Wegovy vs Zepbound: 5-year cost at today's self-pay prices

At today’s published cash prices, five years of Wegovy injections at the usual 2.4 mg dose come to about $22,400 [7], and five years of Zepbound at 10 mg or 15 mg come to about $29,000 [15]. Zepbound held at 5 mg lands between the two [14]. Every year after the first assumes the prices posted in September 2026 stay the same, which nobody promises.

The prices behind the math

Both makers sell directly to people paying cash. A “month” is 28 days for both injections: one box of four Wegovy pens [9], or four Zepbound vials or one KwikPen [17]. So a year is 13 fills [9] [17].

Medicine and dose	Cash price per 28-day fill
Wegovy 0.25 mg and 0.5 mg, first two fills for new patients	$199 [7]
Wegovy 0.25 mg to 2.4 mg after that	$349 [7]
Wegovy HD 7.2 mg	$399 [7]
Zepbound 2.5 mg	$299 [13]
Zepbound 5 mg	$399 [14]
Zepbound 7.5 mg to 15 mg, refilled within 45 days	$449 [15]

Wegovy’s $199 price is for patients who have not used a Wegovy savings offer in the past 365 days [8], and only for fills through December 31, 2026 [7].

The dose paths used

The labels set the climb. Wegovy starts at 0.25 mg and steps up every 4 weeks [1] to a usual maintenance dose of 2.4 mg [2]. After at least 4 weeks on 2.4 mg, some people move up to 7.2 mg (Wegovy HD) [3]. Zepbound starts at 2.5 mg for 4 weeks [4], then 5 mg, rising in 2.5 mg steps no faster than every 4 weeks [5], to a maintenance dose of 5 mg, 10 mg or 15 mg [6]. The paths below follow the fastest schedule the labels allow. Your prescriber sets the real one.

Year 1 and five years

Path	Year 1	Each later year	Five years
Wegovy to 2.4 mg, new patient	$4,237 [7]	$4,537	$22,385
Wegovy to 7.2 mg (HD), new patient	$4,637 [3] [7]	$5,187	$25,385
Zepbound, staying at 5 mg	$5,087 [13] [14]	$5,187	$25,835
Zepbound to 10 mg or 15 mg	$5,637 [15]	$5,837	$28,985

How the rows add up:

• Wegovy to 2.4 mg: two fills at $199, then 11 at $349 in year 1; 13 at $349 in each later year [7].
• Wegovy HD: two fills at $199, three at $349 (1 mg, 1.7 mg and the 4 weeks at 2.4 mg), then eight at $399; 13 at $399 after that [7].
• Zepbound at 5 mg: one fill at $299, then 12 at $399; 13 at $399 after that [13] [14].
• Zepbound to 10 mg or 15 mg: one fill at $299, one at $399, then 11 at $449; 13 at $449 after that [13] [14]. Every dose from 7.5 mg up costs the same $449, so 10 mg and 15 mg cost the same [15].

Over five years the gap between Wegovy at 2.4 mg and Zepbound at 10 mg or 15 mg is $6,600 [7] [15]. From year 2 on, it is $100 a fill, or $1,300 a year [7] [15]. Zepbound held at 5 mg costs $3,450 more than Wegovy 2.4 mg over five years [7] [14].

What can move these numbers

• A late Zepbound refill. The $449 price holds only if you refill within 45 days [15]. Otherwise a fill costs $499 at 7.5 mg and $699 at 10 mg and above [16], so one late refill at 10 mg adds $250 [15] [16].
• Price changes. Novo Nordisk can change or cancel its program at any time [12], and Lilly says the same of its offer [18]. The later years above are today’s prices repeated, not a forecast.
• Extras. The KwikPen needs pen needles bought separately [19]; those and any shipping are not in the totals.
• Missing the Wegovy new-patient price. Without the two $199 fills, Wegovy’s first year at 2.4 mg is 13 fills at $349, or $4,537 [7].

The Wegovy pill

The Wegovy pill is priced per 30-tablet bottle: $149 at 1.5 mg, $199 at 4 mg and $299 at 9 mg or 25 mg [10]. Each step lasts 30 days on the label [11]. Twelve bottles (360 days) on the fastest path cost $3,338 in year 1 and $3,588 in each later year at 25 mg [10]. Because a bottle covers 30 days rather than 28 [10] [9], this is not a like-for-like row in the table above.

If insurance or Medicare pays

Insurance changes everything above. With coverage, the makers’ savings cards can cut a copay sharply; see Wegovy savings and Zepbound savings. On Medicare, the GLP-1 Bridge charges a $50 copay [21], but it only runs through December 31, 2027 [20], so it cannot anchor a five-year plan; see the Medicare GLP-1 Bridge.

For today’s month-by-month comparison, see Wegovy vs Zepbound cost. For what each medicine did in its trials, see weight loss results. Which one suits you, and at what dose, is your prescriber’s call.