INDIANAPOLIS, INDIANA - MARCH 17: A flag flies above the headquarters campus of Eli Lilly and Company on March 17, 2024 in Indianapolis, Indiana. Lilly, a pharmaceutical company, developed a new oral obesity pill known as Foundayo (Photo by Scott Olson/Getty Images)
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The FDA approved a new once-daily oral medication for adults who are obese or overweight with health related conditions. Foundayo, developed by drug maker Eli Lilly, represents a major shift in obesity treatment, since it is now the second GLP-1 therapy now approved for obesity as a pill, in addition to the Wegovy pill.
Until just a couple months ago, the most effective weight loss medications, like tirzepatide (Zepbound) and semaglutide (Wegovy), were only available as injectable drugs. Here’s what to know about the new oral pill Foundayo.
The drug’s active ingredient, orforglipron, belongs to the same class of GLP-1 receptor agonists like Ozempic and Wegovy, which mimic the natural hormone involved in appetite and metabolism. These drugs drive weight loss by slowing emptying of food from the stomach, increasing feelings of fullness and act on hunger centers in the brain to reduce cravings.
Although both oral pills for obesity activate the GLP-1 pathway, they differ in structure and composition. The Wegovy pill is a modified protein that requires special absorption conditions in order to be effective and avoid the acidic environment in the stomach. For this reason, it must be taken on an empty stomach, so patients must fast 30 minutes after taking the drug. Foundayo, on the other hand, is a small molecule that is stable in the stomach and can be taken anytime of the day, with or without food. This makes Foundayo easier for patients to adhere to and offers a more convenient method to treat obesity.
Individuals who took the highest dose of Foundayo for 72 weeks were able to lose 12.4% of their body weight, according to Eli Lilly’s latest clinical trials. That’s less than typical injections of Zepbound or Wegovy, with weight loss of 15-21% of body weight. No clinical trial to date has compared weight loss between oral Wegovy and Foundayo head-to-head. According to Eli Lilly, those who took Foundayo experienced reductions in non-HDL cholesterol, triglycerides and systolic blood pressure across all doses.
In general, like all other GLP-1 agonists, Foundayo is well tolerated with the most common side effects, including nausea, vomiting, constipation and diarrhea. Rarely, the drug can be linked to a painful abdominal condition known as pancreatitis, inflammation of the pancreas. Other less common side effects include inflammation of the gallbladder, kidney injury and a risk of a specific type of thyroid cancer.
For those who decide to pay out of pocket, Foundayo can cost anywhere from $149 to $349, depending on the dose sought after. For those with commercial or private-based insurance, the drug could be as low as $25 per month with select insurance plans. Starting in July, Medicare recipients can access the drug for $50 a month. These costs, like other discounted prices for comparable drugs, are far less than full-priced injectable weight loss drugs, which can cost more than $1,000 a month.
The new oral pill could be a game changer for Americans who fear needles, yet there are real barriers that may prevent Americans from accessing the drug. Although the science has developed a real tool to combat obesity, access to the drug is largely determined by health insurance coverage.
Insurance coverage for Foundayo will vary and high out-of-pocket costs may apply. Adults with obesity, or adults who are overweight with weight-related medical problems, may be eligible for commercial insurance coverage, which can reduce patient cost to as little as $25 per month. Medicare Part D recipients may also be able to access the drug for $50 per month, beginning as soon as July 1, 2026. Some insurers may still require prior authorization or proof that patients have tried other weight loss methods.
As with all GLP-1 drugs, demand and supply could prevent people who need the drug from getting it. Given their enormous popularity, availability constraints may emerge early after the drug is launched.
Foundayo marks a major milestone in obesity care, offering a convenient oral alternative to standard injectable GLP-1 therapies that are known to be effective in weight loss. Its ease of use and flexibility could make it a preferred option for many patients. However, access will ultimately be determined by health insurance companies.
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