The routes, cheapest first
1. Patient assistance — can be $0
Manufacturer programs can supply medication at no cost to uninsured, income-qualified patients. It requires an application with income documentation and it is not instant, which is exactly why people skip it — and why it is the most commonly missed money on this page.
2. Manufacturer self-pay
Direct cash pricing that bypasses insurance entirely. Zepbound starts at $299/mo (2.5 mg); Wegovy runs about $349/month at maintenance with a $199 introductory price; the oral Wegovy pill starts around $149.
3. TrumpRx federal portal
A government self-pay portal routing to manufacturer direct-pay at negotiated prices. A prescription is still required. Worth comparing against the manufacturer program directly, since which is cheaper depends on the drug and dose.
4. Telehealth with a bundled cash price
A visit plus prescription plus delivery, priced as a package. Convenient, and the route most cash payers use. Compare the TOTAL — membership or visit fee plus medication at your maintenance dose.
5. Retail list price
The number to avoid. Four figures a month, and almost nobody needs to pay it.
The list is ordered by price. The order that matters is eligibility — assistance is cheapest and hardest to qualify for, so most people work down until they hit the first route open to them. Patient assistance · TrumpRx prices
What each drug costs on cash
| Drug | Self-pay | List price (avoid) |
|---|---|---|
| Zepbound (weight) | $299/mo (2.5 mg) → $449/mo (7.5 mg and up) | $1,086/mo |
| Wegovy (weight) | $349/mo for maintenance doses ($199/mo for the first 2 fills, then $349) | $1,349/mo |
| Oral Wegovy pill | from $149/mo | — |
| Ozempic (diabetes) | $199/mo for the first 2 fills, then $349 (0.25/0.5/1 mg) or $499 (2 mg) | $969–$998/mo |
| Mounjaro (diabetes) | Lilly self-pay — check current terms | $1,069/mo |
The condition attached to the cheapest price
Worth its own heading because it is easy to miss and expensive. Lilly's discounted Zepbound maintenance price of $449/mo applies only if you buy each refill within 45 days of the previous fill. Miss the window and the same dose reverts to $699/mo — $250 more per month, roughly $3,000 a year for identical medication at an identical dose.
Two consequences if you are paying cash. Set the reminder to the window, not to when you run out. And when comparing products, compare the conditional price against the unconditional one honestly — Wegovy's cash maintenance pricing has no equivalent refill condition, which can make it cheaper in practice for someone whose refills are irregular.
The two mistakes that cost the most
Signing up for a copay savings card
Copay cards reduce a copay, which requires commercial insurance. With no coverage there is nothing for the card to reduce. The programs that DO apply to you are the manufacturer cash program and patient assistance — different applications, often on the same manufacturer site, and easy to confuse.
Budgeting from the introductory price
Introductory pricing is tied to starting doses and early fills. It is not a permanent maintenance price, and multiplying it by twelve produces an annual figure that does not exist. Ask the program two questions before committing: what do I pay at the dose I am titrating toward, and how many fills does the intro price cover?
Where compounded fits
Compounded semaglutide advertises around $69–$300/mo and tirzepatide around $99–$450/mo. Against a four-figure list price that looks decisive, and two things narrow it.
The advertised figure is usually the starting dose, medication only — add the consultation, labs if required, higher pricing at maintenance strengths and shipping, and the real number climbs. And compounded products are not FDA-approved; strength and purity are not FDA-verified.
The decisive difference for someone without insurance today is what happens later: insurance essentially never covers compounded drugs, so that cash price is permanent, with no copay to fall back on and no appeal route. An approved product can drop to a copay if you gain coverage. Full compounded cost breakdown.
Three calls worth making
The manufacturer program
Ask specifically whether you qualify for patient assistance, not just the cash price — they are separate programs and the assistance one is rarely volunteered.
A pharmacy
Ask what the cash price is at your expected maintenance dose, and whether a 90-day fill is priced below three 30-day fills.
A prescriber or telehealth provider
Ask for the total monthly cost including any membership fee, at your maintenance dose — and whether the fee continues after month one.
Prices reflect manufacturer and federal programs as of 2026-07-19 and change without notice — verify current terms before relying on any figure. Educational information, not medical or financial advice.