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Plan copay. Manufacturer savings cards can bring an eligible commercial copay to as little as $25/month; Wegovy's, Zepbound's and Foundayo's cards each cap the benefit at $100/month of savings, and Lilly's cards as written end December 31, 2026. Government beneficiaries are excluded from these cards by statute. Terms read September 25, 2026.

Coverage for obesity — as opposed to type 2 diabetes — is an employer-by-employer decision, and plenty of plans exclude it outright. Prior authorisation is normal. Ask about the indication, not the drug: the same molecule is often covered for diabetes and denied for weight.

Zepbound, through LillyDirect's Self Pay Journey Program, vial or KwikPen (and the KwikPen at retail with the self-pay savings card): $299 (2.5 mg), $399 (5 mg), $449 (7.5–15 mg). Wegovy, through NovoCare Pharmacy: $349/month (0.25–2.4 mg pen), $399 (HD 7.2 mg), and $199 for the two lowest doses for two fills if you are new to the offer, through December 31, 2026. Prices read September 25, 2026.

Two things the headline price hides. First, Zepbound's $449 is conditional: you must complete each refill within 45 days of your last delivery. Miss that window and the regular price applies — $499 at 7.5 mg and $699 at 10 mg and above, vial or pen alike, which is $250 a month more at the higher doses. A gap in supply is exactly what a transition produces, so this is the trap to plan around. Second, a "month" is 28 days, which is 13 fills a year, not 12 — and the retail KwikPen self-pay card covers at most 11 fills a calendar year. Needles and syringes are extra, and nothing you pay counts toward a deductible or out-of-pocket maximum.

Wegovy pill, through NovoCare Pharmacy: $149/month at 1.5 mg, $199 at 4 mg (it was $149 until August 31, 2026) and $299 at 9 mg and 25 mg. Foundayo (orforglipron), self-pay through LillyDirect: $149 at 0.8 mg; $149 at 2.5 mg and $199 at 5.5 mg, both temporary cuts that end December 31, 2026 (regular $199 and $299); $299 at 9 mg; and $299 at 14.5 mg and 17.2 mg only if you refill within 45 days, $349 if you don't. Prices read September 25, 2026.

Both pills get more expensive as you titrate up, and Foundayo's top-dose price carries the same 45-day refill condition as Zepbound's. Foundayo was approved April 1, 2026. It is a small molecule rather than a peptide, taken any time of day with no food or water restriction — the oral semaglutide it competes with does have those restrictions. It is new, which cuts both ways: fewer long-term data, and no generic for years.

$50/month flat, total out-of-pocket. Launched July 1, 2026; runs through December 31, 2027. Price and dates re-read September 25, 2026.

It covers the Wegovy pen and pill, the Zepbound KwikPen and the Foundayo pill — not the single-dose Zepbound pens or vials. It sits outside the regular Part D payment flow, so the $50 does not count toward your deductible or your annual out-of-pocket cap, Extra Help cannot reduce it, and no coupon stacks on it. Prior authorisation is required, and the clinical criteria are assessed as of when you first started GLP-1 therapy — not today. KFF estimated roughly 3.8 million people qualify, about 8% of Part D. Beneficiaries have reported that the published eligibility copy and the prescriber criteria don't obviously agree on whether BMI 30 with prediabetes counts, so confirm rather than assume.

State formulary copay where it is covered at all.

Coverage for obesity is a state-by-state patchwork and is commonly gated behind BMI thresholds, documented lifestyle intervention and step therapy. Coverage for type 2 diabetes is far more widely available than coverage for weight. Your state is the only answer that matters here.

Varies. Cost is not what makes it lawful.

This is the option most misunderstood right now, so be precise about it. 503A pharmacies never depended on the 503B Bulks List, so FDA's 503B proposal does not directly touch them. What ended routine 503A compounding was the shortage resolution back in 2025, which switched off the "essentially a copy" exception. What remains are narrow, patient-specific exceptions — a documented allergy to an inactive ingredient in the approved product, or a strength that simply is not commercially made — determined and documented by a prescriber for you. FDA has been explicit that affordability and insurance access do not constitute clinical need. Adding B12 or an amino acid to claim a "significant difference" is a known pattern and FDA has not accepted it.

Generic liraglutide now exists — Meitheal launched the first in April 2025, Teva followed. Prices vary by manufacturer and pharmacy.

Liraglutide is daily rather than weekly and produces less weight loss than semaglutide or tirzepatide in trials. As of September 25, 2026 it is still carried on FDA's shortage list — generic presentations listed available, Victoza and Saxenda listed limited, and one Saxenda presentation posted as to be discontinued on August 25 — which is a live status that can change without notice. It is also the third drug in FDA's 503B proposal, which is the part most coverage leaves out.

Nothing, which is exactly why it deserves the same scrutiny as the others.

Stopping is a legitimate choice and this page will not talk you out of it. It does insist you make it with the trial data in front of you rather than discover it. In the STEP 1 extension, people who had lost 17.3% of body weight regained about two-thirds of it within a year of stopping, and most of the cardiometabolic improvements drifted back toward baseline with it. In SURMOUNT-4, the group switched to placebo regained roughly 14%. Neither trial says a person is doomed — the semaglutide group was still 5.6% below baseline a year out — but both say the same thing: the effect is a function of the drug being present. Plan the landing rather than falling.