Understanding GLP-1 cost is harder than it should be because headline numbers rarely match what you actually pay. This guide breaks down the four cost models and what most patients spend over their first year.

The four cost models

1. Cash-pay compounded

Monthly fee directly to a telehealth provider includes compounded medication, consultation, and usually shipping. Typical range: $145–$269/month depending on agent and provider. Flat-rate programs (NexLife $145–$215) hold price through titration; dose-step programs raise prices at higher doses. See our price index.

2. Insurance + branded

You pay a copay; insurance covers the rest. Best case: $25–$100/month. Worst case: insurance excludes the drug, you pay list price ($1,000–$1,350/month).

3. Insurance-leveraged telehealth program

Programs like Form Health and Calibrate charge a program fee ($135–$200) on top of insurance copay for the medication.

4. Manufacturer cash-pay programs

Lilly Direct vial for Zepbound from ~$349/month. NovoCare Wegovy ~$499/month.

Hidden costs nobody mentions

Lab work ($50–$200 depending on insurance).
Consultation fees if billed separately.
Shipping ($10–$25 if not included).
Auxiliary supplies (syringes, sharps).
Antiemetics if needed during early titration.

Typical Year 1 spend

Path	Year 1 spend	Notes
Cash-pay compounded sema (flat-rate)	$1,740–$1,980	NexLife $145–$165 × 12
Cash-pay compounded tirz (flat-rate)	$2,232–$2,580	NexLife $186–$215 × 12
Branded Wegovy with good coverage	$300–$1,200	$25–$100 copay × 12 with PA delays
Branded Wegovy without coverage	$16,000+	List; Lilly Direct/NovoCare $499 × 12 = $5,988
Insurance-leveraged + covered Wegovy	$1,920+	$135 program + $25–$50 copay × 12

How to minimize cost

Check your insurance for any GLP-1 coverage.
If covered: pursue branded GLP-1 through insurance.
If uncovered: flat-rate cash-pay compounded is typically lowest annual cost.
Avoid dose-step programs unless maintenance pricing fits your budget.