Affordable pricing for weight-loss medications in pill form from Novo Nordisk and Eli Lilly is encouraging patients to move away from compounded alternatives toward branded treatments like Wegovy and Foundayo, based on conversations with nine physicians nationwide.
The starting doses of both companies’ oral medications typically cost less than their injectable counterparts and match pricing offered by pharmacies that create their own compounded alternatives by mixing ingredients themselves.
With insurance coverage becoming increasingly limited, these more affordable choices have benefited pharmaceutical manufacturers, medical professionals report.
The Danish company Novo and Indianapolis-headquartered Lilly launched their oral treatments in the United States during January and April respectively, reporting robust interest from first-time users.
However, both companies have raised concerns about compounded alternatives, which the U.S. FDA permits for customized formulations and dosing. The Food and Drug Administration has worked to impose stricter regulations after drug shortages that previously enabled compounding operations to expand have resolved.
Medical professionals and health authorities have expressed optimism that competitive pricing would encourage patients toward branded medications, which face more stringent regulatory oversight.
“I am seeing people are switching from compounds,” explained Dr. Michael Weintraub, assistant clinical professor of endocrinology at NYU Langone in New York. He noted that while he doesn’t prescribe compounded medications, he treats patients already using them.
“I have patients increasingly coming to me saying, ‘I hear it’s not as expensive to get the pharmaceutical-grade branded version, can we switch over?’”
A company representative from Lilly stated they were “encouraged by the early momentum, growing prescriber interest and intent to prescribe, and by patients choosing authentic, FDA-approved treatments like Foundayo.”
Novo reported expanding patient access to its GLP‑1 medications through its NovoCare Pharmacy and retail partnerships, designed to guide patients toward FDA‑approved options instead of compounded alternatives.
While physicians indicated some patients are transitioning to injectable GLP-1 treatments, the majority are choosing pill forms because their costs more closely match compounded versions.
Starting doses of Novo’s Wegovy pills run approximately $149 monthly, while injector pens begin at $199 monthly, based on company and White House website information.
Lilly’s Foundayo similarly begins at $149 monthly, while vials and pens of its GLP-1 weight management medication Zepbound can reach $299 or higher for patients paying directly.
Medical professionals noted that Novo’s Wegovy pill enjoys greater brand familiarity since it shares the same active ingredient and name as the injectable version. It also has proven heart-protective benefits, making patients and doctors more confident prescribing it, particularly for individuals with cardiovascular risk factors.
Physicians also mentioned patient hesitancy toward the less familiar Foundayo, as it represents a somewhat different medication type without established heart-benefit research.
“Something about saying it is new creates a little hesitation in at least a handful of patients I’ve spoken about it with,” noted Dr. Jorge Moreno, a Yale Medicine Obesity Specialist. “It’s a small sample, but they’ve opted for the Wegovy (pill).”
Oral Wegovy produced approximately 14% body weight reduction over 64 weeks, while Foundayo achieved roughly 11% reduction over 72 weeks in separate clinical trials. Patients using GLP-1 injections lost 15%-20% of body weight during studies.
Foundayo’s ease of use – requiring no empty stomach like Wegovy – and additional market time are anticipated to help Lilly close Novo’s current advantages in oral medications.
Financial analysts from Citi reported that prescribers anticipated equal distribution between Foundayo and Wegovy pills according to a survey involving 120 doctors who prescribe GLP-1 treatments.
Survey results also revealed that physicians at academic medical centers predict Foundayo will ultimately represent approximately 70% of prescriptions between both pill options. They identified Foundayo’s elimination of fasting requirements as a significant benefit.
Nevertheless, costs remain prohibitive for many patients, and all interviewed doctors confirmed that insurance approval continues presenting obstacles.
“Every day, I get a message from a patient saying ‘my insurance company didn’t approve or denied it again,’” Yale’s Moreno shared.
Frequently, physicians incorrectly code diagnoses for proper prescriptions, resulting in rejections, he explained. Insurance providers also show less willingness to cover preventive treatments compared to existing medical conditions.
Lilly’s representative mentioned that two of America’s three largest pharmacy benefit managers have started covering Foundayo, with the company pursuing broader coverage expansion.
Many physicians expressed anticipation for the U.S. government’s upcoming program providing GLP-1 coverage for Medicare recipients, scheduled to start in July and continue through 2027. They hope this government initiative will encourage commercial coverage for broader patient populations.
Some patients currently using injectable treatments are transitioning to pills, though not in large numbers, according to most interviewed doctors.
“Right now only a small percentage are switching to the pill,” said Dr. Christina Nguyen, an obesity specialist in Atlanta. “The injectables are working well and people don’t want to mess anything up.”
Physicians also confirmed what pharmaceutical executives have indicated: pill options are attracting new patients to the market.
“This is expanding the market of GLP-1,” explained Sarah Ro, medical director of the University of North Carolina Health’s weight-management program. “Patients who have been offered a GLP-1, but due to price, declined… now, they’re wanting to try.”
