There are four, and three of them went on sale in 2026. Most pages on this subject were written when there was one.
The four, side by side
| Pill | Molecule | Strengths | On sale since | Approved for |
|---|---|---|---|---|
| Rybelsus | semaglutide | 3, 7, 14 mg | Sept 2019 | Type 2 diabetes |
| Wegovy pill | semaglutide | 1.5, 4, 9, 25 mg | Jan 2026 | Obesity |
| Ozempic pill | semaglutide | 1.5, 4, 9 mg | Apr 2026 | Type 2 diabetes |
| Foundayo | orforglipron | 0.8 to 17.2 mg | Apr 2026 | Obesity |
Strengths and marketing dates read from the FDA's National Drug Code directory.1
Three of these are the same drug in a tablet, and they are still not interchangeable. They come in different strengths and carry different approvals, so which one you can get depends on what you are being treated for, not on which name you have heard.
The split that decides your options
If you are being treated for weight: the Wegovy pill or Foundayo. Those are the two approved for it.
If you are being treated for type 2 diabetes: Rybelsus or the Ozempic pill. Diabetes indications are also covered by insurance far more readily, so this group has an easier time than the numbers below suggest.
The daily ritual, which nobody mentions and everybody notices
All three semaglutide pills have to be taken on an empty stomach with a small amount of plain water, followed by a wait of around half an hour before you eat, drink or take anything else. It is a real constraint on your morning and it is a common reason people quietly stop.
Foundayo does not have it:3
Take Foundayo by mouth 1 time each day, with or without food.
Eli Lilly
The number of GLP-1 pills you can take with breakfast. If you have already failed a semaglutide tablet on the fasting rule rather than on the drug, that is the distinction worth taking to your prescriber.
The reason is chemistry rather than marketing: orforglipron is a small molecule, so it does not need the absorption enhancer that oral semaglutide depends on, and that enhancer is what the empty stomach is for.
What they cost
Novo publishes one ladder covering its tablets:2
Patients pay $149 for each month of 1.5 mg, $199 per month for 4 mg and $299 per month for 9 mg and 25 mg. One month defined as 1 bottle of 30 tablets.
NovoCare Pharmacy
Lilly's self-pay for Foundayo also starts at $149 and rises with the dose.3 So both weight-loss pills start in the same place.
Novo publishes no cash price for Rybelsus at all. Their self-pay pharmacy lists the Wegovy and Ozempic tablets and does not list Rybelsus, though it remains on sale. If you are uninsured and were prescribed Rybelsus specifically, there is no published figure to compare against and you will have to ask your pharmacy directly. More on that gap here.
Every pill priced, dose by dose
The manufacturers' own self-pay prices, no insurance, read on 2 October 2026:
| Pill | Dose | Self-pay a month |
|---|---|---|
| Wegovy pill | 1.5 mg | $1495 |
| Wegovy pill | 4 mg | $1995 |
| Wegovy pill | 9 mg and 25 mg | $2995 |
| Foundayo | 0.8 mg | $1496 |
| Foundayo | 2.5 mg | $149 through Dec 31, 2026, then $1996 |
| Foundayo | 5.5 mg | $199 through Dec 31, 2026, then $2996 |
| Foundayo | 9 mg | $2996 |
| Foundayo | 14.5 mg and 17.2 mg | $349, or $299 on Lilly's refill offer6 |
| Ozempic pill | 1.5, 4, 9 mg | From $149; Novo says the price varies by dose5 |
| Rybelsus | 3, 7, 14 mg | No published self-pay price5 |
The number that matters is the maintenance dose, not the starting one. The Wegovy tablet label's maintenance dose is 25 mg,8 which is the $299 tier, so a year on the Wegovy pill at maintenance costs about $3,588 paying Novo directly. Foundayo's two top strengths are $349 a month, or $299 if you stay on Lilly's refill offer by refilling within 45 days.6
With commercial insurance that covers the pill, both makers' cards bring the copay to as little as $25; Novo caps its saving at $100 a month.116 On Medicare, the GLP-1 Bridge covers Foundayo and the Wegovy pill at a $50 monthly copay, but not for people with type 2 diabetes.12
What they did in their trials
Each weight-loss pill has one large placebo-controlled trial behind it. They ran for different lengths, so they are not a head-to-head:
| Pill | Trial | Length | Mean weight change | Placebo |
|---|---|---|---|---|
| Oral semaglutide 25 mg (Wegovy pill) | OASIS 4 | 64 weeks | -13.6% | -2.2%9 |
| Orforglipron, highest dose (Foundayo) | ATTAIN-1 | 72 weeks | -12.4% (efficacy estimand; -11.2% treatment-regimen) | -0.9% (-2.1%)10 |
Stomach side effects were the common thread. In OASIS 4, gastrointestinal adverse events were reported by 74.0% on oral semaglutide against 42.2% on placebo.9 In ATTAIN-1, nausea affected 33.7% against 10.4%, and constipation 25.4% against 9.3%.10
Free-drug programs do not cover the pills
If you have no insurance and a low income, the manufacturers' patient assistance programs are the usual last resort. For the pills they do not help. Novo's program lists Ozempic injections as its only GLP-1, with no tablet on the list,13 and Lilly's does not list Foundayo. The patient assistance guide has the full eligibility rules.
The thing to be careful about
Search for a GLP-1 pill and you will find prices below $149. Read what they are before you assume they are the same product.
A large part of the telehealth market sells compounded oral semaglutide, often as dissolving tablets. It is genuinely cheaper. It is also not the branded pill and not FDA-approved. In the FDA's words, "the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed."14 That is a different risk profile rather than a discount on the same thing. Our own ranking below currently has a compounded tablet at the top, under the branded ones, and that ordering is by price alone.
Both things can be true: the compounded route is a legitimate choice many people make with open eyes, and a $147 headline sitting beside a $149 branded price is the easiest place in this whole market to buy something other than what you thought. How to check a seller is the companion to that.
Insurance, briefly
The pills are treated like the injections: diabetes indications are covered far more readily than weight ones, and weight-loss coverage usually depends on whether your employer bought the category at all.
On Medicare there is a real route, and it names two of these four:4
the Medicare GLP-1 Bridge program will give eligible Part D plan members access to Foundayo®, Wegovy® (injection or tablet), or Zepbound® (KwikPen®) weight loss medications for a $50 copayment for each 30-day supply.
Humana
Our coverage tracker carries the verified position for eight insurers, and the four gates explains what your plan will ask for.
Picking one
- Weight, and you want no daily ritual: Foundayo. It is the only one you can take with breakfast.
- Weight, and you want the longest-studied molecule: the Wegovy pill, same semaglutide as the injection.
- Type 2 diabetes: Rybelsus or the Ozempic pill, and your coverage odds are much better here.
- Lowest possible price, eyes open: the compounded market, understanding it is not FDA-approved.
- Best results overall: honestly, an injection. Every pill here lands below what the injectable tirzepatide achieves in trials. The pill is a convenience decision, and a perfectly reasonable one, but it is a trade.
