FDA clears cheaper Eli Lilly pill, raising fresh questions about obesity drug coverage costs
A once-daily pill that can deliver double‑digit weight loss without injections is about to test how far plans will go to cover GLP‑1 drugs.
According to Reuters, the US Food and Drug Administration has approved Eli Lilly’s orforglipron, branded as “Foundayo,” as a once‑daily oral GLP‑1 therapy for weight loss, making it only the second weight‑loss pill in this class,
The FDA granted expedited approval and reviewed the application in 50 days, AP News reported.
Foundayo is a small‑molecule GLP‑1 drug that patients can take any time of day without food or water restrictions.
By contrast, Novo Nordisk’s oral “Wegovy” pill, a peptide version of semaglutide, must be taken first thing in the morning on an empty stomach with only a few ounces of water, followed by a 30‑minute wait before eating or drinking.
On weight loss, the pill trades off convenience against raw efficacy.
Yahoo Finance reported that trial participants on Foundayo lost 11.1 percent of their body weight, while Lilly’s injectable “Zepbound” showed an average weight loss of 20.2 percent.
AP News said a larger trial of more than 3,000 adults with obesity found that people on the highest 36 mg dose of orforglipron lost 11.2 percent of their body weight – about 25 pounds on average over more than 16 months – versus 2.1 percent (less than 5 pounds) on placebo.
Both oral drugs from Lilly and Novo Nordisk produced less weight loss on average than Zepbound, which delivers about 21 percent loss, and injectable Wegovy, which averages around 15 percent.
Yahoo Finance similarly reported roughly 14 percent weight loss with the Wegovy pill and about 15 percent with the Wegovy injection.
AP News said orforglipron users in the trial also saw improvements in waist circumference, blood pressure, triglycerides and cholesterol.
Gastrointestinal side effects led 5 percent to 10 percent of patients on orforglipron to discontinue treatment, compared with nearly 3 percent in the placebo group.
Pricing will sit at the centre of coverage decisions.
AP News reported that people with insurance coverage could pay about US$25 a month for Foundayo with a Lilly coupon or discount card, while those paying cash will face between US$149 and US$349 a month depending on dose.
Reuters said self‑pay pricing for Foundayo through LillyDirect starts at US$149 a month for the lowest dose, with most patients expected to pay around US$349 a month and refill incentives that can bring costs down to about US$299.
For injectables, Zepbound’s US list price ranges from US$499 to US$1,086.37 across six doses, with self‑pay prices starting at US$299 a month for 2.5 mg, US$399 for 5 mg and US$449 for 7.5 mg and higher doses under Lilly’s “Self Pay Journey Program.”
Reuters said commercially insured patients may qualify to pay as low as US$25 for a one‑ or three‑month supply of Zepbound.
On the Novo side, commercially insured patients pay US$25 a month for the Wegovy pill.
Self‑pay prices start at US$149 a month for the 1.5 mg and 4 mg doses through 31 August 2026, rising to US$199 a month for 4 mg after that date.
The 9 mg and 25 mg oral doses cost US$299 a month.
For Wegovy injections, Reuters reported a US list price of US$1,349.02 per package, with commercial insurance potentially reducing costs to US$25 a month, while cash‑pay customers pay US$349 a month for doses ranging from 0.25 mg to 2.4 mg.
According to CNBC, Eli Lilly and Novo Nordisk agreed with the Trump administration that the lowest doses of Foundayo and the Wegovy pill would both be priced at US$149 a month for cash‑pay customers.
AP News reported that, under related Trump administration deals, seniors on Medicare will be able to access Foundayo and other GLP‑1 obesity drugs for US$50 a month starting this summer.
Cost still heavily shapes treatment choices.
CNBC quoted obesity medicine physician Nidhi Kansal of Northwestern Medicine saying that “price is what is driving the decision-making between clinicians and patients” because “they’re all excellent drugs” but “it’s still a financial decision at the end of the day.”
Foundayo also arrives in an environment where US policymakers are scrutinizing drug prices.
Eli Lilly is among more than a dozen drugmakers that signed deals with the Trump administration to charge similar prices in the US as in other wealthy countries.
The White House has since pushed Congress to codify elements of those deals into “most favored nation” drug pricing law, a move Lilly opposes.
CEO Dave Ricks told CNBC the company will use “all the tools we have to combat bad policy” and called such legislation “bad policy.”
