Novo Nordisk starts selling Wegovy HD 7.2 mg nationwide at $399 a month self-pay

Novo Nordisk began selling Wegovy HD, its 7.2 mg semaglutide injection, across the United States on April 7, 2026 ^[1][2]. Adults paying cash can expect to pay $399 a month, while commercially insured patients may pay as little as $25 a month through the company's savings offer ^[1][2].

The $399 figure runs $50 above the $349 monthly self-pay rate for the other Wegovy injection strengths — 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg ^[1]. People new to NovoCare Pharmacy or the savings program pay $199 for each of the first two monthly fills of the 0.25 mg and 0.5 mg starting doses, a price that holds through June 30, 2026 ^[1]. Savings on the card are capped at $100 a month, and government beneficiaries are excluded ^[1].

Novo Nordisk said the medicine reaches patients through more than 70,000 US pharmacies, NovoCare Pharmacy and selected telehealth providers ^[1][2]. The pens are assembled and packaged at the company's Clayton, North Carolina facility ^[1]. Until now, 2.4 mg was the highest approved strength of injectable Wegovy for weight loss ^[1][2]. The 7.2 mg dose cleared the FDA last month under the Commissioner's National Priority Review Voucher program, Reuters reported ^[2].

What STEP UP found

The approval rests on a 72-week phase 3 trial that compared 7.2 mg with 2.4 mg and placebo in 1,407 adults with a body mass index of 30 or higher and no diabetes ^[1].

When every participant stayed on treatment, average weight fell about 21% (20.7%) on 7.2 mg, about 18% (17.5%) on 2.4 mg and about 2% (2.4%) on placebo. Counting everyone regardless of whether they stayed on treatment, the reductions were about 19% (18.8%), about 16% (15.5%) and about 4% (3.9%) ^[1]. Participants started at an average of 248 lb in the 7.2 mg and placebo groups and 257 lb in the 2.4 mg group ^[1].

About 31.2% of those on 7.2 mg lost at least a quarter of their body weight, against 15.3% on 2.4 mg and none on placebo. Among people taking 7.2 mg, 89% lost at least 5% of their body weight, compared with 38% on placebo ^[1].

Common side effects reported with the higher dose included nausea, vomiting, dysesthesia, constipation, abdominal pain, fatigue, headache, dizziness, hair loss and flatulence ^[1]. Five percent of people on 7.2 mg stopped treatment because of side effects, the same share as on 2.4 mg, versus 2% on placebo ^[1]. Reports of altered skin sensation — sensitive skin, hyperesthesia, dysesthesia and paresthesia — were more common on 7.2 mg, at 22%, compared with 6% on 2.4 mg and 0.3% on placebo ^[1].

"Whether patients haven't yet reached their weight loss goals on lower-dose Wegovy injectables, or they simply have a more significant amount of weight to lose, the 21% weight loss demonstrated in the STEP UP trial, if all patients stayed on treatment, shows what's possible with this new dose," said Ed Cinca, senior vice president of marketing and patient solutions at Novo Nordisk ^[1]. The company also says Wegovy is the only weight-loss medicine for adults with obesity shown to cut the risk of stroke, heart attack or cardiovascular death in people who also have heart disease ^[1].

Why it matters for patients

A higher dose now exists for people whose weight loss has stalled on 2.4 mg, but it costs $50 more each month for anyone paying out of pocket ^[1]. In the trial, the gap between the two doses averaged roughly three percentage points of weight loss, and the difference was larger in the share of people who lost at least 25% of their body weight ^[1].

Stopping treatment because of side effects looked similar at both doses, yet altered skin sensation was reported far more often at 7.2 mg ^[1].

Whether insurers will cover 7.2 mg on the same terms as lower doses, and how prior authorization would work for it, has not been reported ^[1][2]. The company said every Wegovy dose, including Wegovy HD, is sold through the same channels ^[1].

What happens next

The $199 starter price for the 0.25 mg and 0.5 mg doses ends June 30, 2026, after which those strengths and the rest of the lower-dose line list at $349 a month ^[1]. Novo Nordisk says it can change or cancel its savings programs at any time ^[1].

The company also said in late March that it plans a discounted subscription plan for US Wegovy patients who pay for the drug themselves, part of an effort to regain ground lost to Eli Lilly in the obesity-drug market, according to Reuters ^[2]. Pricing and a start date for that plan have not been disclosed ^[2].