The advertised price of a GLP-1 programme in the United States is usually the price of the lowest strength, the first fill or the longest prepaid term. The price a person meets once they reach the strength their label calls a maintenance dosage is usually higher. DoseTruth measures that difference as a ratio. On the four manufacturer and government rows we re-read on 21 September 2026 the ratio ran from 1.0 to 2.01, and across the 14 rows of our table that allow a like-for-like comparison the median was 1.71. This article explains how that number is produced, what we accept as an official source, why some rows stay flagged, and where the method is weak. It also records a conflict we found today between one of our own earlier articles and the manufacturer page it describes.
DoseTruth is a price-comparison publisher: it is not a pharmacy, not a telehealth provider, and it does not prescribe or dispense any medication. This article is general information about published prices and published research, it is not medical advice, and decisions about any medicine or any dose belong with a licensed clinician. Every price below was checked on 21 September 2026 against the source named beside it unless a different date is stated. Prices in this market change often, so confirm the live figure on the day you pay.
What is the gap between an advertised price and a maintenance-dose price?
The gap is the monthly cash price at the label's maintenance strength, after any introductory offer has ended, divided by the monthly price shown in the programme's headline. A ratio of 1.0 means the headline and the steady bill are the same. A ratio of 2.0 means the steady bill is double the headline. We use a ratio and not a dollar difference because programmes sit at very different price levels, and a ratio lets a $50 government copay and a $449 branded pen share one scale.
Novo Nordisk's NovoCare Pharmacy page shows how the two prices sit side by side. The page headlines the Wegovy pen as "Starting at $199 per month". The detail beneath says that patients new to the offer pay $199 for each month of the 0.25 mg and 0.5 mg strengths, for two monthly fills through 31 December 2026, then $349 a month for the standard strengths and $399 a month for the 7.2 mg Wegovy HD pen. The same page headlines the Wegovy pill at $149 a month and then states $149 for 1.5 mg, $199 for 4 mg and $299 for 9 mg and 25 mg. Both ladders are printed in plain words on the seller's own page. The gap measures the distance between a headline and a steady bill, and it is not by itself evidence that anyone was misled.
| Programme | Headline price and what it covers | Price at the label's maintenance strength | Ratio | Source, checked 21 September 2026 |
|---|---|---|---|---|
| Wegovy pen, NovoCare self-pay | $199 a month, two fills, 0.25 mg and 0.5 mg, new patients, through 31 December 2026 | $349 a month, 1.7 mg or 2.4 mg | 1.75 | NovoCare Pharmacy page |
| Wegovy pill, NovoCare self-pay | $149 a month, 1.5 mg only | $299 a month, 25 mg | 2.01 | NovoCare Pharmacy page |
| Zepbound KwikPen, Lilly self-pay | $299 a month, 2.5 mg only | $449 a month, 10 mg or 15 mg, refill within 45 days | 1.50 | Lilly Zepbound savings page |
| Medicare GLP-1 Bridge | $50 copay, eligible Part D beneficiaries, 1 July 2026 to 31 December 2027 | $50 copay | 1.00 | CMS bridge page |
Rows with a ratio of 1.0 stay in the table on purpose. An audit that only listed large gaps would be a complaint file and not a measurement. The Medicare row also shows the limit of the ratio, because a flat $50 copay tells you nothing about who qualifies, and eligibility is decided by CMS and a Part D plan, not by a price table.
What counts as a maintenance dose, and who decides it?
The maintenance dose is whatever the FDA-approved label says it is, and we take the term from the label and never from a seller's marketing or from our own judgement. The Wegovy label on DailyMed, revised 18 June 2026, states that the maintenance dosage for weight reduction in adults is either 1.7 mg or 2.4 mg once weekly, with 2.4 mg marked as recommended, and that the dosage may be increased to a maximum of 7.2 mg. For the tablets the same label gives a recommended maintenance dosage of 25 mg once daily. The Zepbound label, revised 28 August 2026, gives a recommended maintenance dosage of 5 mg, 10 mg or 15 mg once weekly and tells prescribers to consider treatment response and tolerability when selecting it.
We quote those lines for one reason, which is to show which rung of a price ladder the word maintenance points to. Which strength any person takes is a decision for their prescriber, and nothing in this article is a suggestion about dose. All of the routes in our table require a valid prescription, and this article does not suggest obtaining any prescription medicine without a prescription.
Because a label can list more than one maintenance strength, the ratio is a choice and not a fact of nature. For the Wegovy pen the choice barely matters, since every standard strength costs $349. For Zepbound it matters a good deal, as the table below shows. The maintenance price is a range set by the label and the programme terms, and any single ratio is one point inside that range. Our public table uses 1.50 for Zepbound, which is the middle of the range and assumes the refill window is never missed.
| Product and scenario | Headline | Monthly price in that scenario | Ratio |
|---|---|---|---|
| Zepbound KwikPen, 5 mg | $299 | $399 | 1.33 |
| Zepbound KwikPen, 10 mg or 15 mg, refill inside 45 days | $299 | $449 | 1.50 |
| Zepbound KwikPen, 7.5 mg, refill window missed | $299 | $499 | 1.67 |
| Zepbound KwikPen, 10 mg to 15 mg, refill window missed | $299 | $699 | 2.34 |
| Wegovy pen, 1.7 mg or 2.4 mg | $199 | $349 | 1.75 |
| Wegovy HD pen, 7.2 mg | $199 | $399 | 2.01 |
How is the audit run?
Each run saves the page first and reads the price second, so that a published figure can be traced to a stored copy of the page it came from. Seller pages change without notice and a saved copy does not. The steps below are the whole procedure, and none of them involves a vendor sending us a number.
- A script requests each programme's pricing page and stores the raw HTML with the date and a SHA-256 hash of the file.
- The script lists every dollar amount on the saved page with the words around it. It does not choose between them. When the tool was built, the NovoCare page carried nine distinct dollar amounts and the WeightWatchers page carried fifteen, which is why the choice is not left to a pattern match.
- A person reads the saved page and records the headline price, what the headline covers, the price at the label's maintenance strength, and every condition attached.
- An automatic extraction rule is allowed only where a page prints a sentence with a fixed structure. One rule exists today, for the NovoCare pill sentence quoted above. If that sentence stops matching, the tool reports that a person needs to read the page. It does not guess.
- One observation per source per day is appended to a history file. Earlier lines are never edited.
- The ratio is computed only when both prices describe the same thing. Where they do not, the ratio field stays empty.
The record is young, and we say so. The evidence archive begins on 1 September 2026, with runs dated 1, 4 and 6 September, and article-level checks between 6 and 21 September. On the 6 September run the script held 22 source records. It saved 18 pages, was refused with an HTTP 403 response by 2, was rate-limited by 1, and got no response from 1. The history file holds 25 observations, and 22 of them are manual entries from the 16 August 2026 baseline. Three weeks of archived pages can prove what a price was on a date, and they cannot yet show a trend.
The method has already failed once in a way worth recording. On 6 September the pill rule was briefly attached to the pen row as well, because both rows point at the same NovoCare address, and the pen record was overwritten with pill prices in our working data until the rule was restricted to the pill. The same archive also caught a real change, when the 4 mg pill rung moved while the $149 headline held, which we wrote up in the oral Wegovy 4 mg price rise from $149 to $199.
What counts as official and what counts as secondary?
A row is official when we read the price on the seller's own page or on a government page on a stated date, and secondary when the figure reaches us through anyone else. That definition is narrower than it sounds. For evidence about health effects this site ranks government documents first, peer-reviewed research second, reputable press third and company pages last, and a company page never carries an efficacy claim here. Price is the one question where the order flips, because we know of no regulator database that lists the cash prices of these programmes, and the seller's page is the primary record of what the seller charges.
Primary does not mean permanent. The Lilly savings page we read today states that card eligibility and terms "may be terminated, rescinded, revoked, or amended by Lilly at any time without notice". Official on this site means primary for that price on that date, and it means nothing more than that.
| Label | What it means | Rows out of 21 | What would change it |
|---|---|---|---|
| Official | Price read on the seller's own page or a government page, with a date | 10 | The page changes, blocks us, or contradicts an earlier reading |
| Secondary | Price taken from a review site, a commercial guide or the press because the seller's page could not be read or prints no price | 10 | A successful reading of the seller's page |
| Conflicting | Sources disagree and we cannot settle it from a primary page | 1 | A primary reading that resolves the disagreement |
| Incomplete field | A maintenance price or a ratio that we leave empty | 7 rows have no ratio, and 1 of those has no maintenance price | A like-for-like price from a source that meets the standard |
The ten secondary rows are mostly compounded programmes and telehealth memberships whose pages refuse automated access or show prices only inside a sign-up flow. Secondary figures carry the errors of whoever wrote them down. In our membership audit, what $25 for the first month actually costs over a year, two well-known review sites disagreed with each other and with a company page about the same fee. None of the secondary rows was re-read for this article, so their figures stand as of 16 August 2026 and are not repeated here.
Why do some rows stay marked incomplete?
A row stays incomplete when we cannot fill a field from a source that meets the standard, and we leave the hole visible instead of estimating. There are six recurring reasons.
- The page refuses the checker. Lilly's Foundayo pricing page returned HTTP 403 on 1 September, on 6 September and again today. Lilly's press release of 1 April 2026 confirms only that self-pay begins at $149 a month for the lowest dose. The row's official label rests on an earlier manual reading that we could not repeat, so its higher rungs are not restated in this article.
- The two prices describe different things. A $25 or $39 first month buys a membership, and the medicine is billed separately, so dividing one by the other would be meaningless.
- There is no advertised dollar figure. A discount card advertises a percentage, which is the case we examine in why GoodRx costs more than buying Wegovy direct.
- The billing unit differs from the advertised unit, as in Noom bills by the quarter, not the month.
- The price depends on a condition the buyer controls only partly, such as the refill window in the LillyDirect 45-day rule in real numbers.
- The offer carries an end date, so the maintenance price itself is provisional, which we track in GLP-1 price routes and the 31 December 2026 reset.
The fifth item needs a correction notice, and it is about our own work. Our article of 17 September gives the price after a missed refill window as $599 to $1,049 depending on strength, figures taken from Lilly's 2025 announcements about single-dose vials. Lilly's release of 25 February 2025 does give standard vial prices of $599 for 7.5 mg and $699 for 10 mg. We did not reopen the June 2025 release behind the two higher figures today. The Zepbound savings page we read on 21 September 2026 states regular KwikPen prices of $499 for 7.5 mg and $699 for 10 mg, 12.5 mg and 15 mg, and the figures $599, $849 and $1,049 do not appear anywhere on it.
Under our own rule a dated reading of the live page outranks an older press release. The earlier figures should therefore be read as historical vial prices, and the missed-window prices in that article and on our home page are in conflict with the current page until they are re-checked. A conflict in our own work is published the same way as a conflict in anyone else's.
How solid is the median gap figure?
It is a descriptive statistic from a small, hand-picked sample, and it is better read as an order of magnitude than as an estimate for the market. The home page states a median of 1.75 across 11 rows, which was computed on the 16 August 2026 snapshot. Recomputed today across the 14 rows that now carry a like-for-like ratio, the median is 1.71 and the range is 1.0 to 2.52. The seven official rows have a median of 1.75. The seven secondary or conflicting rows have a median of 1.67, and their inputs were last checked on 16 August 2026.
Four weaknesses sit under those numbers. The 21 programmes were chosen by us and are not a random sample. No row is weighted by how many people use it. Three of the seven official rows are the same $149 to $299 pill ladder seen through different sellers, so they are not independent observations, and dropping the one that merely resells the manufacturers' pills moves the official median from 1.75 to 1.71. And one of those pill rows is the Foundayo row that we could not re-read today.
The larger caveat comes from research on how these medicines are used. A retrospective cohort study in the journal Obesity, published on 10 June 2025, followed 7,881 adults without type 2 diabetes who began injectable semaglutide or tirzepatide at Cleveland Clinic sites in Ohio and Florida between 2021 and 2023. It classed 80.8 per cent of them as having low maintenance dosages, meaning anything other than semaglutide 1.7 mg, 2.0 mg or 2.4 mg, or tirzepatide 10 mg, 12.5 mg or 15 mg. It also found that 20.4 per cent stopped within three months and a further 32.0 per cent stopped between three and twelve months. The authors note that a single health system in two states limits how far the result generalises.
A second retrospective cohort, published in JAMA Network Open on 31 January 2025, covered 125,474 adults across 30 United States health systems from 2018 to 2023. Within one year, 64.8 per cent of those without type 2 diabetes had stopped, with a 95 per cent confidence interval of 64.4 to 65.2, against 46.5 per cent of those with type 2 diabetes, with an interval of 46.2 to 46.9. Both studies are observational, and both predate the cash prices in our table. Neither measured what anyone paid.
Read together, they say that many people never reach, or do not stay at, the strength our ratio is built on. Where price rises with strength, as it does for Zepbound and for both pills, the maintenance-dose price overstates what many people pay in a given month. Where price is flat, as it is for the standard Wegovy pen at $349, it does not. Our ratio describes the price list, and it does not describe the average bill.
Does any rule require an advert to show the maintenance price?
We have not found a federal rule that does, and that sentence describes the reach of our search, not a legal opinion. The Federal Trade Commission's Rule on Unfair or Deceptive Fees, 16 CFR Part 464, took effect on 12 May 2025 and requires total-price disclosure, but the Commission's own release limits it to live-event tickets and short-term lodging. In 2019 the Department of Health and Human Services finalised a rule, published on 10 May 2019 at 84 Fed. Reg. 20,732, that would have required list prices in television advertisements for prescription drugs. According to a case summary by the Food and Drug Law Institute, which is a professional body and not the court record, the Court of Appeals for the D.C. Circuit affirmed in June 2020 that the department lacked statutory authority for it, in Merck v. Department of Health and Human Services, 962 F.3d 531. That rule concerned list price in any case, and list price is not the cash ladder this site tracks.
The Commission does act case by case. On 14 July 2025 it announced action against Southern Health Solutions, which traded as NextMed. It alleged that the firm advertised membership prices, typically $138 or $188 a month, without adequately disclosing that the price did not include the GLP-1 drug, the lab work or the consultation. The announcement put the payment at $150,000. Those were allegations resolved by settlement, and no programme in our table was a party. Until a rule says otherwise, comparing the headline with the maintenance rung is work the reader has to do, and this audit exists to do it in the open.
How strong is each claim in this article?
The price readings are strong and dated, the summary statistic is modest, and two claims are weak enough that we would not want them quoted without their caveats. A seller's page is graded strong only for the narrow question of what that seller charged on the stated date.
| Claim | Evidence type | Strength |
|---|---|---|
| Wegovy pen, pill and Zepbound KwikPen prices in Tables 1 and 2 | Manufacturer pages read on 21 September 2026 | Strong for that date, and the seller can change them without notice |
| Medicare bridge copay is $50 from 1 July 2026 to 31 December 2027 | CMS page | Strong |
| Maintenance strengths for Wegovy and Zepbound | FDA-approved labels on DailyMed, revised June and August 2026 | Strong |
| Ratios of 1.0 to 2.34 in Tables 1 and 2 | Arithmetic on the prices above, with our choice of maintenance rung | Strong as arithmetic, moderate as a description, because the rung is a choice |
| Median gap of 1.71 across 14 rows | Our own dataset, half of it from secondary sources last checked 16 August 2026 | Weak to moderate |
| Home page figure of 1.75 across 11 rows | Our 16 August 2026 snapshot, now superseded by the 14-row figure | Weak, and due for an update |
| Foundayo maintenance price | Earlier manual reading, page refused the checker three times | Not re-verified, not restated here |
| Missed-window Zepbound prices of $599 to $1,049 in our earlier article | 2025 vial press releases, contradicted by the current KwikPen page | Conflicting, treat as historical |
| Most people in practice are on lower strengths or stop within a year | Two peer-reviewed retrospective cohorts, observational, predate current prices | Moderate, and indirect for self-pay buyers |
| No federal rule requires a maintenance-price disclosure | FTC release, a secondary case summary, and the absence of a finding | Weak, a negative claim |
| The audit procedure and its fetch counts | Our own scripts and logs, not independently audited | Moderate, self-reported |
What else do readers ask about the method?
Is the maintenance-dose price the price I will pay?
Not necessarily. It is the published cash price at the strength the label calls maintenance, with introductory offers ended. Insurance, a lower prescribed strength, a missed refill window or a change in the offer can each move the bill. Treat it as a reference point on a price list and not as a quote.
Why is there no ratio for some well-known programmes?
Because the advertised figure and the real cost describe different things. A first-month membership fee cannot be divided into a medicine price, and a percentage-off claim has no dollar headline at all. Seven of the 21 rows have an empty ratio for reasons of that kind.
Why do you treat a company's own page as official?
Only for the price that company charges, and only for the date we read it. For any statement about what a medicine does, a company page sits at the bottom of our source order and is not used.
How often are the prices re-checked?
The home page commits to a weekly re-check. The archived record so far covers 1, 4 and 6 September 2026, and the rows behind our articles were re-read between 6 and 21 September 2026. Rows not re-read carry their older date on the table.
What happens when DoseTruth gets a number wrong?
The correction is published with the date and the source that overturned the figure, as with the Zepbound missed-window prices above. Readers can report a figure through the contact page. A flagged row is more useful to a reader than a tidy number we cannot prove.
Does any programme in the table pay DoseTruth?
No. As of 21 September 2026 no vendor pays for placement and the site carries no referral links, as stated on the DoseTruth home page. If that changes, the home page says the relationship will be labelled on the line where it applies.
Which sources were opened for this article?
- National Library of Medicine, DailyMed, Wegovy (semaglutide) injection and tablets label, revised 18 June 2026, government-hosted FDA label. dailymed.nlm.nih.gov
- National Library of Medicine, DailyMed, Zepbound (tirzepatide) label, revised 28 August 2026, government-hosted FDA label. dailymed.nlm.nih.gov
- Centers for Medicare and Medicaid Services, Medicare GLP-1 Bridge page, government source, checked 21 September 2026. cms.gov
- Federal Trade Commission, FTC Rule on Unfair or Deceptive Fees to take effect on 12 May 2025, press release, government source. ftc.gov
- Federal Trade Commission, FTC takes action against telemedicine firm NextMed, press release, 14 July 2025, government source. ftc.gov
- Gasoyan and colleagues, Changes in weight and glycemic control following obesity treatment with semaglutide or tirzepatide by discontinuation status, Obesity, 2025, volume 33, issue 9, pages 1657 to 1667, peer-reviewed retrospective cohort of 7,881 adults. pmc.ncbi.nlm.nih.gov
- Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity, JAMA Network Open, 31 January 2025, peer-reviewed retrospective cohort of 125,474 adults. jamanetwork.com
- Food and Drug Law Institute, case summary of Merck v. United States Department of Health and Human Services, October 2020, professional body and not the court record. fdli.org
- NovoCare Pharmacy, Wegovy pen and pill self-pay prices, manufacturer page, primary only for its own prices, checked 21 September 2026. novocare.com
- Eli Lilly, Zepbound coverage and savings page, KwikPen self-pay prices, 45-day refill condition and regular prices, manufacturer page, primary only for its own prices, checked 21 September 2026. zepbound.lilly.com
- Eli Lilly, Lilly launches additional Zepbound vial doses and offers new savings for self-pay patients, press release via PR Newswire, 25 February 2025. prnewswire.com
- Eli Lilly, FDA approves Lilly's Foundayo (orforglipron), press release via PR Newswire, 1 April 2026, used only for the $149 lowest-dose figure. prnewswire.com