One Pen, Four Counters: Zepbound and Wegovy at LillyDirect, NovoCare, TrumpRx and Costco

For Wegovy®, it barely matters which counter you use: NovoCare Pharmacy, TrumpRx and Costco all charged the same $349 a month for a standard pen on September 28, 2026. For Zepbound®, it matters a great deal. LillyDirect and TrumpRx charge $449 for a maintenance-dose fill refilled on time, while Costco's pharmacy price for a box of four Zepbound single-dose pens was $1,086.56.

The reason is structural. Novo Nordisk has pushed its self-pay price out to retail pharmacies. Eli Lilly sells its self-pay Zepbound price through its own channel, and TrumpRx routes Zepbound orders back to that channel.

The same dose at each counter

Every price below was read on the channel's own public page on September 28, 2026. A "month" is 28 days for the pens and 30 tablets for the Wegovy pill.

Read down the Wegovy rows and the three counters agree to the dollar. Read across the Zepbound rows and one counter is more than twice the other two.

The conditions behind each price

The prices match, but the conditions attached to them do not.

LillyDirect. The $449 maintenance price holds only when you refill within 45 days of your last delivery, under Lilly's Zepbound Journey Program. Lilly's own footnote gives the regular prices if you miss that window: $499 at 7.5 mg and $699 at 10, 12.5 and 15 mg.¹ Pen needles and syringes are bought separately. LillyDirect fills a prescription; it does not write one.

TrumpRx. The federal site does not sell Zepbound itself. Its Zepbound page states that Eli Lilly "manages all Zepbound (Tirzepatide) Vial orders through LillyDirect," and its dose picker carries the same late-refill prices.² For Wegovy, TrumpRx issues a coupon you present at a retail pharmacy. The Wegovy pen page repeats Novo's new-patient offer word for word: $199 for the first two monthly fills at 0.25 and 0.5 mg, available between November 17, 2025 and December 31, 2026, then $349 and $399 for the HD pen.³ TrumpRx also prints each drug's original price: $1,087.00 for Zepbound and $1,349.02 for Wegovy.

NovoCare Pharmacy. Novo's pricing footnotes set the Wegovy pill at $149 for 1.5 mg, $199 for 4 mg and $299 for 9 and 25 mg, and the pen at $349 after the two introductory fills, with the HD pen at $399. A month is one box of four pens or one bottle of 30 tablets.⁴

Costco. Costco's Member Value Pricing page lists Wegovy tablets at $149 for 1.5 mg and $299 for 9 to 25 mg, and Wegovy injections at $199 for 0.25 to 0.5 mg and $349 for 1 to 2.4 mg.⁵ Its footnotes repeat that the $199 injection price is "limited to 2 fills" and ends after December 31, 2026, and add a date Novo's own page does not print: the $149 tablet price becomes $199 a month after the same day. Its price tool matches Novo's ladder at every Wegovy dose, including $399 for the HD pen and $199 for the 4 mg pill. Zepbound is not on the member list, and the same tool shows it at the pharmacy's own price.⁶

Why Costco's Zepbound price is so different

A pharmacy counter cannot easily sell below what it pays for a drug. CMS's National Average Drug Acquisition Cost survey put the 10 mg Zepbound single-dose pen at $526.05 per mL as of September 23, 2026.⁷ Four 0.5 mL pens therefore cost a retail pharmacy about $1,052.09 to acquire. Costco's $1,086.56 sits just above that.

LillyDirect's $449 sits far below it, because the manufacturer is selling direct and no wholesaler or dispensing pharmacy takes a margin in between. That is the whole case for a manufacturer storefront. Novo has taken a different route: it extends the self-pay price to retail counters through its savings offer, so a Wegovy prescription costs the same at Costco as it does from Novo's own pharmacy.

The practical rule follows. Send a Zepbound self-pay prescription to LillyDirect, or start it from TrumpRx, which lands in the same place. Send a Wegovy prescription wherever is convenient, and bring the savings offer or TrumpRx coupon with you if the pharmacy is not NovoCare.

Deductible credit

None of these self-pay prices counts toward an insurance deductible, and the channels say so in their own terms.

TrumpRx's coupon terms require you to agree that you "cannot attempt to count the cost of this medicine toward your insurance deductible or out-of-pocket limit."³ Lilly's self-pay fulfillment terms ask for the same promise not to seek reimbursement from any insurance plan; our LillyDirect review quotes them. Costco states that Member Value Pricing "is not insurance," and that claims submitted to Medicare, Medicaid or private insurance are not eligible for it.⁵ Medicare.gov adds that TrumpRx and other discount cards are not creditable coverage, so money spent through them does not count toward a Medicare deductible or out-of-pocket maximum.⁸

If your plan covers the drug and you are close to your deductible, running the prescription through insurance can be cheaper over a year even at a higher monthly copay. Cash pay vs insurance works through that trade.

The insured price is a different schedule

The manufacturers publish a separate price for commercially insured patients. Lilly lists Zepbound pens at "as low as $25" a month for up to a 3-month prescription when a plan covers the drug.¹ Novo lists Wegovy at "as little as $25" a month with a maximum saving of $100 a month.⁴ Government beneficiaries are excluded from both. Medicare patients have a separate route: under the Medicare GLP-1 Bridge, Medicare covers Wegovy (pen or pill), Foundayo™ and the Zepbound KwikPen for eligible patients at a $50 monthly copayment.⁸

When a telehealth program beats every counter

A telehealth company reselling branded Wegovy or Zepbound cannot beat these counters on price, because it buys the same product and adds its own fee. What it can add is the prescription itself, which LillyDirect, NovoCare, TrumpRx and Costco all require you to bring.

Compounded plans are the exception on price. The typical compounded semaglutide year we track costs $2,388 across 88 companies, against $4,537 for thirteen Wegovy pens at $349. The typical compounded tirzepatide year is $3,228 across 78 companies, against $5,837 for thirteen on-time Zepbound fills. Compounded drugs are not FDA-approved, and a lower price buys a different product. The compounded semaglutide and compounded tirzepatide cost pages show the full spread.

For a single channel in depth, see what LillyDirect costs and what NovoCare Pharmacy costs. For the two drugs head to head, see Zepbound vs Wegovy.

Wegovy® is a registered trademark of Novo Nordisk A/S. Zepbound® is a registered trademark and Foundayo™ a trademark of Eli Lilly and Company. TrumpRx is a US government website. Doseworth is not affiliated with any of them.