The drugs
What each one is, who it is approved for, and how it differs from the one next to it.
The drugsEvery GLP-1 pill you can actually get, and what each one costsFour swallowable GLP-1s exist now, and three of them launched in 2026. Rybelsus, the Wegovy pill and the Ozempic pill are all semaglutide in a tablet but are approved for different things; Foundayo is a different molecule entirely and the only one with no food or timing rules. Two are for weight, two are for type 2 diabetes, and the cheapest thing on most rankings is not any of them. Here is the whole landscape, with what each actually costs.The drugsFoundayo: the GLP-1 pill where buying direct is the cheap routeLilly's oral GLP-1 was approved on 1 April 2026, and it does something no other weight-loss pill does: you take it any time of day, with or without food. The pricing is the surprising part. Lilly self-pay starts at $149 a month, and every telehealth program we track charges more once its membership fee is counted, between $199.99 and $223. That reverses the usual arithmetic in this market, and the reason is simple: orforglipron is a new small molecule under patent, so there is no compounded version to undercut it.The drugsSwitching between Wegovy and Zepbound, and who is really decidingMost people searching this did not choose to switch. A formulary chose for them. CVS Caremark removed Zepbound in July 2025 and told members they would have to try and fail Wegovy first, then said it would add Zepbound back as a preferred option on 1 October 2026, so a lot of people are being pushed one way and invited back the other inside fourteen months. Here is what your plan will ask for when you switch in either direction, and what each side costs today.The drugsMounjaro vs Ozempic, and the trial everyone quotes about itMounjaro is tirzepatide and Ozempic is semaglutide: different molecules, not two brands of the same drug. Both are approved for type 2 diabetes, and the weight-loss versions are Zepbound and Wegovy. In the one head-to-head trial, SURMOUNT-5, tirzepatide produced 20.2% mean body-weight loss at 72 weeks against semaglutide's 13.7%. The detail almost every page omits: that trial dosed semaglutide to 2.4 mg in people without diabetes, which is the Wegovy range. Ozempic tops out at 2 mg. The famous result did not test Ozempic's dose range.The drugsSemaglutide for weight loss: which version, and what each costsSemaglutide is the molecule. For weight loss the FDA-approved version is Wegovy, sold as a weekly pen and a daily tablet. Ozempic is the same molecule approved for type 2 diabetes, so using it for weight is off-label. Compounded semaglutide is the same molecule from a compounding pharmacy, is not FDA-approved, and is what most cash buyers actually take because it costs a fraction of the brand. All three produce the same side effects. What differs is the approval, the oversight and the price.The drugsOzempic for weight loss, and where the ladder runs outOzempic is approved for type 2 diabetes, not for weight loss. Taking it to lose weight is off-label, which is legal, extremely common, and a prescriber's decision. The consequence nobody mentions is the ceiling: Ozempic's doses stop at 2 mg while Wegovy, the same molecule approved for weight, goes to 2.4 mg with a 7.2 mg strength above that. Someone using Ozempic for weight eventually runs out of ladder, and switching brand is the usual answer.The drugsRybelsus for type 2 diabetes, and the two pills that arrived after itRybelsus is oral semaglutide, approved for type 2 diabetes and on sale since September 2019 at 3, 7 and 14 mg. For six years it was the only semaglutide you could swallow. That stopped in 2026: Novo launched the Wegovy pill in January and the Ozempic pill in April, at completely different strengths. The practical catch for anyone paying cash is that Novo's own self-pay pharmacy lists both new pills and does not list Rybelsus at all.The drugsOzempic for type 2 diabetes: the on-label one, and what it costsOzempic is approved for adults with type 2 diabetes, to improve blood sugar alongside diet and exercise. That is the indication it was built and priced for, and if you have type 2 diabetes you are in the group the drug is actually for. Doses run 0.25, 0.5, 1 and 2 mg. Novo's published self-pay price is $349 a month up to 1 mg and $499 at 2 mg, with a savings card that can bring an insured copay down to as little as $25, capped at $100 of savings a month. If you are covered, your formulary beats every cash price on this page.The drugsMounjaro for weight loss, and why Zepbound existsMounjaro is tirzepatide approved for type 2 diabetes. Zepbound is the same molecule from the same maker, approved for weight management, and it goes to the same 15 mg. So unlike Ozempic and Wegovy, there is no dose ceiling pushing you from one to the other: the reason people move is coverage and cash price, not strength. Using Mounjaro for weight is off-label and a prescriber's decision. In the one head-to-head trial, tirzepatide beat semaglutide, 20.2% mean body-weight loss at 72 weeks against 13.7%.