Explainer

The approved pills changed the maths

Two oral GLP-1s were approved either side of the new year, both starting at $149 a month. That undercuts a large part of the compounded market.

Updated 2026-09-18

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The whole argument for compounded GLP-1s was price. Two FDA-approved pills have now largely taken that argument away, and a lot of review sites have not caught up.

Both start at $149 a month self-pay. That is more than the cheapest compounded programmes — Ozari Health is $86 and Trimi is $125 — but it is less than the majority of what we track, and it buys a product the FDA has actually reviewed.

Wegovy pill (oral semaglutide)

Approved late December 2025, launched in the US on 5 January 2026. The first oral GLP-1 approved for weight management — the same active ingredient as the Wegovy injection, taken as a daily tablet.

Self-pay from $149/month for the 1.5 mg starting dose. The 4 mg dose was offered at $149/month through 15 April 2026 and $199/month after, with the highest doses around $299/month.

Available through LillyDirect-style manufacturer channels and telehealth partners including Ro, GoodRx Care Direct and Walgreens.

Foundayo (orforglipron)

FDA approved 1 April 2026. The first oral small-molecule, non-peptide GLP-1 receptor agonist approved for weight management. Unlike oral semaglutide it is not a peptide, so it has no food-and-water timing restrictions of the same kind.

Self-pay from $149/month for the lowest 0.8 mg dose, about $199/month at 2.5 mg, and roughly $299-$349/month at higher doses.

Self-pay through LillyDirect, with telehealth partners including Ro.

How they compare with what we normally cover

Option	From	Form	FDA-approved?
Wegovy pill (oral semaglutide)	$149/mo	Daily tablet	Yes
Foundayo (orforglipron)	$149/mo	Daily tablet	Yes
Cheapest compounded semaglutide (Ozari Health)	$86/mo	Weekly injection	No
Cheapest compounded tirzepatide (Trimi)	$125/mo	Weekly injection	No
Typical compounded programme	$189–$449/mo	Weekly injection	No
Wegovy injection, self-pay	$199 then $349/mo	Weekly injection	Yes

Important. What this does not mean. A pill is not automatically better than an injection. Oral semaglutide has strict instructions about taking it on an empty stomach with a small sip of water and waiting before eating — get that wrong and it underperforms. And the trial weight-loss figures for injectable tirzepatide remain the highest of any of these options.

Who should actually consider switching

Anyone paying more than about $200 a month for a compounded injection. You are now paying a premium for a non-approved product, which is a strange place to be.
Anyone who never wanted to inject. This is the obvious one — a genuine approved alternative now exists at a sane price.
Anyone uneasy about the compounding rules. The 2026 regulatory direction is not friendly to compounded GLP-1s; see is compounded still legal.
Medicare beneficiaries. From July 2026 you may be able to get an approved GLP-1 for $50 a month — see the Medicare programme.

Who probably should not

If you are already on Trimi or Ozari Health at under $130 a month, tolerating it well and getting results, the approved pills cost more. That is a real reason to stay put. The comparison changes if your programme raises prices or your dose pushes you into a higher tier.

Whichever direction you are considering, it is a conversation with a prescriber rather than a purchase decision. Both drugs have contraindications, and switching between them is not simply swapping one box for another.