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Head-to-head · WeighScore

1st Optimal vs LillyDirect Foundayo

1st Optimal
Graded #291

Lower grade

vs+5.600000000000001
LillyDirect Foundayo
Graded #173

Higher grade

The verdict

LillyDirect Foundayo takes it — 67.2/100 to 61.6/100.

LillyDirect Foundayo grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Eli Lilly's manufacturer direct-pay channel for Foundayo (orforglipron), the first oral GLP-1 pill for weight loss.

We may earn a commission if you start care through some of these links, at no extra cost to you. It never moves the WeighScore, which is the weighted average of the six factors shown for every provider, and what we write about a provider is the same either way. See our disclosure.

Factor by factor

The same six graded dimensions, side by side. See the methodology.

Cost valueLillyDirect Foundayo +27
45
72
Dose & formulationLillyDirect Foundayo +8
51
59
Clinical oversightLillyDirect Foundayo +1
77
78
Labs & monitoring1st Optimal +45
97
52
FulfillmentLillyDirect Foundayo +20
60
80
Contract termsLillyDirect Foundayo +18
37
55
1st Optimal · left barLillyDirect Foundayo · right bar

The numbers

Metric1st OptimalLillyDirect Foundayo
WeighScore61.6/10067.2/100
GradeCC
Scorecard rank#291#173
SemaglutideNot disclosedNot disclosed
TirzepatideNot disclosedNot disclosed
CoverageCoverage not publishedAll 50 states
Brand-name accessCompounded onlyYes
Oral / sublingualYesYes
1st Optimal

Graded #291 · C

Strengths

  • Offers both semaglutide and tirzepatide with injectable and oral formats
  • Functional-medicine approach with at-home labs and blood-work interpretation
  • Unlimited coaching and ongoing support included
  • No long-term contracts
  • Board-certified doctors and nurse practitioners referenced

Where it loses points

  • No public monthly pricing disclosed
  • No published state availability list
  • Compounded vs branded sourcing not clarified on site
  • Pricing only revealed after quiz or consultation
LillyDirect Foundayo

Graded #173 · C

Strengths

  • Cheapest legal path to a brand-name GLP-1 in 2026 ($25/mo with savings card for commercial insurance)
  • Direct from manufacturer — no compounding, no third-party reseller
  • Daily oral pill, no injections, no refrigeration
  • Available in all 50 states

Where it loses points

  • Lower mean weight loss vs Wegovy (14.9%) and Zepbound (20.9%) — labeled-dose 11.1% per Foundayo PI
  • Requires existing prescription from a separate prescriber (LillyDirect does not write the prescription)
  • $25 savings card requires commercial insurance — Medicare and Medicaid not eligible
  • Strict empty-stomach 30-minute window may be hard for some patients to follow

Also worth a look

Neither is our top-graded pick — CoreAge Rx leads the scorecard

Across all 499 providers, CoreAge Rx grades highest at 91.8/100 (A−). Top of the scorecard: flat transparent pricing, both molecules, nationwide — no teaser-rate games.

Pricing/verification reflect each provider's public disclosures at last grading; the WeighScore is our editorial judgment per the methodology. Prices change — confirm on each provider's site. Not medical advice; see our disclosure.

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