What is the cost of Wegovy (semaglutide)?

Cost of Wegovy (Semaglutide 2.4 mg)

The median monthly cost of Wegovy is approximately $1,619 (AWP) or $1,296 (NADAC) for a 30-day supply at the maintenance dose of 2.4 mg once weekly. 1

Detailed Pricing Information

National Average Costs

• Average Wholesale Price (AWP): $1,619 per month for semaglutide 2.4 mg once weekly 1
• National Average Drug Acquisition Cost (NADAC): $1,296 per month for semaglutide 2.4 mg once weekly 1
• These prices represent national-level costs as of July 2024 and do not account for medication coverage, discounts, or rebates that may affect actual patient out-of-pocket costs 1

Cost Context and Comparisons

• Wegovy costs approximately $1,500 per month in real-world settings, making affordability a significant barrier to access 1
• This places Wegovy among the most expensive weight management medications, comparable to other GLP-1 receptor agonists like liraglutide (Saxenda) at $1,619 AWP/$1,296 NADAC 1
• For comparison, tirzepatide (a dual GIP/GLP-1 agonist) costs $1,272 AWP/$1,017 NADAC per month 1

Insurance Coverage Challenges

Coverage Limitations

• Only 20% of insured adults have coverage for anti-obesity medications like semaglutide 1
• Medicare does not cover Wegovy for weight management 1
• Medicaid coverage is limited to only a few states 1

Populations Most Affected by Cost Barriers

• 11.9% of semaglutide-eligible adults are uninsured 1
• 33.6% have low income 1
• 38.9% lack higher education 1
• 29.3% of Hispanic adults and 14.7% of Black adults who are eligible are uninsured, highlighting significant disparities in access 1

Clinical Implications of Cost

Treatment Duration and Long-Term Costs

• Wegovy requires indefinite continuation to maintain benefits, as patients regain approximately 11.6% of lost weight after stopping treatment 2
• With a recommended treatment duration of at least 1 year 2, annual costs range from approximately $15,552 (NADAC) to $19,428 (AWP)
• Long-term use over 24 months has been demonstrated in real-world settings 3, translating to total costs exceeding $30,000-$38,000

Impact on Medication Adherence

• Medication costs are a major source of stress for patients and contribute to worse adherence 1
• Cost-reducing strategies may improve adherence in some cases 1
• Insurance coverage requirements often influence treatment decisions, and payors should cover evidence-based obesity treatments to reduce barriers to access 1

Cost-Effectiveness Considerations

Value Assessment

• Cost-effectiveness analyses show oral semaglutide (14 mg daily) versus background therapy at $122,000 per QALY gained (adjusted to 2022 dollars) 1
• Oral semaglutide versus injectable liraglutide demonstrated better value at $42,000 per QALY gained with 98% probability of being cost-effective at $156,000 threshold 1

Clinical Efficacy Justifying Cost

• Wegovy produces 14.9% mean weight loss at 68 weeks versus 2.4% with placebo 1, 4
• 86.4% of patients achieve ≥5% weight loss, 69.1% achieve ≥10%, and 50.5% achieve ≥15% weight loss 4
• Cardiovascular benefits include reduction in major cardiovascular events from 8% to 6.5% (NNT=25) 2
• Real-world data shows sustained weight loss of -20.4% at 24 months when combined with patient support programs 3

Practical Recommendations for Addressing Cost

System-Level Interventions

• Health care teams should be knowledgeable about insurance coverage requirements and establish systems to support clinicians in prescribing evidence-based weight management medications 1
• Advocacy for expanded insurance coverage is essential, particularly for populations with obesity-related comorbidities like type 2 diabetes and cardiovascular disease 1

Patient-Level Strategies

• Explore manufacturer patient assistance programs and discount cards that may reduce out-of-pocket costs
• Consider alternative GLP-1 receptor agonists if cost is prohibitive, though efficacy for weight loss may differ (e.g., semaglutide 1.0 mg produces approximately 7% weight loss versus 14.9% with 2.4 mg) 2
• Evaluate whether the patient has cardiovascular disease or type 2 diabetes, as insurance coverage may be more readily available for these indications 1