NICE asks Lilly for more information on Foundayo after a first committee meeting

Eli Lilly began selling its oral weight-loss drug Foundayo in the United Kingdom on August 24 through private prescription, making Britain the first country in Europe to offer the pill to patients ^[1][2]. Foundayo is the brand name for orforglipron, a GLP-1 medicine that Britain's medicines regulator, the MHRA, authorized on August 10 ^[1][2].

Before Foundayo can be covered by the National Health Service, it must clear a review by England's National Institute for Health and Care Excellence, known as NICE. A NICE spokesperson said the agency has asked Lilly for more information after its first appraisal committee meeting, and no date has been set for a second review ^[1]. Lilly said it is working with NICE during the assessment, and the company has confirmed that NHS access depends on the outcome ^[1].

Until NICE finishes its review, UK patients can only get Foundayo through private prescription. Lilly said the pill will likely be priced between £100 and £120 a month there, well below the £330 monthly price of its injectable drug Mounjaro through private providers ^[1][2]. By comparison, Novo Nordisk's oral semaglutide pill, sold under the Wegovy brand in the UK, runs from £74 to £129 a month for starting doses through private providers, with costs rising at higher doses ^[1]. Novo has not yet submitted evidence to NICE for its own pill, the agency said ^[1].

In the United States, where Foundayo launched in April, self-pay prices for the Wegovy pill and Foundayo both start at $149 a month and can climb to $299 and $349, respectively, for higher doses ^[1]. A new Medicare pilot program offers selective access to the oral drugs for $50 a month ^[1]. Lilly's second-quarter earnings, reported in early August, showed Foundayo brought in $98 million in revenue since its U.S. debut, part of $23.0 billion in total company revenue for the quarter, a 48% increase from a year earlier ^[2].

Foundayo is approved in the UK for adults with a body mass index of 30 or higher, or 27 to 30 with at least one weight-related health condition, as well as for improving blood sugar control in type 2 diabetes ^[2]. Dosing starts at 0.8 mg and increases through several levels up to 17.2 mg, with at least one month spent at each dose ^[2]. Common side effects include nausea, constipation, diarrhea, vomiting, indigestion, and abdominal pain ^[2]. Unlike the Wegovy pill, Foundayo can be taken at any time of day without food or water restrictions ^[2].

Why it matters for patients

NICE's review does not change anything for US patients directly, since the FDA already cleared Foundayo and it is being sold here. But the UK process is a real-world test of how much evidence regulators want before paying for a GLP-1 pill, and it shows how pricing can vary sharply depending on payer negotiations and market competition. The gap between UK private pricing (£100 to £120, or roughly $136 to $164, a month) and US self-pay prices ($149 to $349) illustrates how list prices for the same drug differ by country and by insurance arrangement, including the $50-a-month Medicare pilot rate ^[1]. Patients weighing pill versus injection costs, or considering how coverage decisions elsewhere might signal future US insurer behavior, may find these comparisons useful context.

What happens next

No date has been set for NICE's second committee meeting on Foundayo ^[1]. Novo Nordisk has yet to submit evidence to NICE for its Wegovy pill ^[1]. In the European Union, Foundayo remains under regulatory review, while Wegovy's pill form has received a positive recommendation from the European Medicines Agency, with a final European Commission decision still pending ^[1].