Head-to-head · WeighScore
LillyDirect Foundayo vs Rivas Medical Weight Loss
The verdict
LillyDirect Foundayo takes it — 67.2/100 to 55.6/100.
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.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | LillyDirect Foundayo | Rivas Medical Weight Loss |
|---|---|---|
| WeighScore | 67.2/100 | 55.6/100 |
| Grade | C | C |
| Scorecard rank | #173 | #438 |
| Semaglutide | Not disclosed | Not disclosed |
| Tirzepatide | Not disclosed | Not disclosed |
| Coverage | All 50 states | 3 states |
| Brand-name access | Yes | Compounded only |
| Oral / sublingual | Yes | Injection only |
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
Graded #438 · C
Strengths
- Physician-founded (Paul Rivas MD) with 15 clinics plus telehealth
- Flat price for any dose; weekly provider visits included in every payment
- Offers both compounded semaglutide and tirzepatide
Where it loses points
- Expensive: about $498/mo for semaglutide and $715/mo for tirzepatide (billed weekly)
- Only available in Maryland, Virginia, and Florida
- Weekly-visit concierge model requires more frequent engagement than mail-order
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.