Costco offers Wegovy and Ozempic at $499 a month for cash-paying members

Costco has started selling Wegovy and Ozempic to cash-paying members for $499 a month, adding a major warehouse retailer to a widening push to sell GLP-1 medications outside of insurance ^[1]. Walmart has rolled out a comparable arrangement with Eli Lilly for Zepbound, the weight-loss drug that competes with Wegovy ^[1].

Wegovy and Ozempic are both brand names for semaglutide, the drug Novo Nordisk sells as a weekly injection. Costco has not disclosed which doses fall under the $499 price, whether the price includes any pharmacy membership requirements, or how long the price will last ^[1].

The Costco figure is higher than the cash price Novo Nordisk has announced for its lowest-dose Wegovy injection, which the company has said is $349 a month for people paying cash and not using insurance ^[1]. Because the two prices may cover different doses of the same drug, they are not directly comparable ^[1].

Cash prices across the GLP-1 market now vary widely by product and dose. Novo Nordisk has said the two lowest doses of the newly approved Wegovy pill will cost $149 a month for cash payers, with the two higher doses priced at $299 a month for cash payers starting Monday ^[1]. For people whose insurance covers the drug, out-of-pocket costs could be as low as $25 a month, according to the company ^[1].

Clinicians watching the market say competition among sellers is one reason prices have moved.

"With so much product in the market, I hope the competition will further reduce prices," said Dr. Shauna Levy, medical director of the Tulane Weight Loss Center ^[1].

Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina, said the field is changing shape. "The GLP-1 landscape is expected to broaden significantly," he said. "For the first time, medical obesity treatment will move away from a one-size-fits-all model" ^[1].

Why it matters for patients

Retail cash prices are paid month after month, so a $499 monthly price adds up to roughly $6,000 over a year, before any other costs. Whether that is a better deal than using insurance depends on a person's plan, deductible and coverage rules, none of which the Costco arrangement addresses in what has been announced ^[1].

The spread of prices also means the same molecule can carry different costs depending on the seller, the dose and whether a person pays cash. A patient comparing Wegovy, Ozempic and Zepbound now sees monthly cash figures that range from $149 for the lowest doses of the Wegovy pill to $499 at Costco, with a $349 cash price for the lowest-dose Wegovy injection in between ^[1].

Costco has not said whether its $499 price applies to all doses or only some, so a patient cannot yet tell from the announced terms whether the price would rise as a dose increases ^[1].

What happens next

The Wegovy pill, the first GLP-1 pill approved for weight loss, is expected to be widely available this month ^[1]. Novo Nordisk has said the two higher doses will be priced at $299 a month for cash payers starting Monday ^[1].

Eli Lilly's GLP-1 pill is expected to gain approval later this year, and Lilly is still running clinical trials on retatrutide, a weekly injection that targets three hormones and could be the most powerful GLP-1 drug yet ^[1].

How the oral options perform outside of trials is still an open question. Levy noted that the Wegovy pill must be taken every morning on an empty stomach; in a late-stage trial, people who stuck to that schedule lost 16.6% of their body weight on average, compared with 13.6% when the pill was not taken exactly as prescribed ^[1].

Whether other large retailers will match the Costco and Walmart prices has not been reported ^[1].