Rybelsus vs Orforglipron: Weight Loss, Side Effects, Price
Rybelsus (semaglutide) and orforglipron are both GLP-1 medicines, each a daily tablet. Orforglipron self-pay starts at $149 per month.
Foundayo and Rybelsus: a quick overview
Orforglipron and Rybelsus compared side by side
| Rybelsus | Orforglipron | |
|---|---|---|
| Medicine | Rybelsus |  orforglipron |
| Active ingredient | semaglutide | orforglipron |
| Manufacturer | Novo Nordisk | Eli Lilly |
| How it is taken | Daily tablet | Daily tablet |
| Approved for | Type 2 diabetes and heart risk | Weight loss |
| First FDA approval | 2019 | 2026 |
| Average weight loss in trials | Not listed | 11.1% (ATTAIN-1, 72 weeks) |
| Most common side effect | Nausea 20% vs 6% on placebo | Nausea 35% vs 10% on placebo |
| List price | $1,027.51 per 30 tablets | $649 per month |
| Self-pay from | Not listed | $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 drugs directly. The figures come from separate studies whose participants and lengths differed.
| Trial | Who took part | Length | Group | Average weight loss | Placebo | A1C change |
|---|---|---|---|---|---|---|
| ACHIEVE-1 | Adults had early type 2 diabetes and used only diet and exercise | 40 weeks | Orforglipron 3 mg daily (publication dose name) | Not listed | Not listed | -1.24 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults had early type 2 diabetes and used only diet and exercise | 40 weeks | Orforglipron 12 mg daily (publication dose name) | Not listed | Not listed | -1.47 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults had early type 2 diabetes and used only diet and exercise | 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 | Adults with type 2 diabetes who also have obesity or overweight | 72 weeks | Foundayo 5.5 mg daily | 5.1% | 2.5% | Not listed |
| ATTAIN-2 | Adults with type 2 diabetes who also have obesity or overweight | 72 weeks | Foundayo 9 mg daily | 7% | 2.5% | Not listed |
| ATTAIN-2 | Adults with type 2 diabetes who also have obesity or overweight | 72 weeks | Foundayo 17.2 mg daily | 9.6% | 2.5% | Not listed |
Data from the trials: ACHIEVE-1 (PubMed) and ATTAIN-1 (FDA label (DailyMed)).
Side effects compared
Each label studied its own group of people against a placebo group of its own, so compare each drug with its own placebo first.
| Side effect | Rybelsus | Placebo (Rybelsus trials) | Foundayo | Placebo (Foundayo trials) |
|---|---|---|---|---|
| Nausea | 20% | 6% | 35% | 10% |
| Abdominal Pain | 11% | 4% | 14% | 7% |
| Diarrhea | 10% | 4% | 25% | 11% |
| Decreased appetite | 9% | 1% | Not listed | Not listed |
| Vomiting | 8% | 3% | 24% | 4% |
| Constipation | 6% | 2% | 27% | 9% |
| Dyspepsia | Not listed | Not listed | 16% | 4% |
| Headache | Not listed | Not listed | 9% | 7% |
| Abdominal distension | Not listed | Not listed | 9% | 3% |
Prices and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Rybelsus | List price before insurance | $1,027.51 per 30 tablets |
| Rybelsus | RYBELSUS Savings Offer (insured) | from $25 for a fill of 1, 2 or 3 months |
| 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 | Refill within 45 days and the self-pay rate applies to LillyDirect for 14.5 mg or 17.2 mg | $299 per month |
| Foundayo | Medicare GLP-1 Bridge (Foundayo, eligible Part D) | $50 per month |
Our price check was done in November 2026 using Novo Nordisk pricing, rybelsus.com, pricinginfo.lilly.com, foundayo.lilly.com, Eli Lilly, CMS.
Who should pick which?
- For weight loss without diabetes, Orforglipron alone is approved for this use.
- Type 2 diabetes: Rybelsus alone holds a diabetes approval.
- For heart risk, Rybelsus has approval to lower the chance of heart attack and stroke.
- Medicare GLP-1 Bridge lists Orforglipron.
- The published self-pay rate for Orforglipron is $149 per month for cash payments.
After reviewing your medical history, other medicines and coverage, your prescriber decides whether you should switch.