GLP-1 TV · Patient story · views checked Oct 2026
Foundayo Liver Fears? Fda Said Prove It. Lilly Said Here's 2 Years Of Data!
Patient story
Our summary
Christopher Durham of the DOWNSIZED channel, a patient who says he has used GLP-1 medications since September 2023, looks at the April 2026 news around Eli Lilly's oral GLP-1 Foundayo (orforglipron). He says the FDA approved the once-daily pill on April 1st, and that the approval letter requires Lilly to keep collecting safety data on cardiovascular outcomes, potential liver injury, delayed gastric emptying and use in lactating women. In his view, post-approval requirements are a normal part of the system working as intended.
One person's experience, in their words. Not medical advice.
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What else the video covers
He then walks through top-line results from the ACHIEVE 4 trial, released April 16th. According to the video, it enrolled more than 2,700 people with type 2 diabetes and elevated cardiovascular risk across 15 countries for roughly 2 years, comparing the pill with insulin glargine. He reports a hazard ratio of 0.84 (confidence interval 0.59 to 1.20) for non-inferiority, a 57% lower risk of death from any cause in an exploratory analysis that he says is a signal and not proof, A1C down about 1.6% versus about 1%, weight down about 8.8% while the insulin group gained, and no liver safety signal reported by Lilly. He cautions that the comparison with oral Wegovy (16.6% weight loss, or 13.6% in the treatment policy analysis) is not head to head in people without diabetes.
The last part covers the thyroid C-cell tumor box warning, Lilly Direct self-pay pricing of $149, $199 and $299 per month by dose, a $349 price after a lapse of more than 45 days, and a savings card for commercial insurance. He says he dislikes the lapse pricing, urges patients to follow their prescribed dosing, and closes with his view on why an oral option matters for people who avoid injections. He is not a doctor and says this is not medical advice.
Our summary of what is said, in our words. Doses, results and prices are the speaker’s, not advice.
Takeaways
The main points, in the order they come up. Tap a time to play from there.
- 2:05 Durham says the FDA approved Foundayo on April 1st, and that it is a once-daily small-molecule pill with no food or water restrictions.
- 2:36 He explains that the approval letter's post-approval safety requirements (cardiovascular, liver, gastric emptying, lactation) are standard, and in his view show the system working.
- 4:10 According to the video, ACHIEVE 4 (over 2,700 patients, about 2 years, versus insulin glargine) met non-inferiority with a hazard ratio of 0.84, and showed a 57% lower all-cause mortality in an exploratory analysis.
- 7:42 He reports A1C fell about 1.6% versus about 1% on insulin, weight fell about 8.8%, and Lilly found no liver safety signal in the trial.
- 9:17 He says the weight loss comparison with oral Wegovy in people without diabetes is unsettled, while ACHIEVE 3 favored Foundayo over oral semaglutide in diabetic patients.
- 12:21 He lists self-pay prices of $149, $199 and $299 per month by dose, $349 after a lapse of more than 45 days, and about $50 per month for eligible Medicare Part D patients from July 1st, 2026.
Key moments
From the creator's own chapters. Tap one to play from there.
What the video says
As stated in the video, not checked by us. Doses and results are the speaker’s, not advice.
- Medication
- Wegovy, Foundayo and semaglutide
- Doses mentioned
- 14.5 mg and 17.2 mg
- Point in the journey
- Year 2
- Prices mentioned
- $149 a month, $199 a month and $299 a month
- Who is speaking
- Patient
Questions this video answers
Why did the FDA ask for more safety data after approving Foundayo?
Durham says post-approval requirements are a standard part of modern drug approval. The letter lists cardiovascular outcomes, potential liver injury, delayed gastric emptying and use in lactating women, and he describes this as the system working as designed.
What did the ACHIEVE 4 trial show for Foundayo?
According to the video, the trial of more than 2,700 patients with type 2 diabetes met its non-inferiority goal against insulin glargine, with a hazard ratio of 0.84. Durham also reports a 57% lower all-cause mortality in an exploratory analysis, A1C down about 1.6%, weight down about 8.8%, and no liver safety signal per Lilly.
How much does Foundayo cost per month?
Durham says Lilly Direct self-pay is $149 per month at the starting dose, $199 at mid-range doses, and $299 at the two highest doses (14.5 mg and 17.2 mg). He says the top-dose price rises to $349 if a prescription lapses for more than 45 days.
Is Foundayo better than oral Wegovy for weight loss?
Durham says that in diabetic patients, ACHIEVE 3 showed Foundayo outperforming oral semaglutide on weight loss and blood sugar. In people without diabetes, he says there is no head-to-head trial, and oral Wegovy has a numerical edge that cannot be directly compared.
Videos on the same question
The closest videos in the library by what is said in them, not by title.
Foundayo: The First GLP-1 Pill Explained (FDA Approved 2026)According to the video, the FDA approved Foundayo (orforglipron), a once-daily tablet from Eli Lilly, on April 1st, 2026.
Foundayo (Orforglipron): Is This GLP-1 Pill Really Better Than Ozempic Shots?According to the video, Foundayo (orforglipron) is a once-daily oral GLP-1 for weight loss that the FDA has approved.
NEW GLP1 Weight Loss Pill Approved: FOUNDAYO! How Much Does it Cost? A Doctor ExplainsDr. Jen Caudle, a family doctor, reacts to the FDA approval of a new daily GLP-1 pill from Eli Lilly.
Foundayo Explained: The New Oral GLP-1 Weight Loss Pill FDA Just Approved 💊According to the video, the FDA has approved Foundeo, the brand name for orforglipron from Eli Lilly.
Lilly's Foundayo weight loss pill clears heart safety bar in largest diabetes trial yetAccording to the video, a Quartz news segment, Eli Lilly's oral weight loss drug Foundayo has shown cardiovascular safety in its largest phase three trial to date.
About DOWNSIZED
Patient story, 71.9K subscribers. 93 of their videos are in GLP-1 TV, 2.8M views between them, mostly on Zepbound, Foundayo, Wegovy.
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