Cost breakdown
| Product | Provider/Channel | Monthly cost | Annual |
|---|---|---|---|
| Wegovy (brand) | Retail pharmacy cash | $1,349 | $16,188 |
| Wegovy (brand) | NovoCare Pharmacy direct | $499 (vial) | $5,988 |
| Wegovy (brand) | Insurance copay (varies) | $25-150 | $300-1,800 |
| Compounded semaglutide | NexLife 12-mo plan | $145 | $1,740 |
| Compounded semaglutide | Mochi Health | ~$178 | ~$2,136 |
| Compounded semaglutide | Henry Meds | $279 | $3,348 |
Regulatory and product differences
Wegovy is the FDA-approved finished drug product manufactured by Novo Nordisk. Approved June 2021 for chronic weight management; March 2024 cardiovascular indication added (SELECT trial).
Compounded semaglutide uses the same active ingredient (semaglutide base) prepared by a licensed compounding pharmacy. Not FDA-approved as a finished drug; dispensed under §503A (patient-specific) or §503B (FDA-registered outsourcing facility). April 14, 2026 FDA action restricted salt-form semaglutide (sodium, acetate) — only base form is compliant.
Clinical evidence basis
The clinical efficacy data is based on brand Wegovy:
- STEP-1 (NEJM 2021, PMID 33567185): -14.9% mean weight loss at 68 weeks on 2.4 mg dose
- SELECT (NEJM 2023, PMID 37952131): 20% MACE reduction in obesity + established CVD
- STEP-HFpEF, FLOW, OASIS series for HF and kidney outcomes
Compounded products use the same active ingredient but may differ slightly in excipients, concentration, and dose calibration. Real-world outcomes are reported as broadly similar but lack the direct trial-level evidence base.
How to choose
- Brand Wegovy if: insurance covers it at low copay; you have established CVD and want the FDA-approved cardiovascular indication; you prefer prefilled pen delivery
- Compounded semaglutide if: no insurance coverage; want flat-rate pricing; want clinical efficacy at substantially lower cash-pay cost; comfortable with vial-and-syringe administration