Head-to-head · WeighScore
LillyDirect Foundayo vs Rivo Health
The verdict
Rivo Health takes it — 71.7/100 to 67.2/100.
Rivo Health grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Rivo Health is a large nationwide GLP-1 telehealth program (115,000+ members, Trustpilot 4.7) offering compounded semaglutide and tirzepatide as both injections and oral options, starting around $149/mo for…
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.
The numbers
| Metric | LillyDirect Foundayo | Rivo Health |
|---|---|---|
| WeighScore | 67.2/100 | 71.7/100 |
| Grade | C | C |
| Scorecard rank | #165 | #90 |
| Semaglutide | Not disclosed | $149/mo (compounded) |
| Tirzepatide | Not disclosed | $199/mo (compounded) |
| Coverage | All 50 states | All 50 states |
| Brand-name access | Yes | Compounded only |
| Oral / sublingual | Yes | Yes |
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
Graded #90 · C
Strengths
- Compounded semaglutide and tirzepatide as both injections and oral options, starting around $149/mo (sema) and $199/mo (tirz)
- Bundles dietitians, live workouts, support groups and mental-health coaching with the medication, not just a prescription
- Insurance concierge to maximize coverage, FSA/HSA eligible, with multi-month plans that cut the price further
- Large, established program (115,000+ members, Trustpilot 4.7) available nationwide
Where it loses points
- Uses partner compounding pharmacies it doesn't name on the site
- Headline prices are Spring-sale rates — everyday cost is higher and the deepest discounts need a 6-month commitment
- Weight loss is one of several verticals (ED, longevity, sleep, hair, skin), not a single focus
- Some bundled perks (e.g. meal prep) are paid add-ons rather than included
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.