GLP-1 cost in 2026: what you will actually pay

Four prices for the same box

Every GLP-1 sold in the United States now carries at least four public prices, and the gap between them is wider than for almost any other medicine. The list price, or wholesale acquisition cost, is what the maker invoices wholesalers before rebates: $1,028 for a month of Ozempic, $1,112 for Mounjaro. Uninsured patients who walk into a pharmacy without any program are charged a price built on that figure, which is why older articles still quote $900 to $1,400 a month.

The self-pay price is what Novo Nordisk and Eli Lilly charge a cash buyer directly: $349 for Ozempic 1 mg through NovoCare Pharmacy, $399 for a 5 mg Zepbound vial on LillyDirect. TrumpRx.gov, the federal price site, lists exactly the same amounts and sends you to the same programs or to a coupon your pharmacy can scan. The pharmacy acquisition cost comes from CMS’s weekly NADAC survey of retail pharmacies; it says what a pharmacy pays its wholesaler, $996 for that Ozempic pen, and it is the floor of any counter price. Finally, Medicare has its own negotiated price for the drugs picked under the Inflation Reduction Act, the one Part D plans will pay for semaglutide from January 2027.

The calculator shows all four next to the figure that applies to you, so you can see what you pay and how far it sits from the price nobody pays.

Why the way you pay changes everything

Most price pages give one number per drug. That number is wrong for nearly everyone, because the same pen costs a cash buyer, a person with employer coverage, a Medicare beneficiary and a Medicaid enrollee four different amounts, and the rules that set them changed three times in 2026. Our data set follows each of them separately: the dose-by-dose self-pay grids of both makers, the TrumpRx listings for 11 of the drugs priced here, the NADAC cost of each package, the Medicare negotiated prices for 2026 and 2027, the Part D parameters CMS set for both years and the Medicaid prescription counts of every state. None of the pages we reviewed while building the site combines them, and most still quote prices from before the November 2025 price cuts.

Two examples show how much the channel matters. A new Wegovy patient paying cash starts at $199 for each of the first two monthly fills of 0.25 mg or 0.5 mg, an offer that runs to December 31, 2026, then pays $349. A Zepbound patient who lets more than 45 days pass between two LillyDirect refills of 10 mg or more loses the $449 journey price and pays $699. Both toggles are in the calculator.

Medicare: the cap, the 2027 price and the $50 Bridge

Medicare Part D does not cover drugs used only for weight loss; the exclusion comes from the Social Security Act and is repeated in the federal definition of a Part D drug. It does cover a GLP-1 prescribed for type 2 diabetes, and CMS confirms that sleep apnea, MASH and cardiovascular risk reduction are covered uses too. For a covered use, the 2026 standard benefit charges a $615 deductible, then 25% of the cost, and stops at $2,100: with Ozempic at list price, that cap is reached in July. In 2027 the deductible rises to $700 and the cap to $2,400, but semaglutide moves to its negotiated price of $274, so the yearly share for Ozempic falls to about $1,347.

For weight loss alone, CMS opened the Medicare GLP-1 Bridge on July 1, 2026: a flat $50 a month for Wegovy, Zepbound KwikPen and Foundayo, outside the Part D benefit, with a prior authorization and body-mass-index criteria (35 on its own, 30 or 27 with listed conditions). The $50 does not count toward the yearly cap and Extra Help does not lower it. Details are on the Medicare GLP-1 Bridge page and the Part D cap calculator.

Medicaid: state by state, from the claims themselves

Federal law lets each state decide whether its Medicaid program pays for weight-loss drugs, and several reversed course in 2025 and 2026. Rather than repeat secondhand lists, the Medicaid page reads the State Drug Utilization Data that CMS publishes from the claims states actually pay, quarter by quarter, for Wegovy, Zepbound, Ozempic and the others. When a state stops covering obesity treatment, the drop shows up in its own numbers. Copays stay nominal under federal rules, which is why the calculator only asks for yours.

Making the cost lower, legitimately

1. Price the dose you will be on in three months, not the starting one. Most labels raise the dose every four weeks, and several self-pay grids charge more at higher strengths.
2. Check whether your use is covered before paying cash. Self-pay purchases do not count toward an insurance deductible or the Medicare cap.
3. On Medicare with a covered use, ask your plan about the Prescription Payment Plan, which spreads the yearly share into equal monthly bills.
4. With employer insurance that covers the drug, a maker savings card can bring the copay down to as little as $25; it never applies to Medicare or Medicaid.
5. Keep LillyDirect refills within 45 days on the higher Zepbound and Foundayo doses.

Compounded semaglutide and tirzepatide are not priced here: they are not FDA-approved products and no official source publishes their price. The GLP-1 price comparison and the drug pages go further, one medicine at a time.

What this site is not

We do not sell medicine, prescribe, or send you to a telehealth service, and nothing here is medical advice. Whether a GLP-1 suits you, and at which dose, is for you and your prescriber to decide. We read prices and rules; the program, the pharmacy and your plan confirm the final amount.