Zepbound vs Foundayo (orforglipron)
Side-by-side comparison based on SURMOUNT-1 and ATTAIN-1 phase 3 trial data plus April 2026 pricing.
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
Foundayo (orforglipron)
orforglipron (tablet)
Peak weight loss14.7%
TrialATTAIN-1
Administrationoral
FDA statuspending
List price$1,099/mo
Weight loss comparison (220 lbs starting weight)
% of body weight lost over 18 months, modeled from phase 3 trial data
Monthly cost by payment channel
| Channel | Zepbound | Foundayo (orforglipron) | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $88 | $63 | $25 (Foundayo (orforglipron) cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | $349 | $499 | $150 (Zepbound cheaper) |
| Telehealth — brand name (Hims, Ro, Found) | $499 | — | — |
| Cash retail (full list price) | $1,059 | $1,099 | $40 (Zepbound cheaper) |
Zepbound pros and cons
Pros
- ✓ Highest efficacy of any FDA-approved GLP-1 (22.5% in SURMOUNT-1)
- ✓ Dual GLP-1/GIP mechanism
- ✓ LillyDirect self-pay vials starting around $349/mo for lower doses
- ✓ FDA-approved for chronic weight management
Cons
- ✗ List price still high ($1,059/mo)
- ✗ Insurance coverage varies more than for Wegovy
- ✗ GI side effects can be more pronounced at higher doses
- ✗ Periodic supply constraints during demand spikes
Foundayo (orforglipron) pros and cons
Pros
- ✓ Daily pill with NO fasting requirement (advantage over oral Wegovy)
- ✓ Non-peptide small molecule — easier manufacturing/scale
- ✓ 14.7% average weight loss in ATTAIN-1
- ✓ Likely to be lower-priced than peptide injections at scale
Cons
- ✗ Pending FDA approval (expected mid-2026)
- ✗ Less long-term safety data than older GLP-1s
- ✗ Daily adherence required
Common side effects
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
Foundayo (orforglipron)
- • Nausea
- • Diarrhea
- • Vomiting
- • Constipation
Which should you choose: Zepbound or Foundayo (orforglipron)?
Choose Zepbound if: you want maximum weight loss (22.5% vs 14.7%); you prefer a weekly injection over a daily pill; cash-pay cost matters most to you; you want a drug FDA-approved specifically for weight loss.
Choose Foundayo (orforglipron) if: you prefer a daily pill over a weekly injection.
Final decisions should always be made with a licensed prescriber. This is educational content only.
Medical disclaimer: This calculator provides estimates only based on phase 3 clinical trial data and publicly listed prices. It is not medical advice. Real-world weight loss varies significantly. Consult a licensed healthcare provider before starting any medication.