Singapore GLP-1 May 2026: MOH Circular 87/2024 one year on, Foundayo HSA outlook, oral Wegovy approval pathway

The Singapore GLP-1 picture moved enough since our April buyer's guide and clinics-deeper update to warrant a focused May refresh. Three structural shifts: MOH Circular 87/2024 (the in-person-consultation rule for telehealth GLP-1 prescribing) hit its one-year mark in March 2026 with observable rather than theoretical effects, the Foundayo (orforglipron) HSA pathway is becoming the gating question for the next oral-GLP-1 wave, and the HSA suicidal-thoughts safety signal investigation entered its second phase.

This is the May 2026 snapshot. Companion to the existing SG content + the cross-region pulse piece.

MOH Circular 87/2024 · one year on

The in-person-consultation rule for GLP-1 telehealth prescribing in Singapore turned one year old in March 2026. Observable patterns:

Operators that built around the rule (Chi Longevity, Longevity GP, Siena) have continued operating with hybrid telehealth + in-clinic flows. Compliance overhead is real but absorbed into operating model. These are the routable answers in the catalog.

Operators with telehealth-first flows that haven't fully retrofitted (Bay Aesthetics, Noah SG, Zoey SG) sit on the conditional-side of the verdict line. Their rx-legality scores reflect the partial in-clinic-copy compliance · routable for cohorts that complete the in-person step, marginal for cohorts that rely on the telehealth-first onramp.

No headline enforcement events have hit the catalog operators in the past year. MOH's enforcement posture has been guidance + practice notes rather than infringement notices · the pattern is "rule is the rule; non-compliance loses your license", not "rolling fines for ad copy."

Routing implication: the MOH 87/2024 framework is now part of the durable Singapore GLP-1 environment. Readers asking "is the in-person rule a real constraint" → yes, observably. Operators that route around it are taking real risk; operators that accept the constraint are the cleaner answer.

Foundayo (orforglipron) HSA pathway

Lilly received FDA approval for Foundayo (oral small-molecule GLP-1) on April 1, 2026. The HSA pathway typically runs 12-18 months behind FDA for a new molecular entity. Realistic SG timeline: mid-2027 to early 2028 HSA decision.

Lilly's APAC strategy historically prioritises Singapore as a regional hub for early launch · the SG HSA timeline is plausibly faster than the broader 12-18 month ASEAN average. Whenever Foundayo lands in SG, expect:

• Cash-pay private pricing in the SG$200-300/mo range (extrapolating from Lilly's US Ro launch at $149/mo + typical SG vs US pharma pricing markup)
• Distribution via the established SG telehealth + clinic operators rather than a Lilly-direct channel (LillyDirect Singapore is not announced)
• Compliance with MOH 87/2024 · Foundayo is still a Rx, the in-person rule still applies for first-prescription handoff

Routing implication: too early. Foundayo doesn't change the May 2026 routing answer. Watch the HSA application announcement (Lilly typically discloses it within 1-3 months of FDA approval).

Oral Wegovy 25mg HSA pathway

Oral semaglutide 25mg was FDA-approved late December 2025 and is shipping at US + UK private pharmacies. The HSA pathway is faster than for Foundayo because:

• HSA already approved Wegovy injectable (2023) and the related Rybelsus low-dose oral semaglutide (lower-dose for diabetes) · this is a dose escalation rather than a new molecular entity
• Novo Nordisk has an active SG distribution chain via the existing Wegovy KwikPen channel

Realistic SG availability: late 2026 or early 2027. Sooner than Foundayo.

Routing implication: for needle-averse SG readers willing to wait 6-12 months, oral Wegovy is the more-likely-near-term oral path. For readers needing oral today, the path is travel to AU or UK · not a Panya recommendation.

HSA suicidal-thoughts safety signal · investigation status

HSA's safety alert on potential suicidal thoughts and self-harm with GLP-1 receptor agonists (open since 2024) entered a more-visible phase in early 2026. The Singapore-specific framing tracks the international evidence (FDA + EMA) which has been mixed: large-cohort observational studies (Wegovy + Mounjaro post-marketing surveillance) have not consistently confirmed the signal, but the regulatory-watchful-waiting posture continues.

What changed in 2026 specifically: nothing in HSA's public guidance has shifted to require warnings, label changes, or prescribing restrictions in SG specifically. The investigation continues. Operators are voluntarily including mental-health screening in their intake flows; the catalog scoring on "support quality" implicitly weights this.

Routing implication: ask your prescribing clinician about mental-health history. If you have a history of suicidal ideation, depression, or eating-disorder behaviour, this is a real conversation to have, not a reflex skip-the-question. The data is unsettled; the prudent posture is informed disclosure to your clinician.

What we're watching for the next update

• HSA Foundayo filing announcement: usually disclosed by Lilly within 1-3 months of FDA approval; would expect a public submission by August 2026.
• Novo Nordisk oral Wegovy 25mg HSA submission: faster track than Foundayo; could land in 2026.
• MOH 87/2024 enforcement updates: any infringement notice or licence-action against a major operator would shift the catalog risk profile.
• HSA safety-signal investigation conclusion: if HSA issues a formal warning + label change request, ripple effects across all SG operators.

For the SG vendor catalog: /blog/singapore-glp1-buyers-guide-2026 (April · still current on operator scoring). For the deeper clinic-by-clinic breakdown: /blog/singapore-glp1-clinics-deeper-2026 (May 2). For cross-region context: /blog/peptide-pulse-may-2026 + /blog/uk-glp1-may-2026-nhs-update + /blog/australia-glp1-buyers-guide-may-2026 + /blog/new-zealand-glp1-may-2026-update.