Semaglutide cash prices settle into a $149 to $499 band while list prices stay above $1,000

Cash-pay prices for branded semaglutide have settled into a band between $149 and $499 a month, depending on whether a patient takes the pill or the pen and which dose they are on, according to Novo Nordisk's NovoCare Pharmacy pricing pages ^[1][3]. The same products carry list prices of roughly $1,028 for Ozempic and $1,349 for Wegovy, as displayed on the federal TrumpRx site ^[2].

What the tiers actually are

The cheapest branded option is the oral form. The Wegovy pill starts at $149 a month, but that price applies only to the 1.5 mg dose. The 4 mg dose is $199 a month, and both the 9 mg and 25 mg doses are $299 a month ^[1][3]. The Ozempic pill also starts at $149 a month, with Novo Nordisk noting that self-pay pricing varies by dose ^[1]. In each case, one month is defined as a single bottle of 30 tablets ^[1].

The injectable pens work differently. Patients new to the savings offer and to NovoCare Pharmacy pay $199 a month for the 0.25 mg and 0.5 mg doses of either Wegovy or Ozempic — but that is an introductory price good for two monthly fills, available through December 31, 2026 ^[1][3]. After that, Wegovy pens at 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg are $349 a month, and Wegovy HD (semaglutide) injection 7.2 mg is $399 a month ^[1][3]. Ozempic pens at 0.25 mg, 0.5 mg and 1 mg are $349 a month, and Ozempic 2 mg is $499 a month ^[1]. A month is one box of four Wegovy pens or one box containing a single Ozempic pen ^[1].

Against those cash prices, TrumpRx lists the Wegovy pill and pen at $149 and $199 a month versus an original price of $1,349, and Ozempic at $199 versus $1,028 ^[2]. The site also lists Zepbound (tirzepatide) at $299 a month versus $1,087, and claims more than $700 million saved for Americans overall ^[2]. The exact cents on those list prices are not spelled out in the sources; TrumpRx shows rounded figures ^[2].

For people with commercial insurance, Novo Nordisk advertises a separate route: pay as little as $25 a month for up to three months on Wegovy or Ozempic, subject to a maximum savings of $100 a month ^[1][3]. Government beneficiaries — such as people on Medicare or Medicaid — are excluded from the Wegovy copay offer, and the insurance-based savings are only available for local pharmacy pickup ^[3].

Why it matters for patients

The headline numbers are not a single price. The gap between $149 and $499 comes down to three things: pill versus pen, which dose a prescriber lands on, and whether a patient is new to the program. Someone who titrates up over time may start at one price and end at another. On the pen side, the $199 figure expires after two fills, so the durable cash price for most pen doses is $349, rising to $399 for Wegovy HD and $499 for Ozempic 2 mg ^[1][3].

The pill tiers move in the opposite direction from what some might expect: the higher oral doses cost more, with 9 mg and 25 mg both at $299 a month ^[3]. That means the cheapest advertised entry point, $149, is tied to the 1.5 mg Wegovy tablet ^[3].

It is also worth noting that these are self-pay prices tied to a manufacturer program with eligibility rules and restrictions, and Novo Nordisk states it reserves the right to modify or cancel the program at any time ^[1][3]. Whether the prices hold beyond the stated dates is not known from the sources.

What happens next

December 31, 2026 is the key date: the $199 introductory pen price for new patients covers two monthly fills through that day, after which the standard $349 and $399 or $499 tiers apply ^[1][3]. The sources do not say whether the pill pricing or the $25 commercial copay offer has an end date ^[1][3].