Ozempic vs Orforglipron: Weight Loss, Side Effects, Price
Ozempic (semaglutide) and orforglipron are both GLP-1 medicines, weekly injection versus daily tablet. Self-pay starts at $199 per month for Ozempic and $149 per month for Orforglipron.
Foundayo and Ozempic at a glance
Comparing Ozempic and Orforglipron
| Ozempic | Orforglipron | |
|---|---|---|
| Medicine | Ozempic |  orforglipron |
| Active ingredient | semaglutide | orforglipron |
| Manufacturer | Novo Nordisk | Eli Lilly |
| How it is taken | Weekly injection | Daily tablet |
| Approved for | Type 2 diabetes, heart risk and kidney disease in type 2 diabetes | Weight loss |
| First FDA approval | 2017 | 2026 |
| Average weight loss in trials | Not listed | 11.1% (ATTAIN-1, 72 weeks) |
| Most common side effect | Nausea 20.3% vs 6.1% on placebo | Nausea 35% vs 10% on placebo |
| List price | $1,027.51 per pen | $649 per month |
| Self-pay from | $199 per month | $149 per month |
| Medicare GLP-1 Bridge | Not listed | $50 per month, eligible Part D |
| FDA shortage | Resolved February 21, 2025 | Not listed |
Sources: FDA label, FDA label (DailyMed), Novo Nordisk pricing, pricinginfo.lilly.com.
Weight loss compared
No trial has compared the two drugs directly, so the figures come from separate studies with different participants and different lengths.
| Trial | Who took part | Length | Group | Average weight loss | Placebo | A1C change |
|---|---|---|---|---|---|---|
| ACHIEVE-1 | Adults in the early stages of type 2 diabetes who rely on diet and exercise alone | 40 weeks | Orforglipron 3 mg daily (publication dose name) | Not listed | Not listed | -1.24 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults in the early stages of type 2 diabetes who rely on diet and exercise alone | 40 weeks | Orforglipron 12 mg daily (publication dose name) | Not listed | Not listed | -1.47 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults in the early stages of type 2 diabetes who rely on diet and exercise alone | 40 weeks | Orforglipron 36 mg daily (publication dose name) | Not listed | Not listed | -1.48 percentage points (mean HbA1c change) |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 5.5 mg daily | 7.4% | 2.1% | Not listed |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 9 mg daily | 8.3% | 2.1% | Not listed |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 17.2 mg daily | 11.1% | 2.1% | Not listed |
| ATTAIN-2 | Overweight or obese adults who also have type 2 diabetes | 72 weeks | Foundayo 5.5 mg daily | 5.1% | 2.5% | Not listed |
| ATTAIN-2 | Overweight or obese adults who also have type 2 diabetes | 72 weeks | Foundayo 9 mg daily | 7% | 2.5% | Not listed |
| ATTAIN-2 | Overweight or obese adults who also have type 2 diabetes | 72 weeks | Foundayo 17.2 mg daily | 9.6% | 2.5% | Not listed |
For the trial sources, see ACHIEVE-1 (PubMed) and ATTAIN-1 (FDA label (DailyMed)).
Side effects compared
For each label, the trial tested its own participants against its own placebo group. Compare each drug with its placebo first.
| Side effect | Ozempic | Placebo (Ozempic trials) | Foundayo | Placebo (Foundayo trials) |
|---|---|---|---|---|
| Nausea | 20.3% | 6.1% | 35% | 10% |
| Vomiting | 9.2% | 2.3% | 24% | 4% |
| Diarrhea | 8.8% | 1.9% | 25% | 11% |
| Abdominal pain | 7.3% | 4.6% | 14% | 7% |
| Constipation | 5% | 1.5% | 27% | 9% |
| Dyspepsia | Not listed | Not listed | 16% | 4% |
| Headache | Not listed | Not listed | 9% | 7% |
| Abdominal distension | Not listed | Not listed | 9% | 3% |
Price and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Ozempic | List price before insurance | $1,027.51 per pen |
| Ozempic | Ozempic Savings Offer (insured) | starting at $25 per month, for up to 3 months |
| Ozempic | Self-pay: Ozempic pill (from 1.5 mg) | $149 per month |
| Ozempic | Pay on your own: an intro offer for the Ozempic pen applies to the first 2 fills in the 0.25 mg and 0.5 mg doses | $199 per month |
| Ozempic | Self-pay: 1 mg, 0.5 mg or 0.25 mg doses of the Ozempic pen | $349 per month |
| Ozempic | Self-pay: Ozempic pen 2 mg | $499 per month |
| Ozempic | Self-pay via TrumpRx | $199 per month |
| Foundayo | List price before insurance | $649 per month |
| Foundayo | Foundayo Savings Card (insured) | from $25 per month |
| Foundayo | Self-pay: LillyDirect 0.8 mg and 2.5 mg | $149 per month |
| Foundayo | Self-pay: LillyDirect 5.5 mg | $199 per month |
| Foundayo | Self-pay: LillyDirect 9 mg | $299 per month |
| Foundayo | Pay on your own: LillyDirect at 17.2 mg and 14.5 mg, with a refill within 45 days | $299 per month |
| Foundayo | Medicare GLP-1 Bridge (Foundayo, eligible Part D) | $50 per month |
Prices checked November 2026 (7)
Novo Nordisk pricing, NovoCare, TrumpRx, pricinginfo.lilly.com, foundayo.lilly.com, Eli Lilly, CMS.
Who should pick which?
- No needles: You take Orforglipron as a tablet, while Ozempic requires a weekly injection.
- For weight loss alone, with no diabetes, Orforglipron is the only approved option.
- Type 2 diabetes: Ozempic is the only drug with a diabetes approval.
- For kidney disease with type 2 diabetes, Ozempic is approved.
- Heart risk: Ozempic's approval includes lowering the risk of heart attack and stroke.
- Medicare: Orforglipron appears on the Medicare GLP-1 Bridge list.
- If you pay cash, Orforglipron starts at the lower price of $149 per month.
Your prescriber takes into account your health history, plus other medicines and insurance coverage.