The Pricing Reality Check
Let's start with the number that should make you angry: GLP-1 medications cost approximately $0.89 to $4.73 to manufacture for a month's supply. Yet Americans pay nearly $1,000 at retail. That's a markup exceeding 20,000%.
But here's what the pharmaceutical companies don't want you to know: almost nobody should pay retail price. Between manufacturer programs, insurance savings cards, compounded alternatives, and patient assistance programs, there are multiple pathways to significant savings.
This guide breaks down every pricing option available in January 2026 so you can find the cheapest legitimate path to these medications.
Brand-Name Pricing
First, let's establish the baseline: what do these medications actually cost at list price? These are the prices you'd pay at a retail pharmacy without any discounts or insurance.
Semaglutide Medications (Novo Nordisk)
| Medication | Indication | List Price | Annual Cost |
|---|---|---|---|
| Ozempic | Type 2 Diabetes | $969/mo | $11,628 |
| Wegovy (injection) | Weight Loss | $1,349/mo | $16,188 |
| Wegovy (oral) - NEW | Weight Loss | $1,349/mo | $16,188 |
| Rybelsus | Type 2 Diabetes | $936/mo | $11,232 |
Tirzepatide Medications (Eli Lilly)
| Medication | Indication | List Price | Annual Cost |
|---|---|---|---|
| Mounjaro | Type 2 Diabetes | $1,079/mo | $12,948 |
| Zepbound (pens) | Weight Loss | $1,086/mo | $13,032 |
Self-Pay Programs That Actually Work
Both Novo Nordisk and Eli Lilly offer significant discounts for patients paying out-of-pocket. These programs have slashed prices dramatically, especially since late 2024.
NovoCare Self-Pay (Wegovy)
| Form | Dose Range | Monthly Price | Notes |
|---|---|---|---|
| Wegovy Injection | 0.25mg-0.5mg (intro) | $199/mo | First 2 fills only |
| Wegovy Injection | 1mg-2.4mg (maintenance) | $349/mo | Ongoing price |
| Wegovy Oral (NEW) | 1.5mg-4mg | $149/mo | New oral option |
| Wegovy Oral (NEW) | 9mg-25mg | $299/mo | Higher oral doses |
Eligibility: Must be 18+, have a valid prescription, and NOT have Medicare, Medicaid, VA, or TRICARE coverage. Commercial insurance patients without coverage can use this program.
LillyDirect Self-Pay (Zepbound)
Eli Lilly offers significant discounts through their LillyDirect program, particularly for vials (which require you to draw your own doses):
| Form | Dose | Monthly Price | Notes |
|---|---|---|---|
| Zepbound Vials | 2.5mg | $299/mo | Starter dose |
| Zepbound Vials | 5mg | $399/mo | Must refill within 45 days |
| Zepbound Vials | 7.5mg-15mg | $449/mo | Must refill within 45 days |
| Zepbound Pens | All doses | $499-650/mo | Via savings card |
Compounded GLP-1 Pricing
Compounded semaglutide and tirzepatide from telehealth providers offer the lowest prices—typically 50-80% less than brand-name self-pay programs.
| Medication | Price Range | Annual Cost | Typical Providers |
|---|---|---|---|
| Compounded Semaglutide | $149-299/mo | $1,788-3,588 | Eden, Hims, Helimeds, etc. |
| Compounded Tirzepatide | $299-449/mo | $3,588-5,388 | Varies by availability |
Compounded Pricing Comparison
Insurance Copays: What You'll Actually Pay
If you have commercial insurance that covers GLP-1 medications, manufacturer savings cards can reduce your copay to as little as $25/month.
| Medication | With Insurance + Savings Card | Max Savings/Month | Annual Cap |
|---|---|---|---|
| Ozempic | $25/mo | Up to $100 | None listed |
| Wegovy | $25/mo | Up to $100 | Up to 48 months |
| Mounjaro | $25/mo | Up to $100 | $1,300/year |
| Zepbound | $25/mo | Up to $100 | $1,300/year |
Why Americans Pay 16x More
If you think these prices seem high, you're right. Here's what people in other countries pay for the exact same medications:
| Country | Ozempic Price | % Cheaper Than US |
|---|---|---|
| 🇺🇸 United States | $969/mo | — |
| 🇩🇪 Germany | $59/mo | 94% cheaper |
| 🇫🇷 France | $71-83/mo | 91% cheaper |
| 🇬🇧 United Kingdom | ~$95/mo | 90% cheaper |
| 🇨🇦 Canada | $155/mo | 84% cheaper |
| 🇦🇺 Australia | $87/mo | 91% cheaper |
The United States accounts for 77.72% of worldwide GLP-1 sales despite having only 4% of the world's population. Approximately 72% of Novo Nordisk's $50 billion in GLP-1 revenue comes from American patients.
12-Month Cost Projections
Planning your budget? Here's what you'll spend over a full year depending on your pathway:
| Option | Monthly | 12-Month Total | Savings vs. Retail |
|---|---|---|---|
| Wegovy Retail | $1,349 | $16,188 | — |
| Wegovy NovoCare Self-Pay | $349 | ~$3,988* | $12,200 |
| Zepbound LillyDirect Vials | $299-449 | ~$5,000 | $8,000+ |
| Compounded Semaglutide | $149-299 | $1,788-3,588 | $12,600-14,400 |
| Brand w/ Insurance + Card | $25 | $300 | $15,888 |
*NovoCare price assumes $199/mo for first 2 months, then $349/mo for remaining 10 months.
Finding Your Cheapest Option
Your best pricing pathway depends on your insurance situation:
If You Have Commercial Insurance
- Check if your plan covers Wegovy or Zepbound for weight loss
- If covered, use the manufacturer savings card for $25/month
- If denied, file an appeal—65% succeed
If You're Paying Cash (No Coverage)
- Lowest cost: Compounded semaglutide ($149-199/mo)
- Best brand value: Zepbound vials via LillyDirect ($299-449/mo)
- Most convenient brand: Wegovy NovoCare ($349/mo)
If You Have Medicare
- Check if you qualify for the BALANCE Model launching July 2026 ($50/mo)
- Consider diabetes indication if applicable (better coverage)
- Look into patient assistance programs for low-income patients
Compare All Your Options
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