Head-to-head · Cost-Efficiency Index
Strut Health vs LillyDirect Foundayo
Two GLP-1 programs on the bench, scored on the same six factors. Here's how their real cost of ownership compares — and which one we'd start with.
Strut Health
Anyone optimising total monthly outlay who will keep an auto-refill running, and anyone whose real objection is the needle.
Visit Strut HealthLillyDirect Foundayo
Patients with commercial insurance who want the cheapest legal brand-name GLP-1.
Visit LillyDirect FoundayoThe verdict
Strut Health takes it, leading the Cost-Efficiency Index 87 to 79. The lowest true entry cost on this board — $99/month sublingual semaglutide — and the only place selling the same molecule as a lozenge or an injection at one price. LillyDirect Foundayo still earns a C — Patients with commercial insurance who want the cheapest legal brand-name GLP-1.
Worth knowing either way: our overall #1 pick is CoreAge Rx (Cost-Efficiency Index 94/100 — the top of the board). See how it stacks up: CoreAge Rx vs Strut Health.
Factor by factor
Both providers scored on our six Cost-Efficiency Index factors. The stronger side on each row is marked in teal.
Normalized Cost/Month
Price Transparency
Nationwide Access
Formulation Options
Clinical Oversight
Contract Flexibility
Pricing, coverage & formulary
The disclosed facts behind the scores. Lower price wins its row (teal).
| Spec | Strut Health | LillyDirect Foundayo |
|---|---|---|
| Cost-Efficiency Index | 87/100 | 79/100 |
| Semaglutide / mo | From $99/mo sublingual, $149/mo injectable | Not disclosed |
| Tirzepatide / mo | From $199/mo either route | Not disclosed |
| Semaglutide / yr (modeled) | $1,188 | — |
| Tirzepatide / yr (modeled) | $2,388 | — |
| Coverage | 49 states (not Arkansas) | All 50 states |
| Oral / sublingual | Yes | Yes |
| Brand-name access | Compounded only | Yes |
| Rank on the board | #4 | #41 |
Strut Health
87/100Where the value is
- Cheapest disclosed monthly cost here at $99/mo for sublingual semaglutide; tirzepatide $199 either route
- Sublingual lozenges for both molecules at the same price as the injection
- Free physician visit, free shipping and free follow-up care included rather than billed separately
The tradeoffs
- The $99 and $149 headline figures require auto-refill — a one-off order costs more, so the true cost depends on staying subscribed
- Asynchronous by design: their FAQ notes some states need no phone consultation, so you may never speak to the prescriber
LillyDirect Foundayo
79/100Where the value is
- 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
The tradeoffs
- 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)
Assume any provider we list may compensate us — we may earn a commission, at no cost to you. It never changes the Cost-Efficiency Index. Pricing, states and verification reflect each provider's public disclosures at last review; prices change — confirm on the provider's site. Not medical advice. See our disclosure.