1st Optimal vs LillyDirect Foundayo
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
LillyDirect Foundayo
Best for: patients with commercial insurance who want the cheapest legal brand-name GLP-1
Visit LillyDirect Foundayo →1st Optimal and LillyDirect Foundayo are both GLP-1 Providers competing for the same patients, but they make different trade-offs on price, coverage, and what's included. In our scoring, LillyDirect Foundayo starts at $149/mo, and LillyDirect Foundayo edges ahead overall (8.1 vs 6.7 out of 10). Below we break down pricing, what each plan covers, the six-dimension score, pros and cons, and exactly who should pick which.
Pricing
1st Optimal
Pricing not publicly listed.
LillyDirect Foundayo
Requires commercial insurance; Medicare/Medicaid not eligible. 'Starting at $25 per month'.
Regular self-pay price, 1-month (30-day) supply.
Regular self-pay price, 1-month supply.
Regular self-pay price, 1-month supply.
Regular self-pay price $349; available for $299 via an automatic purchase offer ONLY if you complete your refill within 45 days of the delivery/receipt date of your previous Foundayo fill (14.5/17.2 mg only).
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Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
6.7/10
LillyDirect Foundayo
8.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | LillyDirect Foundayo |
|---|---|---|
| Starting Price | — | $149/mo |
| Features | ✓8 features | 5 features |
| States Available | Not disclosed | 51 |
| Compounded | — | — |
| Brand Name | — | ✓ Yes |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets. Its model pairs prescription GLP-1 therapy with at-home lab testing, blood-work interpretation, unlimited coaching, and personalized protocols framed around long-term weight loss and longevity. Care is delivered virtually by credentialed providers, and treatments ship to the home with no long-term contracts. The site does not publish monthly pricing or a state list.
Read our full 1st Optimal review →About LillyDirect Foundayo
Eli Lilly's manufacturer direct-pay channel for Foundayo (orforglipron), the first oral GLP-1 pill for weight loss. With the Lilly Savings Card, commercially insured patients pay $25/month; cash-pay patients pay $149-$299/month depending on labeled dose. Requires a valid US prescription from any licensed prescriber.
Read our full LillyDirect Foundayo review →Pros & Cons
1st Optimal
What we like
- Offers both semaglutide and tirzepatide with injectable and oral formats
- Functional-medicine approach with at-home labs and blood-work interpretation
- Unlimited coaching and ongoing support included
- No long-term contracts
- Board-certified doctors and nurse practitioners referenced
Watch-outs
- No public monthly pricing disclosed
- No published state availability list
- Compounded vs branded sourcing not clarified on site
- Pricing only revealed after quiz or consultation
LillyDirect Foundayo
What we like
- 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
Watch-outs
- 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
Our Verdict
LillyDirect Foundayo edges out 1st Optimal with a higher overall score of 8.1/10 and is particularly strong for patients with commercial insurance who want the cheapest legal brand-name GLP-1. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose LillyDirect Foundayo if…
You want patients with commercial insurance who want the cheapest legal brand-name GLP-1 and a starting price around $149/mo.
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MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →Breeze Meds
Compounded GLP-1 access with named prescribers and 4-pharmacy network
From $169/mo
Get started →1st Optimal vs LillyDirect Foundayo: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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