 72 weeks.
| At week 72 | Placebo (n=949) | 5.5 mg (n=723) | 9 mg (n=725) | 17.2 mg (n=730) |
|---|---|---|---|---|
| Mean weight change | −2.1% | −7.4% | −8.3% | −11.1% |
| Lost ≥5% | 26.8% | 59.6% | 63.1% | 71.5% |
| Lost ≥10% | 13.0% | 32.5% | 39.8% | 54.5% |
| Lost ≥15% | 6.0% | 14.3% | 20.1% | 35.9% |
| Lost ≥20% | 2.9% | 5.9% | 8.9% | 18.4% |
A second label trial, in 1,613 adults with type 2 diabetes, gave −9.6% at 17.2 mg against −2.5% on placebo. Between 22% and 24% of participants in the Trial 1 drug groups stopped the trial drug, against 30% on placebo; adverse events specifically caused discontinuation in 5.3% to 10.3% of orforglipron participants against 2.7% on placebo in the published paper.
Wegovy pill, OASIS 4: 205 adults on oral semaglutide 25 mg and 102 on placebo, 71 weeks with the primary readout at 64.
- Mean weight change −13.6% against −2.2% on placebo, a difference of 11.4 percentage points (95% CI −13.9 to −9.0), P<0.001.
- Significantly more participants reached −5%, −10%, −15% and −20% than on placebo, and physical-function scores improved.
- Gastrointestinal adverse events: 74.0% on the drug, 42.2% on placebo.
The two trials are not the same size. OASIS 4 randomised 307 people at 22 sites; the orforglipron trials randomised 4,740 between them. That difference does not favour either drug's result, but it does mean the precision behind the two headline numbers is not equal.
Neither pill has been measured against an injection either. Our page on orforglipron against tirzepatide works through the closest thing the evidence offers — two placebo-controlled trials from the same sponsor, of the same length, in the same kind of population — and explains why even that is not a comparison.
The one cross-trial comparison, and who wrote it
Because no head-to-head exists, a population-adjusted indirect comparison was published in August 2026, matching individual patient data from OASIS 4 against aggregate data from ATTAIN-1. It found oral semaglutide 25 mg gave 3.2 percentage points more weight loss than orforglipron 36 mg (95% CI −5.9 to −0.4), with discontinuation for any adverse event four times as likely on orforglipron (odds ratio 4.1, 95% CI 1.3 to 13.0) (Diabetes Obes Metab 2026;28:7247-7256).
Five of the eight authors are employees and shareholders of Novo Nordisk, which makes semaglutide, and two more work for an agency Novo Nordisk paid to support the study. The method is a legitimate one and the paper declares all of this openly. It is still a comparison of a company's drug against a competitor's, written by that company, in the absence of a trial that would settle it.
The boxed warning worth reading twice
Foundayo carries the GLP-1 class boxed warning about thyroid C-cell tumours observed in rats and mice, and is contraindicated in people with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. The unusual part is in the warning's own text: orforglipron, it states, "is not pharmacologically active in rats or mice and did not produce tumors in rodents." The warning is there because the molecule acts on the human GLP-1 receptor and the human relevance of the rodent finding has not been determined — a class-level precaution, not a finding about this drug's animal data.
Sources
- openFDA Drugs@FDA API, read 2026-09-06: FOUNDAYO NDA 220934 (original approval 2026-04-01, supplement approved 2026-08-04); WEGOVY tablets NDA 218316 (original approval 2025-12-22).
- FOUNDAYO prescribing information via the openFDA label API, label effective 2026-07-29: indications, dosage and administration, boxed warning, and clinical studies including Table 6.
- Wharton S et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. N Engl J Med 2025;393(18):1796-1806. PubMed 40960239 · NCT05869903
- Wharton S et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. N Engl J Med 2025;393(11):1077-1087. PubMed 40934115 · OASIS 4, NCT05564117
- Michalak W et al. Oral Semaglutide 25 mg Versus Orforglipron 36 mg in Obesity: A Population-Adjusted Indirect Treatment Comparison. Diabetes Obes Metab 2026;28(8):7247-7256. PubMed 42225305
- NovoCare Wegovy savings and pricing page, read 2026-09-06.