Two years ago, paying cash for a GLP-1 meant four figures a month or rolling the dice on a compounded copy. That changed fast. Eli Lilly and Novo Nordisk now sell Zepbound, Wegovy, and Ozempic directly to self-pay patients at a fraction of list price, and a federal pricing site (TrumpRx) launched in early 2026 to point cash payers at those deals.
The catch is that the discounts live inside specific programs with specific rules: certain pharmacies, refill windows, intro offers that expire. This guide walks through every published self-pay price as of August 2026, verified directly on Lilly’s, Novo Nordisk’s, and TrumpRx’s own pages, plus what happened to compounding and how to pay the least.
What Do GLP-1s Cost Without Insurance?
Here is the current landscape at a glance. “Low” is the cheapest published program price, “Average” is what most self-pay patients pay month to month on a maintenance dose, and “High” is the price without any program (the list price).
| Medication | Low | Average | High (list price) |
|---|---|---|---|
| Zepbound (tirzepatide) | $299/mo (2.5 mg, self-pay program) | $449/mo (7.5-15 mg) | ~$1,087/mo |
| Wegovy pens (semaglutide) | $199/mo (first 2 months, new patients) | $349/mo | ~$1,349/mo |
| Wegovy pills (oral semaglutide) | $149/mo (promotional doses) | $299/mo | ~$1,349/mo |
| Ozempic (semaglutide) | $199/mo (first 2 months, new patients) | $349/mo | ~$1,028/mo |
List prices come from the original prices shown on trumprx.gov; program prices come from Lilly’s and Novo Nordisk’s published self-pay pages. All prices are per month (a 28-day supply) and assume no insurance.
Zepbound self-pay prices through LillyDirect
Lilly sells Zepbound directly to cash-pay patients through LillyDirect Pharmacy, in both single-dose vials and the newer single-patient-use KwikPen. According to Lilly’s published pricing, the self-pay savings program prices are:
| Zepbound dose | Program self-pay price | Regular self-pay price |
|---|---|---|
| 2.5 mg | $299/mo | $299/mo |
| 5 mg | $399/mo | $399/mo |
| 7.5 mg | $449/mo | $499/mo |
| 10 mg | $449/mo | $699/mo |
| 12.5 mg | $449/mo | $699/mo |
| 15 mg | $449/mo | $699/mo |
The fine print matters on the higher doses. Lilly’s pricing page states the $449 price on 7.5 mg and above holds only if you refill within 45 days of your previous fill’s delivery date. Miss that window and you pay the regular self-pay price for that refill, which is $699 per month on the three highest doses. If you are on a maintenance dose, set a refill reminder; the gap costs $250 a month.
Wegovy and Ozempic self-pay prices through NovoCare
Novo Nordisk’s equivalent channel is NovoCare Pharmacy, which ships to your home or lets you pick up at more than 9,000 CVS locations. In November 2025 Novo cut its standard self-pay price from $499 to $349 per month and added a $199 introductory offer, according to the company’s press release.
Current published prices on NovoCare’s Wegovy page and the official Ozempic savings page:
- Wegovy pens: $349 per month for every standard dose (0.25 mg through 2.4 mg). The high-dose 7.2 mg pen is $399. New self-pay patients pay $199 per month for their first two fills, an offer currently available through December 31, 2026.
- Wegovy pills: $299 per month at standard pricing, with promotional pricing of $149 per month on the 1.5 mg and 4 mg doses (the 4 mg offer runs through August 31, 2026).
- Ozempic pens: $199 per month for the first two months for new patients (0.25 mg or 0.5 mg), then $349 per month for the 0.25 mg, 0.5 mg, and 1 mg doses. The 2 mg dose stays at $499 per month.
- Ozempic pills: $149 per month for 1.5 mg, $199 for 4 mg, and $299 for 9 mg.
One month means one box of four pens or one 30-tablet bottle, and shipping is free.
TrumpRx: what it is and what it lists
TrumpRx (trumprx.gov) went live in early 2026 as part of the administration’s most-favored-nation drug pricing push. It is not a pharmacy. It is a listing site that shows negotiated cash prices and sends you to the manufacturer’s program or a partner pharmacy to actually fill the prescription.
As of August 2026 the site lists Wegovy pills at $149 per month, Wegovy pens at $199, Ozempic at $199, and Zepbound at $299, against original prices of $1,349, $1,028, and $1,087 respectively. Note that the headline numbers generally correspond to the lowest tier of each manufacturer’s own program (starting doses and intro offers), so what you pay long term will usually match the LillyDirect and NovoCare prices above. It costs nothing to check, and it is a legitimate front door to the same discounts.
Compounded semaglutide and tirzepatide: mostly gone
During the 2022-2024 shortages, compounding pharmacies could legally sell copies of semaglutide and tirzepatide, often for $100-$250 a month. That window has closed. The FDA declared the tirzepatide shortage resolved in December 2024 and the semaglutide shortage resolved in February 2025, and by mid-2025 mass-producing copies was no longer permissible for compounding pharmacies, as reported by Pharmacy Times. In April 2026 the FDA went further and proposed permanently barring outsourcing facilities from compounding these drugs from bulk ingredients.
The FDA’s current guidance is that compounded GLP-1s are only appropriate when a patient’s medical need cannot be met by the approved drug. The agency also warns about fraudulent products still sold online, flagging red flags like deep discounts that seem too good to be true, no prescription requirement, and mislabeled packaging. With real Zepbound now at $299-$449, the price gap that justified the risk has mostly disappeared.
What Drives the Price
Dose. This is the biggest variable on Zepbound: $299 at 2.5 mg versus $449 at maintenance doses, and up to $699 if you lose program pricing. Wegovy is flatter ($349 across standard doses), while Ozempic jumps to $499 at 2 mg.
Which program and channel you use. The same drug can cost $349 through NovoCare or $1,349 at a retail pharmacy counter without any program. Self-pay pricing only applies when you buy through the manufacturer’s channel or a participating pharmacy.
Intro offers and deadlines. The $199 Wegovy/Ozempic intro price applies only to your first two months as a new patient, and promotional pill pricing has published end dates. Lilly’s 45-day refill window decides whether you pay $449 or $699.
Pens versus vials versus pills. Lilly’s cheapest prices launched on single-dose vials (you draw up the dose with a syringe) before extending to KwikPens. Novo’s oral semaglutide tablets undercut the pens at lower doses.
Formulation and brand. Zepbound and Mounjaro contain the same drug (tirzepatide) at very different self-pay prices depending on indication and program, and the same is true of Wegovy versus Ozempic (semaglutide). What your prescriber writes determines which program you can use.
Cash Price vs. Insurance
If you have commercial insurance that covers your GLP-1, use it with a manufacturer savings card. Lilly’s card brings Zepbound down to as little as $25 per month for covered commercial patients (up to $1,300 in annual savings), and Novo’s cards bring Wegovy and Ozempic to as little as $25 per month (maximum $100 per month in savings). That beats every cash program.
The problem is that many plans simply exclude weight-loss drugs, and Medicare and Medicaid patients are barred from manufacturer savings cards entirely. If your plan denies coverage, the self-pay programs above are your real price, and they do not require being uninsured; anyone can use them by paying cash. Some patients with high-deductible plans even find the $349-$449 cash price cheaper than their pre-deductible insurance price. If you are weighing whether coverage is worth it for one expensive drug, our guide to self-pay vs. health insurance walks through that math.
How to Pay Less
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Buy through the manufacturer, not the counter. LillyDirect and NovoCare pricing ($299-$449) only applies in those channels. Walking a paper prescription into a random pharmacy without a program can cost you the full $1,000+ list price.
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Capture the intro offers. New Wegovy and Ozempic self-pay patients save $300 over their first two months at $199. If you are starting oral semaglutide, the $149 promotional doses are the cheapest branded GLP-1 entry point on the market.
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Never miss Lilly’s 45-day refill window. On maintenance Zepbound doses this single habit is worth $250 per month.
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Check TrumpRx before you fill. It aggregates the current negotiated cash prices in one place and links to the fulfillment channel, so you will not overpay against the published floor.
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Ask about patient assistance if money is tight. Novo Nordisk’s Patient Assistance Program provides free medicine to qualifying low-income, uninsured patients. A free or sliding-scale clinic can also handle the prescribing visit at low cost.
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Use discount cards for everything else. GoodRx-style cards rarely beat manufacturer programs on brand GLP-1s, but they routinely cut companion prescriptions (metformin, blood pressure meds) to a few dollars. See GoodRx vs. SingleCare for how the cards compare.
Bottom Line
Budget $449 per month for Zepbound at a maintenance dose, $349 for Wegovy or Ozempic, and less in your first months if you catch the intro offers. Those are real, published prices from Lilly and Novo Nordisk, no insurance required, and they have fallen twice since 2024, so it is worth rechecking before every refill cycle.
Remember to budget the prescribing visit too (these are prescription drugs, and telehealth or a cash-pay doctor visit typically adds $50-$150 to get started). And if you also pay cash for diabetes supplies, our guide to insulin costs without insurance covers the $35 cap programs that pair well with these.