Here's the thing most "cost by state" guides get wrong: the GLP-1 drug itself costs about the same everywhere. A month of Wegovy or Zepbound has a similar list price in Texas and in New York. What actually changes from state to state is whether your Medicaid plan covers the drug and how much the local clinic charges to run your program. As of mid-2026, those two things drive most of the price gap.
What the drugs list for nationally
Before any discounts, brand-name GLP-1 medications carry these monthly list prices:
- Wegovy (semaglutide): $1,349.02 for a package of 4 pens, which is a month
- Ozempic (semaglutide): about $1,000 a month
- Zepbound (tirzepatide): $499 to $1,086.37 per fill, by product and dose
- Mounjaro (tirzepatide): $1,112.16 per fill, which Lilly counts as four pens
One note: Wegovy and Zepbound are the versions approved for weight loss. Ozempic and Mounjaro are the same drugs approved for type 2 diabetes, so a weight loss clinic will usually prescribe Wegovy or Zepbound. Almost nobody pays these full list prices. Wegovy and Ozempic are made by Novo Nordisk; Zepbound and Mounjaro are made by Eli Lilly. Both companies now sell directly to cash-pay patients for far less.
Self-pay prices that actually apply
If you pay out of pocket, the manufacturer's direct programs are usually the best deal:
- Wegovy through NovoCare: $349 per month for the pens, $399 for Wegovy HD, or from $149 for the pill
- Zepbound through LillyDirect: $299 to $699 for a 28-day supply, by dose, as a KwikPen or a 4-count vial. A $449 first-fill offer on the 7.5 mg and higher KwikPen holds only while each refill purchase is completed within 45 days of the previous delivery, through December 31, 2026
- Mounjaro through LillyDirect: self-pay starting at $499 a month, listed at every dose, terms apply
These prices are the same no matter which state you live in. That's why the "cheap state, expensive state" story is mostly about clinic fees, not the medicine. See our semaglutide guide and tirzepatide guide for details, or run the numbers with our savings calculator.
Where insurance changes the math
If you have commercial insurance that covers the drug, a manufacturer savings card can drop your cost to as little as $25 per month. Getting there often takes prior authorization, which means your doctor has to show you meet the plan's rules. Some employer plans cover these drugs, and some specifically exclude them to save money. (See our insurance coverage guide.)
This is where your state matters most. Medicaid is run state by state, and only some states cover GLP-1 drugs for weight loss. If you live in a state whose Medicaid covers Wegovy or Zepbound and you qualify, your out-of-pocket cost can be very low. In a state that excludes them, you're back to self-pay. Check what your program does in our Medicaid coverage guide.
New in 2026: the Medicare bridge
Since July 1, 2026, a CMS demonstration called the Medicare GLP-1 Bridge has covered Wegovy, the Zepbound KwikPen and Foundayo for obesity at $50 a month. It is for eligible Part D enrollees. It runs outside the normal Part D benefit and ends December 31, 2027. If you're on Medicare, this is a big shift. We break down who's eligible in our Medicare GLP-1 coverage guide.
What about compounded GLP-1s?
You may have read that compounded semaglutide or tirzepatide runs $150 to $500 per month. That was true during the 2023 to 2024 shortage, when pharmacies were allowed to make copies of the drugs. That shortage is over. The FDA ended its enforcement discretion in early 2025. On April 30, 2026, it also proposed keeping semaglutide, tirzepatide and liraglutide off a list of drugs that 503B outsourcing facilities (large pharmacies that compound in volume) may make from bulk ingredients. It said it found no clinical need for them to do so (FDA announcement). That was a proposal, not a final rule. It does not cover the local pharmacies that compound for individual patients, which work under separate FDA limits on copying approved drugs. If a clinic still offers a compounded GLP-1 at a low price, ask hard questions about where it comes from. Our compounded vs brand-name breakdown explains the risks.
How to pay less, wherever you live
Start with the manufacturer's direct program or savings card. Ask any clinic for its cash-pay price in writing, since many offer one they don't advertise. If in-person clinics near you are pricey, compare telehealth GLP-1 providers, who serve most states. And check your Medicaid and Medicare options before assuming you have to pay full price. Talk to your doctor about which drug and program fit your health and budget.
Find a clinic near you
Program fees are the one cost you can shop around on. Search clinics by state or browse our full directory to compare real prices where you live.