What each costs per month, on cash
| Drug | Starting | Maintenance | List (avoid) |
|---|---|---|---|
| Zepbound | $299/mo | $449/mo on schedule / $699/mo if missed | $1,086/mo |
| Wegovy | $199/mo for the first 2 fills, then $349 | $349/mo for maintenance doses | $1,349/mo |
| Oral Wegovy pill | from $149/mo | — | — |
| Ozempic | $199/mo for the first 2 fills, then $349 (0.25/0.5/1 mg) or $499 (2 mg) | Varies — check current terms | $969–$998/mo |
| Mounjaro | Lilly self-pay — check terms | Varies | $1,069/mo |
| Compounded semaglutide | $69–$300/mo | Usually tiered higher | Not FDA-approved |
| Compounded tirzepatide | $99–$450/mo | Usually tiered higher | Not FDA-approved |
The three numbers people confuse
Most disagreement about “what a GLP-1 costs” is really people quoting different numbers at each other.
- List price. Four figures a month. Real, published, and almost nobody needs to pay it — quoting it makes the drugs sound less accessible than they are.
- Introductory price. Tied to starting doses and early fills. Genuinely available, genuinely temporary. This is the number most often used in headlines.
- Maintenance price. What you pay at the dose you settle on, indefinitely. This is the number that matters and the one least often quoted.
When a program quotes you a figure, the useful follow-up is one sentence: “is that the starting dose or my maintenance dose, and how many fills does it cover?”
The conditions that move the number
Dose tier (tirzepatide)
Zepbound self-pay steps up with strength: $299/mo (2.5 mg), $399/mo (5 mg), then $449/mo (7.5 mg and up) from 7.5 mg. Wegovy's cash maintenance price is flat, which makes it more predictable to budget.
The 45-day refill window
Zepbound's cheaper maintenance price applies only if each refill is bought within 45 days of the previous one. Miss it and the same dose costs $250 more that month. Set the reminder to the window, not to when you run out.
Where you fill it
On insurance, a 90-day mail-order fill is frequently priced below three 30-day copays. Same drug, same dose, lower monthly cost purely from how it is dispensed.
Membership and visit fees
Telehealth programs bundle a fee with the medication. Ask whether it continues past month one, and compare TOTAL monthly cost rather than the medication line alone.
Annualised — the number to budget from
These are ongoing treatments rather than a course you finish, so the year is the honest unit. At maintenance on cash:
| Scenario | Per month | Per year |
|---|---|---|
| Wegovy cash maintenance | $349 | ~$4,188 |
| Zepbound, refilled in window | $449 | ~$5,388 |
| Zepbound, window missed | $699 | ~$8,388 |
| Oral Wegovy pill (starting) | $149 | ~$1,788 |
Do not annualise an introductory price. Multiplying a starting-dose figure by twelve produces a number that does not exist, and it is the single most common budgeting error in this category.
How to actually lower it
- Check coverage first. A copay beats every cash route on this page, which is why confirming your formulary is worth more than any discount hunt.
- Read a denial before accepting it. A criteria denial is frequently reversible; a benefit exclusion is not. The letter says which.
- Check patient assistance if uninsured and income-qualified — it can be $0 and is routinely skipped because it needs an application.
- Ask about 90-day mail order. One phone call, frequently a real reduction.
- If on Medicare, Medicaid, TRICARE or VA: the manufacturer copay card is barred for you by federal law. The cash and assistance programs are not.
Coverage and appeals · every cash route in order · cost per pound calculator
Prices reflect manufacturer programs as of 2026-07-20 and change without notice — verify current figures and conditions before relying on them. Compounded products are not FDA-approved. Educational information, not medical or financial advice.