Why GLP-1 drugs cost more in the US than abroad

Brand-name medicines cost far more in the United States than in other wealthy countries, and GLP-1 drugs are a clear example. A federal study found US brand-drug prices were at least 3.22 times those in comparison countries even after estimated rebates [1], and when TrumpRx launched in 2026 the White House gave the earlier monthly price of injectable Wegovy as $1,349 and Zepbound as $1,088 [7] [9].

What the federal numbers say

The research office of the Department of Health and Human Services (ASPE) hired RAND to compare US drug prices with those in other countries in the OECD, a group of mostly high-income nations. For 2022, it found US prices across all drugs, brand and generic, were nearly 2.78 times as high, and brand drugs at least 3.22 times as high after adjusting for estimated US rebates [1]. The same work found most new drugs reach the US market before other countries [2]. The White House cites the same kind of figure: Americans pay more than three times what other OECD nations pay for brand-name drugs, even after the discounts makers give in the US [3].

These comparisons cover drugs in general. They are not a GLP-1 price list, and we have not found a federal agency page that compares Wegovy or Zepbound prices country by country. The closest official source is a Senate committee, covered at the end of this page.

List price is not what everyone pays

The list price is the maker’s price before any discounts. On TrumpRx.gov, the government’s discount site, the “original price” shown for a Wegovy pen is $1,349.02 [5] and for an Ozempic pen $1,027.51 [6]. Drugmakers give rebates and discounts off that price in the US, which is why both the federal study and the White House adjust for them [1] [3]. We have not found an official source that publishes the rebate on any GLP-1, so the net price for a given drug is hard to see from outside.

Why the gap exists, in officials’ words

Two explanations appear on official pages. The White House says the system let drugmakers offer low prices to other wealthy countries while charging Americans much more [4]. The second is about bargaining power at home: Medicare did not negotiate drug prices directly until recently. HHS says that under the Inflation Reduction Act, Medicare is now able to negotiate the prices of certain drugs [15], and it picked Ozempic, Rybelsus and Wegovy as one of the drugs in its second round [16], with negotiated prices taking effect in 2027 [17]. CMS publishes the agreed semaglutide price in a PDF fact sheet, which we do not download, so it is not repeated here.

What changed in 2025 and 2026

• May 2025: an executive order told the administration to bring US drug prices in line with those paid by similar nations, the “most-favored-nation” approach [11].
• November 2025: deals with Novo Nordisk and Eli Lilly. The White House said Ozempic and Wegovy would drop from $1,000 and $1,350 a month to $350 through TrumpRx, and Zepbound from $1,086 to an average of $346 [12]. It set Medicare prices for Ozempic, Wegovy, Mounjaro and Zepbound at $245 [13], with a $50 monthly copay for people on Medicare [14].
• February 2026: TrumpRx.gov launched, promising prices in line with the lowest paid by other developed nations [10]. The Wegovy pill was listed at as low as $149 a month [8], and Zepbound at as low as $299 [9].

The White House used slightly different starting prices in different releases ($1,086 and $1,088 for Zepbound) [12] [9]. We quote each as published.

What you can pay today

Prices now depend on where you buy. On TrumpRx today, new Wegovy injection patients pay $199 for the first two monthly fills at the two starting doses, then $349 a month [18]; later fills are $349 for most doses and $399 for the 7.2 mg Wegovy HD dose [19]. Every seller in our price comparison shows its current price with the source we checked, and TrumpRx prices and GLP-1 cost without insurance go deeper. If you have Medicare, see the Medicare GLP-1 Bridge.

Other figures you may see

Prices in other countries. An April 2024 press release from the chair of the Senate health committee, Senator Bernie Sanders, said Novo Nordisk charged Americans $969 a month for Ozempic against $155 in Canada and $59 in Germany, and $1,349 for Wegovy against $140 in Germany and $92 in the United Kingdom [20]. Those were the prices cited in 2024, before the price cuts above.

What the drugs cost to make. A 2024 study in JAMA Network Open estimated sustainable prices based on manufacturing costs of $0.75 to $72.49 a month for GLP-1 diabetes drugs, far below the prices it found in the 13 countries it surveyed [21]. That is a modeled estimate by researchers, not a figure from Novo Nordisk or Eli Lilly.

Patents. For Ozempic, the FDA’s Orange Book lists a patent on the drug substance, number 8129343, expiring on December 5, 2031 [22].