What a GLP-1 costs in the first year, dose step by dose step
Paying cash, the first twelve months of Wegovy cost $3,888 for a new patient who follows the label’s escalation to 2.4 mg; Zepbound to 10 mg costs $5,188.
The monthly price of a GLP-1 is not the price of the first year, because every label starts low and raises the dose every four weeks or 30 days, and several self-pay grids charge by strength. A new Wegovy patient paying cash pays $199 for each of the first two months, then $349 at every step to 2.4 mg: $3,888 over twelve months. The Wegovy pill climbs from $149 to $299 over four steps and costs $3,338. Zepbound vials start at $299 and settle at $449 from 7.5 mg, so the year costs $4,688 if the dose stays at 5 mg and $5,188 if it goes to 15 mg. Foundayo, with its reduced middle steps, costs $3,188 to 9 mg. These figures follow the fastest escalation the labels allow; a prescriber who holds a dose longer changes them, and the tool lets you see the effect of starting as a new patient or not.
Your first 12 months, paying cash
First 12 months
$3,888
| Month one | $199 |
| Average a month | $324 |
| At the target dose | $349 |
One dose step a month, as the label describes; your prescriber may go slower. Estimate only.
Prices read by Radif Partners · Editorial policy · Method and data
Twelve months for each drug
| Drug and target dose | Month 1 | First 12 months, new patient | First 12 months, not new | At target dose, a month |
|---|---|---|---|---|
| Wegovy injection to 2.4 mg | $199 | $3,888 | $4,188 | $349 |
| Wegovy pill to 25 mg | $149 | $3,338 | $3,338 | $299 |
| Ozempic to 1 mg | $199 | $3,888 | $4,188 | $349 |
| Zepbound vial to 5 mg | $299 | $4,688 | $4,688 | $399 |
| Zepbound vial to 10 mg | $299 | $5,188 | $5,188 | $449 |
| Zepbound vial to 15 mg | $299 | $5,188 | $5,188 | $449 |
| Foundayo to 9 mg | $149 | $3,188 | $3,188 | $299 |
| Foundayo to 17.2 mg | $149 | $3,188 | $3,188 | $299 |
The escalation rules we apply
Wegovy injection starts at 0.25 mg for four weeks and steps through 0.5, 1 and 1.7 mg to 2.4 mg every four weeks. Wegovy tablets start at 1.5 mg for 30 days, then 4, 9 and 25 mg every 30 days. Ozempic starts at 0.25 mg, moves to 0.5 mg after four weeks and to 1 mg if more control is needed. Zepbound starts at 2.5 mg for four weeks and rises by 2.5 mg every four weeks or more to a maintenance dose of 5, 10 or 15 mg. Foundayo starts at 0.8 mg for at least 30 days, then 2.5 and 5.5 mg, then 9, 14.5 or 17.2 mg if needed. We treat each step as one month’s fill, which matches how the makers sell a month of treatment.
Why the totals diverge
Three pricing designs coexist. Flat grids, like Wegovy pens or Mounjaro, cost the same from the first month to the last. Rising grids, like the Wegovy pill, Ozempic pill and Foundayo, are cheap at the start and rise to the maintenance price. Lilly’s Zepbound grid rises too, but adds a condition: from 7.5 mg the price assumes each refill within 45 days. A year with two late refills at 10 mg costs $500 more than the table shows.
Starter offers and end dates
Novo Nordisk’s $199 offer for the first two months of Ozempic or Wegovy at 0.25 and 0.5 mg applies to fills until December 31, 2026, and Lilly’s reduced prices for Foundayo 2.5 and 5.5 mg end the same day. Someone starting in November 2026 will cross that date mid-escalation; the calculator’s 2027 setting applies the regular prices.
With coverage
The first-year view matters less with insurance, where a flat copay applies to each fill, or with Medicare, where the $2,100 cap limits the year. It matters most for cash payers budgeting the start of treatment.
Budgeting the first year, month by month
The first-year total hides a shape. On rising grids the first bills are the lightest and the bill stabilises once the target dose is reached, usually by the fourth or fifth month. On Zepbound the jump comes at 7.5 mg, the third month on the fastest schedule, when the price moves from $399 to $449. On Wegovy pens, after the two starter months, every month costs the same. Someone paying from a monthly budget should plan for the maintenance price from the start; the calculator’s monthly figure is that number.
Three events change the plan. A dose held longer at a lower strength lowers the total on rising grids. A pause and restart often means going back down the escalation, which on Zepbound can also trigger the higher late-refill price. And coverage can change mid-year, when an employer plan adds or drops anti-obesity drugs or when a Medicare enrollee becomes eligible for the GLP-1 Bridge; from that month on, the self-pay figures in the table no longer apply.
What the table leaves out
Pen needles for the Zepbound KwikPen and syringes for vials, sales tax where a state charges it, and shipping if a program bills it are not included; Lilly and Novo Nordisk both advertise free delivery through their pharmacies at the time of writing. Office visits and lab tests needed for a prescription are outside the scope of a price calculator.