What pharmacies pay for GLP-1s: the NADAC survey explained
A pharmacy pays about $1,307 for a box of Wegovy 2.4 mg, according to the federal NADAC survey of October 14, 2026; the self-pay price is $349.
NADAC, the National Average Drug Acquisition Cost, is a weekly CMS survey of what retail pharmacies pay their wholesalers, built from invoices that a sample of pharmacies submits each month and published per unit, per tablet or per milliliter, for nearly every drug on the market. States use it to reimburse Medicaid pharmacies, and it is the best public answer to a question uninsured buyers ask at the counter: why does the pharmacy want so much more than the price I saw online? For GLP-1s the answer is plain. The pharmacy pays about $1,307 for a box of Wegovy 2.4 mg and $996 for an Ozempic pen, close to their list prices of $1,349 and $1,028. It cannot sell below that without losing money, so a plain cash claim starts there. The self-pay prices of $349 and $349 exist only because the manufacturer makes up the difference through its program or the TrumpRx coupon.
What the pharmacy pays, and what you pay
Pharmacy cost for one month
$1,307
| NADAC per mL | $435.53 |
| Self-pay price | $349 |
| List price | $1,349 |
Weekly CMS survey of retail pharmacy invoices. Estimate only.
Prices read by Radif Partners · Editorial policy · Method and data
Pharmacy cost of each drug, per month
| Drug and dose | NADAC per unit | Pharmacy cost a month | List price | Self-pay |
|---|---|---|---|---|
| Ozempic 1 mg | $331.90 / mL | $996 | $1,028 | $349 |
| Ozempic pill 4 mg | $33.18 / tablet | $995 | $1,028 | $199 |
| Wegovy 2.4 mg | $435.53 / mL | $1,307 | $1,349 | $349 |
| Wegovy pill 25 mg | $43.43 / tablet | $1,303 | $1,349 | $299 |
| Mounjaro 7.5 mg | $538.68 / mL | $1,077 | $1,112 | $499 |
| Foundayo 9 mg | $20.85 / tablet | $626 | $649 | $299 |
| Rybelsus 7 mg | $33.19 / tablet | $996 | – | none |
| Trulicity 1.5 mg | $487.54 / mL | $975 | $987 | $389 |
| Eliquis 5 mg twice a day | $5.52 / tablet | $331 | – | none |
| Jardiance 10 mg | $11.19 / tablet | $336 | – | none |
| Xarelto 20 mg | $19.54 / tablet | $586 | $612 | $197 |
| Farxiga 10 mg | $12.08 / tablet | $362 | $378 | $35 |
| Januvia 100 mg | $10.55 / tablet | $317 | – | none |
| Entresto 97/103 mg twice a day | $11.59 / tablet | $695 | – | none |
How a month is counted
NADAC is per unit, so we multiply by what makes a month: one 3 mL Ozempic pen, four Wegovy pens of 0.5 or 0.75 mL, four Mounjaro or Trulicity pens of 0.5 mL, one 2.4 mL Zepbound KwikPen, 30 tablets for once-daily pills and 60 for Eliquis and Entresto, taken twice a day. Those are the quantities the makers and TrumpRx use to define a month.
What NADAC is not
It is not a price you can pay. The counter price adds the pharmacy’s margin and a dispensing fee, and insurers negotiate their own reimbursement. It is also an average across pharmacies and a few weeks behind: the file is weekly, prices are updated when the survey shows a change, and the effective date of each figure is published. The NADAC Comparison file on the same site shows which prices moved each week.
Why we show it
Three reasons. It is current, official and neutral, unlike coupon-site “typical cash prices” that depend on a sign-up. It is the only public figure for drugs without any self-pay offer, such as Rybelsus, Eliquis, Jardiance or the Zepbound single-dose pen. And it shows how far a self-pay price sits below what the supply chain charges, which tells you how much depends on the manufacturer keeping that program open.
Reading a NADAC line yourself
On data.medicaid.gov, each NADAC row gives a drug description, its NDC, the price per unit, the pricing unit, the effective date and the date of the file. For a pen sold by the milliliter, multiply by the volume of the pen; for tablets, by the number in the bottle. A price unchanged for weeks keeps its old effective date even in the newest file. Brand drugs carry a classification flag that tells a state whether to price them as brands or generics.
NADAC and the GLP-1 price cuts
When manufacturers cut self-pay prices, NADAC does not move, because pharmacies still buy from wholesalers at prices tied to the list price. That gap, close to a thousand dollars a month for Wegovy, is what the makers’ programs absorb, and it is why a pharmacy that runs a plain cash claim instead of the program will quote a price near NADAC.