Why is Ozempic so expensive in the US? A pricing breakdown

Ozempic lists near $969 a month in the US and Wegovy near $1,349, per the Senate HELP Committee. The same molecule costs about $92 a month in the UK, per Fortune. A 2024 JAMA Network Open analysis put the cost to manufacture semaglutide at $0.89 to $4.73 a month. So the price is not the drug. It is everything layered on top.

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The US is the outlier

The US pays more than any other country, often by ten times. When Senator Bernie Sanders and the Senate HELP Committee opened their investigation into the price of Ozempic and Wegovy, they put Ozempic's US list near $969 and Wegovy's near $1,349. The same pen sells for roughly $155 in Canada and $59 in Germany. Fortune put the UK price near $92, where the NHS negotiates one price for the whole country. None of those numbers reflect production: the JAMA estimate of $0.89 to $4.73 is under 1 percent of the US list. Healthline reached the same read.

Where the money goes

Two things hold the price up. First, the patent. Novo Nordisk holds the semaglutide patents, and its core US protection runs to about 2032, so no generic can enter and undercut it until then. Second, the middlemen. The list price is not what Novo Nordisk keeps. Pharmacy benefit managers, wholesalers and pharmacies each take a cut through rebates, fees and spread, and the Senate HELP Committee found them collecting close to $700 of the list price on GLP-1 fills. Those rebates are negotiated in private, which is why the markup is hard to see.

Why Medicare could not negotiate

Medicare, the largest drug buyer in the country, was legally barred from bargaining over price for most of its history. The 2003 law that created Medicare's drug benefit included a non-interference clause, in force from 2006, that blocked the government from negotiating directly with manufacturers. Private insurers could. Medicare could not. The 2022 Inflation Reduction Act changed that for a short list of drugs, and Medicare selected semaglutide (Ozempic, Wegovy and Rybelsus) for negotiation in 2025, with the prices set to take effect in 2027.

How to pay less than list today

You can pay far less than $969 this month. The floor is compounded semaglutide, about $149 to $178 a month at the programs we track, including Strut Health and Mochi. See the cheapest GLP-1 programs for the current list. Brand routes cost more but ship straight from the manufacturer: oral Wegovy is $299 a month, and LillyDirect sells Zepbound for $299 to $449. Check manufacturer savings and coupons before you pay. On Medicare, the Medicare GLP-1 Bridge caps Wegovy, Foundayo (the oral GLP-1) and the Zepbound KwikPen at $50 a month from July 2026. To line every program up on price, use our comparison chart.

Compounded semaglutide is the cheapest legitimate route we track. See Strut's score and today's price on the Strut Health review page.