At a Glance
- Wegovy pill approved and will be available this month
- GLP-1 pills expected to lower costs compared to injections
- Retatrutide injection shows up to 29% weight loss but higher side-effect risk
- Why it matters: These changes could make weight-loss treatments more affordable, accessible, and effective for patients.
The 2026 shift in GLP-1 drug pricing and delivery is set to broaden access and lower costs for patients seeking weight-loss solutions.
Oral GLP-1 Pills
Novo Nordisk’s Wegovy pill received FDA approval last month and is expected to hit shelves this month.
Dr. Christopher McGowan said:
> “The GLP-1 landscape is expected to broaden significantly… For the first time, medical obesity treatment will move away from a one-size-fits-all model.”
Eli Lilly’s pill is expected to gain approval later this year.
Dr. Shauna Levy noted:
> “The pills will be a great option for patients who prefer oral medications or who have struggled to access the injectable versions.”
Dr. Shauna Levy added:
> “With so much product in the market, I hope the competition will further reduce prices.”
Dr. Shauna Levy said:
> “I think we need to consider that the efficacy of these medications is decreased if they are not taken consistently, and I am curious to see how they perform in real life.”
Dr. Shauna Levy mentioned:
> “There’s a bit more flexibility around Lilly’s pill, which still must be taken daily but can be taken any time of the day.”
Dr. Shauna Levy said:
> “I think there is potential for increased access with deals for cheaper products at Walmart and Costco, but I really want to make sure patients are treated and are followed by obesity medicine specialists or providers who really know what they are doing with anti-obesity medications.”
Pricing of the Wegovy pill:
- $149 per month for the two lowest doses (cash, no insurance)
- $299 per month for the higher doses (cash, no insurance)
- $25 per month out-of-pocket with insurance coverage
A month’s supply of the pills is expected to be cheaper than a month’s supply of injections.
Dr. Daniela Hurtado Andrade said:
> “Even $149 a month for some is still too expensive… It’s something that needs to be discussed with patients because they may have expectations that are not real.”
Dr. Daniela Hurtado Andrade added:
> “The lower prices will most likely expand access, but the most drastic weight loss in the trials came from the highest dose, which means people would likely have to pay more if they want to lose more weight.”
Potent New Injection
Lilly’s experimental retatrutide injection is a weekly dose that targets GLP-1, GIP, and glucagon.
In a Phase 3 trial, the highest dose produced an average 29% weight loss after ~16 months.
Dr. Christopher McGowan said:
> “These are numbers we simply didn’t think were possible just a few years ago.”
The injection’s high effectiveness may come with a trade-off of more intense side effects, such as nausea, diarrhea, constipation, and vomiting.
Lilly reported an 18.2% dropout rate for the drug compared with 4% in the placebo group.
By comparison, the highest-dose group in a separate Zepbound trial had a dropout rate of 6.2%.
Dr. Daniela Hurtado Andrade said:
> “The medication could be helpful for people with severe obesity, who may still have trouble losing weight on the existing GLP-1 medications, although I’d like to see more data on the side effects.”
A Lilly spokesperson said the company is completing seven additional trials on retatrutide, expected to finish in 2026, and could file for FDA approval as early as this year.
Pricing and Access
Cash-pay programs are expanding through partnerships with retailers.
Retail programs:
- Costco announced it will sell Wegovy and Ozempic for $499 a month for cash payers (October 2025)
- Walmart has a similar arrangement with Lilly for Zepbound
- TrumpRx.gov, a 2026 self-pay platform, will connect users to drugmakers’ discount sites
TrumpRx pricing:
- Average monthly cost of injections starts around $350 and could drop to about $250 within two years
- Starting doses of GLP-1 pills are expected to cost $149
Dr. Susan Spratt said:
> “The partnerships will ‘only improve access.’ The question, she added, is whether the discounts will be enough to improve access to everyone who could benefit from the medications. ‘They are still quite expensive,’ Spratt said.”
Dr. Shauna Levy said:
> “The self-pay options would make the drugs easier to get, particularly for people whose insurance doesn’t cover them.”
Many self-pay options connect patients with doctors on telehealth who determine eligibility and write prescriptions.
Key Takeaways
- Wegovy pill and other GLP-1 pills will be cheaper than injections and are set to launch in 2026.
- Retatrutide injection shows the strongest weight loss yet but carries higher side-effect and dropout rates.
- Cash-pay and retailer programs, plus the TrumpRx platform, aim to reduce costs, yet prices remain high for many.
These developments signal a significant shift toward more accessible and affordable weight-loss therapies, but patients and providers must weigh cost, efficacy, and side-effect profiles carefully.
