GLP-1 Drug Prices in the US 2026: Self-Pay, Medicare, TrumpRx

Key points

• As published on 8 November 2026, Lilly lists self-pay Zepbound from $299 a month and Foundayo from $149; Novo Nordisk lists the Wegovy pill from $149 and the Wegovy pen at $349 after an introductory offer [1][2][5].
• Novo states a list price of $1,349.02 per package for Wegovy and will cut the US list price of Wegovy, Ozempic and Rybelsus to $675 a month from 1 January 2027. It says self-pay prices are not affected [5][6].
• Medicare’s GLP-1 Bridge, a CMS demonstration, runs from 1 July 2026 to 31 December 2027 with a $50 monthly copay [7].
• Prices differ by strength, pack definition and eligibility terms, so the lists are not like-for-like. This article states them and gives no advice on paying less.

What this article uses

Every price below was read on 2026-11-08 from the company or government page cited. Pages that show no date are marked “undated”, and the companies say they can change or end offers at any time [1][5]. Pages were opened through a fetch tool that summarises text, except the LillyDirect and Lilly 10-K pages, which we read directly. We did not open any official source giving international list prices, so we report none. Company results and market share are in Eli Lilly (LLY) GLP-1 business, Novo Nordisk (NVO) GLP-1 business and Lilly vs Novo Nordisk market share; this article does not repeat them.

What the manufacturers publish

Lilly: LillyDirect

LillyDirect is Lilly’s direct-to-patient platform. The 10-K says it delivers select Lilly medicines dispensed by third-party pharmacies, offers tools to reach independent healthcare providers, and that self-pay sales through it “represented a growing portion” of the business in 2025 [13]. The 10-K gives no dollar figure we could find.

The Zepbound page (undated, read 2026-11-08) lists the self-pay price per product as “starting at” figures [1]:

Product	Lowest strength	Second strength	Four highest strengths
KwikPen (28 days, one pen)	$299	$399	$449 with refill within 45 days
Single-dose vial (28 days, four vials)	$299	$399	$449 with refill within 45 days

The page states that without a refill within 45 days the regular prices apply: $499 for one of the four highest strengths and $699 for the other three [1]. It says pen needles or needles and syringes must be bought separately. The single-dose pen is listed for insurance only, with “pay as low as $25” per month for commercially insured patients, and governmental beneficiaries are excluded [1].

The Foundayo page (read 2026-11-08, undated) lists self-pay “starting at” $149 a month for the two lowest strengths, $199 for the third, and $299 for the three highest, one footnote tying the top two to a refill within 45 days [2]. It says prices for the middle strengths are “temporarily reduced through December 31, 2026” [2]. A month is defined as 30 days. The page also says “as low as $25” for commercially insured patients with coverage [2].

Novo Nordisk: NovoCare

The NovoCare Wegovy page (undated, read 2026-11-08) lists [5]:

Product	Self-pay price
Wegovy pill	$149, $199 or $299 a month depending on strength (30 tablets)
Wegovy pen, new patients	$199 a month for two monthly fills, offer “through December 31, 2026”
Wegovy pen, after the offer	$349 a month
Wegovy HD pen	$399 a month

The page says “Wegovy pill has a list price of $1,349.02/package”, and gives the same figure for the pen and the HD pen [5]. With commercial insurance it says “pay as little as $25”, up to a maximum savings of $100 a month, with government beneficiaries excluded [5].

Novo announced on 24 February 2026 that it will lower the list price of Wegovy, Ozempic and Rybelsus to $675 a month, effective 1 January 2027. It describes cuts of about 50 percent for Wegovy and 35 percent for Ozempic, aimed mainly at people whose costs follow list price, such as high-deductible plans. The release says this does not affect direct-to-patient self-pay prices [6].

How cash channels work as the companies describe them

Both channels sit outside insurance. NovoCare says money spent “outside of your insurance” does not count toward out-of-pocket limits or the deductible [5]. Lilly says its pharmacy partners fill prescriptions sent by a provider, apply “available savings” and deliver or arrange pickup; a valid prescription is required [2]. Lilly’s Zepbound page says savings are applied automatically if the prescription is filled through LillyDirect and that another pharmacy may need a separate savings program [1].

The “$25” offers are a different thing: manufacturer savings for commercially insured patients with coverage, each described as not insurance and subject to caps and terms [1][2][5].

Neither company sets the price a pharmacy or insurer applies once a plan covers the drug. NovoCare says that if a plan covers it, “your insurance will set the cost” [5].

Telehealth partnerships as described

Lilly’s telehealth page lists five independent providers: Counsel Health, General Medicine, Sesame, WeightWatchers and knownwell. It says these providers apply “independent clinical judgment” on whether medication is right, that Lilly “does not endorse or recommend” them, and that fees they report do not include medication [4]. Reported rates range from $25 a visit to $149 a month. The page was undated when read [4].

NovoCare’s Wegovy page names no telehealth provider or partner pharmacy. It points to resources to find “an independent doctor you can meet virtually”, and to NovoCare home delivery or a local pharmacy [5].

Government agreements and announcements

6 November 2025. A White House fact sheet announced pricing agreements with Lilly and Novo Nordisk. It states Medicare prices of $245 for Ozempic, Wegovy, Mounjaro and Zepbound, a $50 monthly Medicare copay, access to the same prices for state Medicaid programs, and TrumpRx cash prices: $350 for Ozempic and Wegovy and an average of $346 for Zepbound. It listed $150 for the starting dose of oral drugs if approved [9]. The fact sheet we read gave no effective dates. Lilly’s 10-K calls these agreements voluntary and says they were still being finalised when it was written [13]. We did not open the agreement texts themselves.

5 February 2026. The TrumpRx.gov launch fact sheet states Ozempic and injectable Wegovy at an average $350 and “as low as $199”, the Wegovy pill “as low as $149” and Zepbound at an average $346 and “as low as $299”, depending on dosage [10]. It describes savings as coupons and manufacturer channels “integrated into TrumpRx.gov”, so the page does not clearly say whether the site sells drugs itself [10]. The TrumpRx page, undated when read, listed Wegovy pill $149, Wegovy pen $199, Ozempic $199 and Zepbound $299, and no Foundayo [12]. These match the manufacturers’ lowest self-pay tiers, not their highest.

18 September 2026. A White House fact sheet on state Medicaid describes a payment model in which manufacturer rebates keep Medicaid’s price from exceeding the most-favoured-nation price. It names no GLP-1 product and gives no obesity-drug price [11].

Medicare and Medicaid coverage decisions

CMS says the Medicare GLP-1 Bridge starts on 1 July 2026 and was extended to 31 December 2027 because the BALANCE model is not launching in Medicare in 2027 [7][8]. Terms on the CMS page, last updated 13 July 2026 [7]:

• Eligible Part D beneficiaries pay a $50 copay. The Part D deductible does not apply, the copay does not count toward true out-of-pocket costs, and low-income subsidies do not apply.
• It “will operate outside of the Medicare Part D benefit’s coverage and payment flow”, with one central processor handling prior authorisation, claims and pharmacy payment. Part D sponsors bear no risk.
• The page does not name the drugs or list the criteria and does not state a price paid to manufacturers.

Lilly’s Bridge page names Foundayo and the Zepbound KwikPen as covered at $50 a month. It says a prescription is required, a prior authorisation is done once, and certain plan types are excluded. It also states that someone prescribed Zepbound for moderate to severe sleep apnoea with obesity is not eligible for the Bridge [3]. NovoCare says only that it links to a Medicare guide and excludes government beneficiaries from its $25 offer [5].

For Medicaid, CMS describes BALANCE as a voluntary model. State Medicaid agencies can join from May 2026 through 1 January 2027, coverage depends on state and manufacturer participation, and it “will not guarantee coverage for any individual”. CMS says it negotiates with manufacturers on behalf of states and Part D sponsors [8]. The page, last updated 29 September 2026, shows no participant count [8]. Which states cover obesity drugs is not on the pages we opened.

Private insurance rules

We found one documented rule: Lilly’s 10-K states that in the US “self-insured employers must generally opt in for coverage of anti-obesity medicines”, and that payers in various international markets do not cover them for weight loss, which leaves patients to self-pay [13]. Plan-by-plan formulary and prior authorisation terms are not published by the companies, and we did not review insurer documents.

What we could not verify

• Official international list prices.
• The text of the November 2025 agreements, and whether the $245 Medicare price applies to the Bridge.
• Medicare price negotiation figures for semaglutide; we did not open a CMS source.
• Medicaid participation by state.

Frequently asked questions

What does Zepbound cost through LillyDirect? As published on 8 November 2026, Lilly lists KwikPen and vial self-pay prices “starting at” $299, $399 and $449 a month by strength, with higher regular prices of $499 to $699 if a refill is late [1]. A month is defined as 28 days.

What is the list price of Wegovy? Novo states $1,349.02 per package for the pill, pen and HD pen on its NovoCare page [5]. It announced a $675 list price from 1 January 2027 [6].

Is Medicare covering obesity drugs? Through the Bridge demonstration, CMS says eligible Part D beneficiaries pay $50 a month from 1 July 2026 to 31 December 2027 [7]. Lilly lists Foundayo and Zepbound KwikPen as covered [3].

Is TrumpRx a pharmacy? The 5 February 2026 White House fact sheet describes coupons and manufacturer channels integrated into the site. We could not determine from the pages we read whether it sells drugs itself [10].

Sources

1. Eli Lilly and Company, LillyDirect Zepbound page (read 2026-11-08; undated). https://www.lilly.com/lillydirect/zepbound
2. Eli Lilly and Company, LillyDirect Foundayo page (read 2026-11-08; undated). https://www.lilly.com/lillydirect/foundayo
3. Eli Lilly and Company, LillyDirect Medicare GLP-1 Bridge page (read 2026-11-08; undated). https://www.lilly.com/lillydirect/medicare
4. Eli Lilly and Company, “Telehealth for Obesity”, LillyDirect Care (read 2026-11-08; undated). https://www.lilly.com/find-care/telehealth/obesity
5. Novo Nordisk Inc., NovoCare Wegovy page (read 2026-11-08; undated). https://www.novocare.com/obesity/products/wegovy.html
6. Novo Nordisk, “Novo Nordisk announces significant reduction in U.S. list price for Wegovy, Ozempic, and Rybelsus” (2026-02-24). https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=916504
7. CMS, “Medicare GLP-1 Bridge” (page updated 2026-07-13). https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge
8. CMS Innovation Center, “BALANCE Model” (page updated 2026-09-29). https://www.cms.gov/priorities/innovation/innovation-models/balance
9. The White House, “Fact Sheet: President Donald J. Trump Announces Major Developments in Bringing Most-Favored-Nation Pricing to American Patients” (2025-11-06). https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/
10. The White House, “Fact Sheet: President Donald J. Trump Launches TrumpRx.gov to Bring Lower Drug Prices to American Patients” (2026-02-05). https://www.whitehouse.gov/fact-sheets/2026/02/fact-sheet-president-donald-j-trump-launches-trumprx-gov-to-bring-lower-drug-prices-to-american-patients/
11. The White House, “Fact Sheet: President Donald J. Trump Announces Lower Drug Prices for All 50 State Medicaid Programs” (2026-09-18). https://www.whitehouse.gov/fact-sheets/2026/09/fact-sheet-president-donald-j-trump-announces-lower-drug-prices-for-all-50-state-medicaid-programs/
12. TrumpRx.gov home page (read 2026-11-08; undated). https://www.trumprx.gov
13. Eli Lilly and Company, Form 10-K for fiscal year 2025, SEC EDGAR (filed 2026-02-12). https://www.sec.gov/Archives/edgar/data/59478/000005947826000013/lly-20251231.htm

This article is information, not medical advice. This is not investment advice.