From the Guidelines
Semaglutide is the most expensive medication among metformin, semaglutide, human insulin, and glargine insulin, with a median cost of $875 for a 1 mg pen, as reported in the 2019 study 1. While prices vary by location, insurance coverage, and specific formulations, semaglutide generally costs significantly more than the other options. Metformin is usually the least expensive option, often costing just a few dollars per month as it's available as a generic medication and has been on the market for decades. Human insulin and glargine insulin fall somewhere in between, with glargine typically being more expensive than regular human insulin but still considerably less expensive than semaglutide, as shown in the 2025 study 1, which lists the median cost of glargine as $77 for a U-100 vial and $152 for a U-300 prefilled pen. The high cost of semaglutide relates to its newer development, patent protection, complex manufacturing process as a GLP-1 receptor agonist, and its significant clinical benefits for both diabetes management and weight loss, which have driven high demand for the medication. Some key points to consider when evaluating the cost of these medications include:
- The cost of metformin, with a median cost of $84 for a 500 mg immediate release tablet and $1,028 for a 1,000 mg extended release tablet, as reported in the 2019 study 1
- The cost of human insulin, with a median cost of $58 for a U-100 vial, as reported in the 2025 study 1
- The cost of glargine insulin, with a median cost of $77 for a U-100 vial and $152 for a U-300 prefilled pen, as reported in the 2025 study 1
- The cost of semaglutide, with a median cost of $875 for a 1 mg pen, as reported in the 2019 study 1. It's essential to consider these costs in the context of the patient's specific needs and insurance coverage to determine the most appropriate and cost-effective treatment option.
From the Research
Cost Comparison of Metformin, Semaglutide, Human Insulin, and Glargine Insulin
- The cost of semaglutide is higher compared to metformin, with a 52-week treatment cost of $2,660 2.
- In comparison to insulin glargine, semaglutide has been shown to have a higher cost, but with greater reductions in HbA1c and weight, and fewer hypoglycemic episodes 3.
- The cost-effectiveness of semaglutide versus dulaglutide for the treatment of type 2 diabetes in China has been evaluated, with results showing that once-weekly semaglutide 0.5 mg and 1.0 mg demonstrated an improvement in QALYs and a reduction in total direct medical costs compared to dulaglutide 1.5 mg 4.
- The cost of human insulin is not directly compared to semaglutide, metformin, or glargine insulin in the provided studies.
- However, it can be inferred that semaglutide is likely to be more expensive than human insulin, given its higher cost compared to metformin and insulin glargine.
Key Findings
- Semaglutide has a higher cost compared to metformin and insulin glargine, but offers greater reductions in HbA1c and weight, and fewer hypoglycemic episodes 2, 3.
- Once-weekly semaglutide 0.5 mg and 1.0 mg are cost-effective compared to dulaglutide 1.5 mg for the treatment of type 2 diabetes in China 4.
- The cost-effectiveness of semaglutide is influenced by factors such as medication efficacy on mortality and medication cost 5.