Three weeks after Eli Lilly's oral GLP-1 pill Foundayo hit pharmacy shelves, early prescription data suggest a slow uptake compared with Novo Nordisk's rival Wegovy pill. Meanwhile, insurer hesitancy is casting a shadow over the July Medicare GLP-1 Bridge program that both manufacturers had counted on to broaden access.
Foundayo's Launch: Early Prescription Numbers Disappoint
Eli Lilly's new weight-loss pill Foundayo has gotten off to a sluggish start: it generated 3,707 prescriptions in its second week on market, compared with 18,410 prescriptions in oral Wegovy's second week of launch, according to IQVIA data cited by RBC Capital Markets. JPMorgan analysts had flagged this risk, noting Novo benefited from being first to market and from immediate name recognition because its pill carries the same brand name as the injectable. Brokerages still estimate Foundayo will see sales of anywhere from $1.5 billion to $2.8 billion this year.
FDA Approval Recap: What Foundayo Is and What It Costs
The FDA approved Foundayo (orforglipron) for adults with obesity or overweight with weight-related medical problems; when used alongside a reduced-calorie diet and increased physical activity, it helps individuals lose excess body weight and keep the weight off. It is the first small-molecule GLP-1 receptor agonist to secure approval, offering a potential convenience edge over established peptidic GLP-1-based obesity drugs. The FDA reviewed the application in just 50 days under its Commissioner's National Priority Voucher pilot program, making it the fastest approval of a new molecular entity since 2002; typically, new drug approvals take at least six to ten months. On pricing, eligible patients with commercial insurance may pay as little as $25 per month with the Foundayo savings card, while self-pay patients can access Foundayo starting at $149 per month for the lowest dose; eligible Medicare Part D individuals may be able to access Foundayo starting July 1, 2026.
Medicare GLP-1 Bridge: Insurers Push Back
CVS Health has declined to participate in the program to cover GLP-1 weight-loss drugs under Medicare — a program that grew out of November 2025 deals between the Trump administration, Novo Nordisk, and Eli Lilly — and the administration gave insurers a deadline of April 20 to confirm whether they would participate. According to Bloomberg, the program cannot move forward unless most insurers sign up. CMS updated its Medicare GLP-1 Bridge drug list on April 6 to include Foundayo following its FDA approval; beginning July 1, 2026, all formulations of Foundayo, all formulations of Wegovy, and the KwikPen formulation of Zepbound will be available to eligible beneficiaries through the Bridge.
New Research: GLP-1 Resistance Affects ~1 in 10 Patients
Genetic variants carried by roughly 10% of the general population cause a phenomenon researchers call GLP-1 resistance, in which levels of the hormone GLP-1 are higher but less biologically effective; it is not yet clear whether the variants affect weight loss from drugs such as Ozempic and Wegovy. The new study, published April 10 in Genome Medicine, was a decade-long international effort involving experiments in humans and mice as well as analysis of diabetes drug trial data. Researchers note this is the first in-depth investigation of GLP-1 resistance, but they have yet to pin down the underlying mechanism.
Novo Nordisk vs. Eli Lilly: Diverging Fortunes
Alongside its oral obesity approval, Novo Nordisk also recently won an FDA nod for a high-dose 7.2-mg format of injectable Wegovy, which the company hopes can help patients achieve superior weight loss. Novo's February 2026 guidance warning was its first projected sales drop in over a decade; the company cited "unprecedented" pricing pressures in the U.S. and acknowledged it has been unable to scale its volume quickly enough to compensate for lower revenue per patient. Both Lilly's and Novo's drugs are now subject to most-favored-nation pricing deals with the Trump administration, but while Novo is modeling a steep sales fall for the current year as a result, Lilly projects full-year revenues will rise from just over $65 billion in 2025 to more than $80 billion in 2026.