GLP-1 Compounded Pricing Index 2026

This pricing investigation is part of Weight Loss Rankings' living editorial database — 100+ research articles and 360+ clinically-reviewed GLP-1 telehealth providers, with prices verified directly against each provider's live page on a monthly cadence.

Compounded GLP-1 medications have rewritten the cash-pay weight-loss market. A year ago, brand-name Wegovy at roughly $1,349/month was the only injectable semaglutide most uninsured Americans could access. Today, 273 of the 460 telehealth providers we track offer compounded semaglutide — and the median monthly price is $175, a 87% discount to brand.

That gap, repeated thousands of times across our dataset, is the single biggest force shaping the consumer GLP-1 market right now. This article puts hard numbers on it: the median, the cheapest and most expensive providers, the distribution shape, and how the savings compare against the brand-name baseline. The data updates every time we verify a provider — so the numbers below are always current as of the timestamp at the top of the page.

The headline numbers

Across our entire telehealth dataset, here's what people are actually paying per month for compounded semaglutide and tirzepatide— the same active ingredients in Wegovy and Zepbound respectively:

For semaglutide, the median monthly cost is $175. The cheapest 10% of providers charge $99 or less, while the priciest 10% start at $299. That spread — roughly 3× from cheapest to priciest — is much wider than most readers expect, and it's the main reason it's worth comparing providers directly instead of taking the first ad you see at face value.^[1]

At the median compounded price, a patient choosing semaglutide saves roughly $14,088 per year versus Wegovy at list price. For tirzepatide, the median compounded price produces an annual savings of about $10,044 versus Zepbound at list. These are real numbers that reset the calculation for anyone whose insurance excludes GLP-1s for obesity (which is most of the privately insured market).^[2]

Pricing magnitude — brand vs manufacturer self-pay vs compounded

The cleanest way to see what the cash-pay GLP-1 market looks like right now is to plot every major channel on a single magnitude axis: the brand retail list price, the manufacturer's own self-pay programs (NovoCare for Wegovy, LillyDirect for Zepbound), and the live median compounded monthly cost from our telehealth dataset.

Two structural observations from this chart. First, the manufacturer self-pay programs already cut the retail list price by 65–90% — Wegovy NovoCare standard pen at $299/month is a 78% discount to the $1,349 retail list, and the Wegovy oral pill tier at $149/month is an 89% discount. The brand retail list price is no longer the realistic ceiling for a cash-pay patient who is willing to enroll directly with the manufacturer. Second, the compounded channel still sits materially below every brand channel — the live median compounded semaglutide is $175/month vs $149–$299 for the cheapest Wegovy NovoCare tiers, and the cheapest 10% of compounded providers ($99/month) undercuts even the oral Wegovy pill tier.

How prices are distributed

Aggregate medians hide a lot. The histograms below show how the market actually breaks out by price band. Compounded semaglutide skews heavily toward the $100–$200 range, with a long tail of more expensive providers — usually programs that bundle clinical coaching, lab work, or in-network pharmacy guarantees on top of the injection itself.

Tirzepatide's distribution sits noticeably higher. There are two reasons: tirzepatide's active pharmaceutical ingredient is more expensive at the wholesale level, and the FDA only removed it from the official drug shortage list in late 2024, which constrained the number of 503A pharmacies legally allowed to compound it during most of 2024.^[3]

The cheapest providers right now

The most useful number for most readers isn't the median — it's the actual list of providers at the cheapest end. These update live from our verified dataset:

The lowest list prices are usually first-month introductory deals. Always read the fine print on whether the rate jumps after month one and whether the listed price includes shipping, the consult, and the medication itself, or whether some of those are billed separately. Our individual side-by-side comparisons normalize for these differences.

Why the spread is so wide

A 99–$299 range for what is, at the molecular level, the same drug raises an obvious question: what are buyers in the higher tier actually paying for? Five things, in our experience working through provider data:

1. Sourcing quality. The 503A pharmacies that supply compounded semaglutide vary in size, accreditation, and quality systems. Some publish their certificates of analysis on every batch; others won't share them at all. Providers that source from PCAB-accredited or NABP VPP facilities often charge more.^[4]
2. Bundled clinical care. The cheapest providers tend to be pure prescription delivery — a 5-minute async intake and the medication mailed out. The mid-tier programs include ongoing physician check-ins, dose titration support, and side- effect management. The most expensive include lab work, dietitian access, or in-app coaching.
3. Brand-name fulfillment guarantees. A handful of providers will switch you to brand-name Wegovy (at brand-name prices) if compounded supply is interrupted. This is rare and usually buried in the fine print.
4. State availability. Compounding rules differ state to state. Providers licensed in all 50 states have higher compliance overhead than ones operating in 20.
5. Marketing and CAC. Some of the spread is just customer acquisition cost. The best-funded brands pay $200+ for a new sign-up and recover it through higher monthly prices or longer minimum commitments.

None of these inherently make the more expensive provider a worse deal — but they do mean that comparing on price alone misses the story. Our individual ranked best-of lists score on six dimensions (value, effectiveness, UX, trust, accessibility, support) precisely because price is just one input.

How the gap to brand has evolved

We started tracking GLP-1 telehealth pricing in early 2024. At that point, brand-name Wegovy was effectively unavailable to most uninsured patients — supply constraints meant pharmacies routinely ran out, and the cash price hovered near $1,349 when it could be filled at all. The compounded market existed but was concentrated among a small number of telehealth players, and prices clustered around $250–$350/month.^[5]

Two things changed that. First, the FDA's formal drug shortage designation for semaglutide gave 503A pharmacies clear legal cover to compound it. That brought dozens of new entrants into the market and pushed prices down through ordinary competition. Second, the wholesale cost of semaglutide API itself fell sharply through 2024 and 2025 as more suppliers came online. The combination is why the median sits where it sits today rather than where it sat 18 months ago.^[6]

The current state of play: compounded prices have largely stopped falling, and the cheapest providers are approaching what looks like a floor around $30–$80/month. Brand-name Wegovy and Zepbound, meanwhile, have started offering their own cash-pay programs at roughly half their old retail price as the manufacturers chase share. The gap has narrowed, but it's still meaningful — and for the median patient on the median compounded plan, the savings are still measured in five figures per year.

Methodology

Every price in this index is taken from the public-facing website of the named provider. We re-verify each provider on a rolling basis; the “data as of” stamp at the top of this page reflects the most recent verification across the dataset.

Where a provider lists both an introductory price and an ongoing rate, we use the introductory price (“promo price”) as the comparable monthly cost, because that's what readers actually pay when starting a program. Brand-name comparison baselines come from the manufacturer cash-pay list prices for Wegovy and Zepbound as published by Novo Nordisk and Eli Lilly respectively.

Percentile calculations use linear interpolation between the two surrounding ranks (the same convention as Excel'sPERCENTILE function and NumPy's default). The full source is open on GitHub for anyone who wants to audit it.

Related research

This pricing index is one of several editorial pieces in our compounded GLP-1 market coverage:

• Weight loss injections guide — every FDA-approved option, effectiveness, cost, safety
• How compounded GLP-1 prices moved over the last 16 months — provider-by-provider price trajectories since January 2025.
• Is $99 compounded semaglutide real? Verifying every floor-price provider — deep dive on the cheapest tier of the market.
• Compounded tirzepatide vs compounded semaglutide — efficacy, stability, and regulatory status compared head-to-head.
• What happens when you stop taking semaglutide — why long-term costs matter more than the monthly sticker price.
• GLP-1 insurance coverage at the 10 largest US insurers — helps you decide between insured brand-name and cash-pay compounded.
• GLP-1 generics 2026: patent cliff tracker — when each drug goes generic and what that means for compounded pricing.
• GLP-1 shot beginner guide — start here if you are new to injectable weight-loss medication.
• Maryland Medicaid GLP-1 coverage (2026) — unique medical-benefit J3490 pathway; no retail-pharmacy Wegovy route.
• Michigan Medicaid GLP-1 coverage (2026) — coverage retained but gated at BMI ≥ 40.
• New Jersey Medicaid GLP-1 coverage (2026) — categorical exclusion with published $208M fiscal-impact memo.
• Arizona Medicaid (AHCCCS) GLP-1 coverage (2026) — blanket weight-loss exclusion; no carve-backs as of May 2026.
• Indiana Medicaid (IHCP) GLP-1 coverage (2026) — Zepbound preferred on the PDL but inaccessible for obesity without T2D.
• Virginia Medicaid (Cardinal Care) GLP-1 coverage (2026) — BMI > 40 threshold; pending legislation tied to a $245/month price target.
• Missouri Medicaid (MO HealthNet) GLP-1 coverage (2026) — Wegovy excluded for weight management even in a positive-coverage state.
• Minnesota Medicaid GLP-1 coverage (2026) — currently covered; HF4142 threatens termination in January 2027.
• Wisconsin Medicaid (ForwardHealth) GLP-1 coverage (2026) — two-lifetime-attempt cap; members who exhaust it move to cash-pay.
• Kentucky Medicaid GLP-1 coverage (2026) — coverage amendment extinguished by SB 65 veto override; ~350,000 affected members.
• Alabama Medicaid GLP-1 coverage (2026) — categorical exclusion in the state with the 5th-highest obesity rate nationally.
• Oklahoma Medicaid GLP-1 coverage (2026) — only a 7.8% PA approval rate for anti-obesity agents as of June 2025.
• Pharmacy Legitimacy Lookup tool — verify any compounded GLP-1 pharmacy against FDA and state records.

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