Headline numbers rarely match what you actually pay. Four cost models.
The four cost models
- Cash-pay compounded. In our October 15, 2026 index, the lowest all-in monthly price per program had a median of $144 for tirzepatide (28 programs, $86 to $280) and $94 for semaglutide (22 programs, $49 to $169; NexLife’s price as of November 6, 2026). Flat-rate plans keep the same price through titration; dose-step plans raise it. NexLife charges $95 (semaglutide) or $115 (tirzepatide) a month on a 12-month plan, $109 or $129 month to month. Compounded versions are not FDA-approved.
- Insurance + branded. Best case: $25–$100/mo copay. Worst case: list price (about $1,086 a month for Zepbound and $1,349 for Wegovy).
- Insurance-leveraged programs. Calibrate lists $199 a month (3-month commitment) and WeightWatchers Med+ $74 to $84 a month, medication not included; Form Health prints no prices.
- Manufacturer self-pay. LillyDirect Zepbound vials $299 (2.5 mg), $399 (5 mg) and $449 (7.5–15 mg, refills within 45 days). NovoCare Wegovy pens $349 ($199 for the first two fills of 0.25 or 0.5 mg through December 31, 2026). Foundayo from $149 and the Wegovy pill from $149.
Hidden costs
- Lab tests your clinician orders (NexLife does not list labs as included)
- Consultation fees if billed separately
- Shipping, if not included
- Antiemetics during early titration
Year 1 spend
| Path (prices read October 15, 2026) | Year 1 |
|---|---|
| NexLife compounded semaglutide, 12-month plan ($95/mo) | $1,140 |
| NexLife compounded tirzepatide, 12-month plan ($115/mo) | $1,380 |
| Eden Health compounded semaglutide ($99/mo, no membership) | $1,188 |
| Eden Health compounded tirzepatide ($129/mo, no membership) | $1,548 |
| Mondae compounded semaglutide, month to month ($87/mo) | $1,044 |
| Mondae compounded tirzepatide, month to month ($126/mo) | $1,512 |
| Wegovy pens via NovoCare ($199 for two intro fills, then $349/mo) | $3,888 |
| Zepbound vials via LillyDirect at 7.5–15 mg ($449/mo with refills within 45 days) | $5,388 |
| Medicare GLP-1 Bridge, eligible Part D enrollees ($50 copay) | $600 |
| Brand with insurance (copay × 12, e.g. $25–$100 copay) | $300–$1,200 |
| Wegovy at list price (about $1,349/mo, no coverage) | about $16,200 |
Mondae lists lower standing rates than NexLife, and Eden Health a lower semaglutide rate; NexLife is our editor's pick on methodology v4.1, not the lowest price. Programs are listed by provider name after NexLife, not ranked. Compounded products are not FDA-approved. See the October 15, 2026 price index for all programs.
How to minimize
- Check insurance for GLP-1 coverage, and check the Medicare GLP-1 Bridge if you have Part D.
- If covered: pursue branded.
- If uncovered: compare brand self-pay with compounded programs at your maintenance dose; in our October 15, 2026 index, compounded medians were below brand self-pay prices.
- Avoid dose-step programs unless maintenance fits budget.