A new weight-loss pill is here. Here's how Foundayo compares to Wegovy, Zepbound, and other GLP-1 rivals.

• Eli Lilly's weight loss pill Foundayo was approved by the FDA.
• The pill rivals GLP-1 weight loss medications from other major drugmakers, like Novo Nordisk.
• Here's everything to know about side effects, cost, and insurance coverage.

The GLP-1 world is buzzing after Eli Lilly released a new weight loss pill.

The Federal Food and Drug Administration approved the medication, called Foundayo, for market on April 1. Unlike most other GLP-1 drugs, the pill can be taken at any time of day without food or water restrictions. It's intended for adults with obesity, who are overweight, or who have weight-related health conditions.

From side effects to sticker price, here's everything to know about the pill.

How does Foundayo compare to other GLP-1s?

GLP-1s revolutionized weight loss treatment when drugs like Zepbound and Wegovy were made available in the early 2020s. The medications were initially intended to treat type 2 diabetes, and have since been used to treat a variety of obesity-related conditions. Most GLP-1s have been available as injections, not pills. FDA approval of the Foundayo pill could give Eli Lilly a new edge over other drugmakers.

Novo Nordisk, which makes Ozempic, released the first oral semaglutide pill for type 2 diabetes treatment with FDA approval in 2019. Called Rybelsus, that pill must be taken each morning with a small amount of water on an empty stomach. Oral Wegovy, also made by Novo Nordisk, became available for weight loss in early 2026, and Novo plans to soon release a pill form of Ozempic. Per Lilly, Foundayo has more flexibility than competitors: It can be taken at any time of day and has been approved for generalized weight loss-related use.

In a Lilly-funded trial published by The Lancet, patients on 7 to 14 milligrams of Rybelsus lost an average of 8 and 11 pounds, while patients on 12 to 36 milligrams of orforglipron, the active ingredient in Foundayo, lost an average of 15 to 20 pounds. Lilly's pill "outperformed" Novo's "on every key endpoint we measured, including A1C and weight loss," lead trial investigator Dr. Julio Rosenstock said in a release. In a report published Wednesday, Lilly reported that adults who took Foundayo lost an average of 27 pounds on the highest dose.

Patients and doctors interviewed by Business Insider said they've used GLP-1s to treat everything from polycystic ovarian syndrome, to osteoarthritis, to obstructive sleep apnea. For many, the treatment has been life-changing.

"I had tried all the medications that existed, supplements on top of supplements, and nothing really was able to fully grasp the insulin resistance piece for me," said a 20-something with PCOS. "It improved my quality of life significantly," said another patient who said her GLP-1 helped alleviate debilitating joint pain. "I'm 53 and probably in better shape than I was in my 30s."

Will the pill be covered by insurance?

Insurance coverage for Foundayo will vary. For people with private plans, coverage is set by individual insurance companies and employers who purchase the plans. Some will cover GLP-1s for those with a type 2 diabetes diagnosis only. Others will cover the drugs for weight-loss patients if they submit prior authorization from their doctor or complete a series of health assessments to ensure eligibility, like nutrition counseling or lab tests. Marketplace plans have similar rules, rarely covering GLP-1s for weight loss.

Government-run insurance plans, like Medicare and Medicaid, typically don't cover weight-loss drugs. This means that GLP-1s are often only covered for patients who are type 2 diabetic. Medicare Part D enrollees may be able to get the pill for $50 per month as soon as July 1, according to Lilly, though Medicare has not yet announced coverage.

Insurers will begin evaluating what they will and will not cover this summer, before 2027 open enrollment begins. By the fall, Americans will have a clearer picture of their insurance coverage for Foundayo and other GLP-1 medications for next year.

Still, the insurance conversation around GLP-1s has been complex — with insurers and companies rolling back coverage as the drugs' popularity drives up costs. A GoodRx analysis found that the number of Americans without coverage for Eli Lilly's Zepbound increased by 12% from 2025 to 2026. Over 16 million people with private insurance don't have any coverage for this class of drug in 2026 when prescribed for weight loss, the analysis found.

How much will the pill cost?

Eli Lilly said that the highest dose of Foundayo will be available to Americans for $349. Oral Wegovy, by contrast, costs $299 at the high dose.

At the lowest dose, Lilly said patients can get the drug for $149 with their self-pay option, or $25 with commercial insurance and a Foundayo savings card. Savings cards are pharmacy discounts used to lower the cost of prescriptions, which may be used by both uninsured and insured Americans.

The rise of GLP-1s — both pills and injections — has fueled a rapidly growing direct-to-consumer industry. LillyDirect, Eli Lilly's self-pay platform, already partners with Walmart, Amazon, and the telehealth company Ro.

"More consumers are exploring things like a cash option, bypassing insurance, shopping around to get the best price," Amanda Nguyen, GoodRx's senior health economist, told Business Insider. An April 1 report from UBS Investment Bank said analysts expect the direct-to-consumer market to be "the largest channel" for consumers to get Foundayo.

Last month, Lilly also rolled out Lilly Employer Connect, designed to help employers reduce costs associated with Zepbound coverage. The drugmaker has not yet announced if a similar employer savings program will become available for Foundayo.

Does the pill have side effects?

Similar to other GLP-1 medications, Foundayo can cause side effects in some patients. Research released by Eli Lilly reports that common side effects include nausea, constipation, diarrhea, vomiting, indigestion, abdominal pain, headache, bloating, fatigue, and hair loss. Inflammation of the pancreas, dehydration, severe stomach problems, and allergic reactions are also possible, but rare.

The company advised patients to take the pill under supervision of a medical provider, take only one pill a day, and avoid simultaneous use with other GLP-1s.

In trials, however, participants on Foundayo experienced more side effects and were less likely to stay on the medication compared to people using Rybelsus.

What's next for GLP-1s?

GLP-1s are still a new medical treatment and long-term research is limited. The latest studies show the drugs could help alleviate symptoms of sleep apnea, arthritis, heart disease, and addiction. More clinical trials could result in the drugs being approved for more uses.

The insurance battle between drugmakers, insurers, companies, and their employees is likely to escalate, as GLP-1 demand continues to skyrocket and drive up US healthcare costs. Someone has to foot the bill.

To maintain health benefits and avoid rapid weight regain, research shows many people will need to stay on these drugs long-term. Economists and researchers told Business Insider this could be expensive, but could have preventative healthcare payoffs in the future — potentially reducing disease and obesity rates.