Monthly price tells you what a program costs. Cost per pound lost tells you what it's worth. We ran the numbers across clinical trial data and real-world provider pricing to find out which GLP-1 options deliver the most value per dollar spent.
Disclosure: Some links on this page are affiliate links. This doesn't influence our calculations or rankings. All clinical data sourced from published trials.
The Clinical Weight Loss Data
Before we can calculate cost per pound, we need the expected weight loss. Here's what major clinical trials demonstrated:
| Drug | Trial | Duration | Avg. Weight Loss | For 220 lb Person |
|---|---|---|---|---|
| Semaglutide 2.4mg | STEP 1 | 68 weeks | 14.9% | ~33 lbs |
| Tirzepatide 15mg | SURMOUNT-1 | 72 weeks | 20.9% | ~46 lbs |
| Tirzepatide (vs. sema) | SURMOUNT-5 | 72 weeks | 20.2% | ~44 lbs |
| Semaglutide (vs. tirz) | SURMOUNT-5 | 72 weeks | 13.7% | ~30 lbs |
| Oral semaglutide 50mg | OASIS 1 | 68 weeks | 15.1% | ~33 lbs |
Weight loss varies significantly by individual. Trial averages include non-responders. Your results may differ.
Cost Per Pound: Semaglutide
Using 16 months of treatment (matching the STEP 1 trial duration) and 33 lbs of expected weight loss for a 220 lb person:
| Route | Monthly Cost | 16-Month Total | Cost/Pound Lost |
|---|---|---|---|
| Wegovy (list price) | $1,349 | $21,584 | $654/lb |
| Wegovy (savings card) | ~$500 | $8,000 | $242/lb |
| Wegovy (with insurance) | ~$50 | $800 | $24/lb |
| Compounded (Yucca) | $146 | $2,336 | $71/lb |
| Compounded (Gala flat) | $179 | $2,864 | $87/lb |
| Compounded (dose-dep. avg.) | ~$275 | $4,400 | $133/lb |
At list price, brand-name semaglutide costs over $650 per pound lost. With insurance, it drops to around $24/lb — the best value if you can get coverage. Compounded flat-rate options land around $71–$87/lb, making them the most cost-effective cash-pay route.
Cost Per Pound: Tirzepatide
Tirzepatide costs more monthly but delivers greater average weight loss. Using 18 months of treatment and 46 lbs of expected loss:
| Route | Monthly Cost | 18-Month Total | Cost/Pound Lost |
|---|---|---|---|
| Zepbound (list price) | $1,060 | $19,080 | $415/lb |
| Zepbound (savings card) | ~$500 | $9,000 | $196/lb |
| Compounded (Yucca tirz) | $258 | $4,644 | $101/lb |
Even though tirzepatide has a higher monthly price than compounded semaglutide, the greater weight loss brings the cost per pound closer. At $101/lb for compounded tirzepatide vs. $71–$87/lb for compounded semaglutide, the gap is smaller than the monthly price suggests.
The Variables That Change Everything
1. Individual Response Rate
Clinical trial averages include everyone — high responders who lost 25%+ and low responders who lost less than 5%. If you're a high responder, your cost per pound drops dramatically. If you're a low responder, it goes up.
2. Treatment Duration
Most weight loss occurs in the first 12–16 months. After that, the medication primarily maintains your loss. Your "active weight loss" cost per pound is lower than your "lifetime maintenance" cost per pound.
3. Dose Requirements
Some patients achieve their target weight at lower doses, which costs less per month and per pound. Others need maximum dosing. You won't know until you're several months in.
Best Value Picks
Best $/lb for Semaglutide
Best Predictable Value
Best If Insurance Covers GLP-1s
- Brand-name semaglutide at list price: ~$654/lb. With insurance: as low as $24/lb
- Compounded semaglutide (flat-rate): $71–$87/lb — best cash-pay value
- Tirzepatide costs more monthly but the higher weight loss narrows the $/lb gap
- Individual response rate is the single biggest variable in your actual cost per pound
- Always check insurance coverage first — insured brand-name beats every cash-pay option
These calculations use clinical trial averages and verified provider pricing. Individual results vary significantly. This is not medical advice — consult a healthcare provider.