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Head-to-head · WeighScore

LillyDirect Foundayo vs Optimized Health

LillyDirect Foundayo
Graded #165

Level

vs
Optimized Health
Graded #166

Level

The verdict

Too close to call — both grade 67.2/100 (C).

LillyDirect Foundayo and Optimized Health land on the same WeighScore, so neither clears the other on our six graded dimensions. LillyDirect Foundayo sits one line higher on the board (#165 vs #166) on the underlying tiebreak, but it's a genuine coin-flip — pick on the factors and prices that matter most to you below.

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
72
45
Dose & formulationOptimized Health +16
59
75
Clinical oversightLillyDirect Foundayo +2
78
76
Labs & monitoringOptimized Health +37
52
89
FulfillmentLillyDirect Foundayo +13
80
67
Contract termsEven
55
55
LillyDirect Foundayo · left barOptimized Health · right bar

The numbers

MetricLillyDirect FoundayoOptimized Health
WeighScore67.2/10067.2/100
GradeCC
Scorecard rank#165#166
SemaglutideNot disclosed$200/mo (starting dose, compounded)
TirzepatideNot disclosed$250/mo (starting dose, compounded)
CoverageAll 50 states5 states
Brand-name accessYesCompounded only
Oral / sublingualYesYes
LillyDirect Foundayo

Graded #165 · 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
Optimized Health

Graded #166 · C

Strengths

  • Fully transparent pricing published on the website
  • Semaglutide from $200/mo and tirzepatide from $250/mo
  • Lab panels included with clinician-supervised dosing
  • LegitScript certified clinic
  • Lead PA-C with over a decade in obesity medicine

Where it loses points

  • Telehealth limited to MO, IA, KS, UT, and WA
  • Compounded GLP-1 only, not brand-name
  • No insurance billing (cash-pay)
  • PA-led rather than MD/DO-led

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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