Wegovy's prices are going down, but they are 'wildly different' - and confusing

MW Wegovy's prices are going down, but they are 'wildly different' - and confusing

By Jaimy Lee

Drug pricing in the U.S. has always been complex, and having more prices be public may make it hard for patients to understand

Prices are going down for Novo Nordisk's weight-loss drug Wegovy.

How much does Novo Nordisk's weight-loss drug Wegovy actually cost?

It depends on a patient's medical coverage, of course, but also on an increasingly tangled web of federal policies and corporate pricing strategies, along with the ability to do good old-fashioned research.

There are now a handful of publicly available prices for a month's supply of Wegovy, all of which are different and none of which take into account the prices negotiated by commercial health insurers.

There's the list price of $1,349 per package. For patients who pay for the medication directly, the cost is $199 for the first two months and $349 per month after that. On TrumpRx, the direct-pay site that's set to launch early next year as part of the Trump administration's most-favored-nation initiative, a month's supply will cost $350. And for people on Medicare, the copay for Wegovy could be $50. (The Centers for Medicare & Medicaid Services has said the MFN price supersedes the negotiated Medicare Part D price of $386 in 2027.)

"There is really no precedent for the wildly different public prices for a single medicine," Brian Reid, an expert in drug pricing, said in an email.

And there are a few more disrupting factors, like the coupon worth up to $225 from the manufacturer (NVO) - but not for those on Medicare or Medicaid - or the compounded versions of Wegovy that are still sold through telehealth platforms like Hims & Hers Health( )$(HIMS)$.

"It's not new that one drug (or one service) has multiple prices in the U.S. healthcare system, which has a very complex way of paying for drugs across a highly fragmented set of purchasers [and] payers," said Suhas Gondi, chief medical officer for health strategy and a physician at Massachusetts General Hospital. "But in drugs, it is getting even more complicated."

The U.S. has long had one of the messiest drug-pricing systems in the world, and it has been made even more complex by the advent of direct-pay options that allow consumers to pay out of pocket through a third-party site and by the Trump administration's negotiations. Even for policy wonks, it's a challenge to keep up with the cadence of discounts and negotiated prices while deciphering what is merely optics and what represents actual savings.

Most patients, meanwhile, don't know what any of this means.

"The unintended consequence is extreme confusion for patients," said Divya Iyer, senior vice president of go-to-market strategy for GoodRx Holdings $(GDRX)$, which is working with the administration on TrumpRx. "Like, what is it actually going to cost me?"

It's assumed that some people are willing to pay cash for lifestyle medications like Wegovy or Eli Lilly's $(LLY)$ weight-loss drug Zepbound, the dermatology cream retinol or immunology drugs. These therapies are prescribed to millions of Americans, are far cheaper than cancer drugs and are not always covered by insurance.

"They do fall into this kind of strange middle ground of being somewhat affordable but expensive for the average person, and also that they're not commonly covered by insurance," said Courtney Yarbrough, an assistant professor of health policy at Emory University's Rollins School of Public Health.

GLP-1 drugs like Wegovy are now far more affordable than they were a year ago, and some of the many different prices for Wegovy (and a few other drugs) are no longer kept secret as they were in the past.

At the same time, it's unclear whether the MFN initiative or direct-pay sites will save money for patients or for the system. Arnold Ventures, a foundation that studies drug prices, is considering funding research into direct-pay sites to see how many patients use them, who those patients are and what kind of insurance coverage they have. None of that information is available at this time.

But the broader concern is over whether price transparency will make drugs more affordable for the people who need them.

For a 45-year-old who pays out of pocket for Wegovy, the cost comes to $3,900 a year - even with the discounts. For a Medicare beneficiary, that cost will be $600 a year in copays. But some research has shown a link between obesity and income status.

"Who's being left behind by this pricing?" Yarbrough asked.

-Jaimy Lee

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December 04, 2025 12:01 ET (17:01 GMT)

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