Tirzepatide (Mounjaro for diabetes, Zepbound for weight loss) and semaglutide (Ozempic for diabetes, Wegovy for weight loss) dominate conversations about modern injectable treatments because both deliver results many patients have never seen before with pills or older therapies. Weekly dosing, meaningful HbA1c improvement, and substantial weight reduction make them go-to options when lifestyle changes alone are not enough. Yet for most people the deciding factor is not efficacy alone—it’s the actual monthly cost after insurance, coupons, and pharmacy variables are applied.
Both drugs carry high list prices that can exceed $1,000 per month without coverage, creating real barriers for patients who are already managing doctor visits, lab work, and other diabetes or obesity-related expenses. Manufacturer savings programs, pharmacy discount cards, insurance formularies, and cash-pay options create a complicated landscape where the same pen can cost one person $25 and another $1,000 depending on coverage details and location. Prices also shift year to year with manufacturer adjustments, new formulations, and competitive pressures.
Understanding current 2025–2026 pricing, how different insurance tiers and discount routes affect the final bill, and which strategies reliably lower out-of-pocket costs helps patients plan realistically and avoid treatment interruptions. This article compares the two medications head-to-head on price, breaks down savings programs, and provides actionable steps so you can secure the lowest sustainable cost for the drug that best fits your health needs.
List Prices and Wholesale Costs in 2025–2026
The wholesale acquisition cost (WAC)—the baseline price before any discounts or rebates—is the starting point for both medications. As of mid-2025 through 2026:
- Trulicity (dulaglutide) pens: ~$977–$1,069 per carton of four pens (28-day supply), same price across all strengths (0.75 mg, 1.5 mg, 3.0 mg, 4.5 mg).
- Ozempic (semaglutide injection): ~$968–$1,060 per carton of four pens for 0.25 mg, 0.5 mg, and 1 mg strengths; the 2 mg pen (higher-dose option) is priced similarly per pen but delivers fewer doses per carton in some configurations.
These are manufacturer list prices before pharmacy markup, dispensing fees, or rebates. Actual retail cash prices (no insurance) typically add 5–15 % depending on the pharmacy chain, location, and local competition.
Cash Prices Without Insurance – Retail Pharmacy Comparison
When paying full cash (no insurance claim or coupon applied), prices vary noticeably by retailer. Here are typical 2025–2026 ranges for a 28-day supply:
- Walmart: $795–$925 (frequently one of the lowest consistent cash prices)
- Costco Pharmacy: $800–$880 (often the lowest among national chains; membership usually not required for pharmacy)
- Sam’s Club Pharmacy: $810–$890 (similar to Costco; membership usually not required for pharmacy)
- CVS / Walgreens: $950–$1,050 (higher base cash price before coupons)
- Independent / regional pharmacies: $850–$1,000 (wide variation; some match or beat big chains)
Discount cards (GoodRx, SingleCare, RxSaver, Blink Health) often reduce these prices further—commonly to $780–$920 at participating locations. The lowest advertised coupon prices appear sporadically below $780 during promotions, but $800–$950 is the realistic sustained range for cash-pay patients.
Manufacturer Savings Programs Comparison
Eli Lilly (Trulicity) and Novo Nordisk (Ozempic) both offer savings cards for commercially insured patients. Here is a side-by-side look at the programs as of 2025–2026:
| Program / Medication | Eligible Insurance Types | Cost per 30-day Supply (4 pens) | Maximum Savings per Fill | Fills per Year Allowed | Government Plan Eligible? | Renewal / Restrictions |
|---|---|---|---|---|---|---|
| Trulicity Savings Card | Commercial only (no Medicare/Medicaid) | As low as $25 | $150 per fill | 12 | No | Expires Dec 31 each year; resets Jan 1 |
| Ozempic Savings Card | Commercial only (no Medicare/Medicaid) | As low as $25 | $150 per fill | 13 | No | Expires Dec 31 each year; resets Jan 1 |
| LillyDirect (Trulicity cash-pay) | No insurance required | $850–$950 | N/A | Unlimited | Yes (cash-pay) | Free home delivery in many areas |
| NovoCare (Ozempic cash-pay via pharmacy partners) | No insurance required | $900–$1,000 | N/A | Unlimited | Yes (cash-pay) | Delivery available; prices vary by partner |
Savings cards provide the lowest cost for eligible patients; cash-pay programs are the fallback for everyone else.
Medicare and Government Insurance Coverage
Original Medicare (Parts A & B) does not cover Trulicity or Ozempic because they are outpatient prescription drugs. Coverage falls under Medicare Part D plans, which vary widely.
- In the Part D coverage gap (“donut hole”) patients pay a high percentage until reaching catastrophic coverage.
- Many Medicare Advantage plans (Part C) include prescription drug coverage (MA-PD) with tiered copays for GLP-1 agonists—often $100–$500+ per month depending on the plan’s formulary tier and phase.
- Some plans place Trulicity and Ozempic on Tier 3 or 4 (non-preferred brand), requiring prior authorization or step therapy through metformin or other agents.
- Low-income subsidy (Extra Help) can reduce copays to $4–$10 per fill for qualifying beneficiaries.
Medicaid coverage varies by state; many states cover both drugs but may require prior authorization or step therapy. Dual-eligible beneficiaries (Medicare + Medicaid) usually pay very low or $0 copays under Medicaid rules.
Practical Ways to Lower Your Monthly Cost
If you have commercial insurance, activate the manufacturer savings card immediately—download from the official website or ask your doctor/pharmacy. It reduces cost to $25 per fill (max $150 savings) for up to 12 fills per year.
Without commercial insurance, compare cash prices at Walmart, Costco (pharmacy usually no membership required), Sam’s Club, and GoodRx-participating stores. These locations often have the lowest consistent prices ($780–$950).
Ask your doctor for samples—many offices receive free starter cartons from manufacturers. A few months of samples can bridge the gap while you arrange a lower ongoing cash price.
Check for state-specific or charitable assistance programs for uninsured/underinsured patients with diabetes or obesity. NeedyMeds, RxAssist, and the Partnership for Prescription Assistance list foundations that occasionally help with GLP-1 costs for qualifying individuals.
If you have a high-deductible health plan, use a flexible spending account (FSA) or health savings account (HSA) to pay for Trulicity. These tax-advantaged accounts effectively reduce the net cost by 20–40 % depending on your tax bracket.
Summary
Trulicity cash prices without insurance range from $795–$925 per month at Walmart and similar big-box pharmacies in 2025–2026, with discount cards often lowering the amount to $780–$900. The official Trulicity Savings Card reduces cost to $25 per fill (up to $150 savings per month, 12 fills per year) for patients with commercial insurance, but Medicare, Medicaid, and other government-plan beneficiaries cannot use it. Manufacturer direct programs (LillyDirect) offer reliable $850–$950 cash pricing with delivery, while Costco and Sam’s Club frequently provide the lowest in-store cash rates.
The lowest sustainable monthly cost for most uninsured patients is $780–$950 using discount cards at Walmart/Costco or LillyDirect. Samples, employer discount programs, charitable assistance, and tax-advantaged accounts further reduce the burden. For many patients the combination of improved blood sugar control, modest weight loss, and cardiovascular risk reduction justifies the expense when lower-cost alternatives are insufficient. Always verify current pricing at your pharmacy and explore every legitimate discount before paying full retail.
FAQ
How much does Trulicity cost per month without insurance at Walmart in 2025–2026?
The cash price at Walmart typically ranges from $795 to $925 for a 28-day supply (four pens) of any dose strength. Using GoodRx or SingleCare coupons often lowers it to $780–$900 at participating Walmart locations.
Do all Trulicity doses cost the same without insurance?
Yes—Eli Lilly sets the same wholesale price for every pen strength (0.75 mg, 1.5 mg, 3.0 mg, 4.5 mg). The monthly cash cost remains consistent regardless of which dose you are prescribed.
Is Costco cheaper than Walmart for Trulicity cash price?
Costco pharmacies frequently offer some of the lowest cash prices ($800–$880 per month) even without a membership in most states. Prices are very stable and often beat Walmart and GoodRx at many locations. Call your local Costco pharmacy for a current quote.
Can I use GoodRx or SingleCare at Walmart for Trulicity?
Yes—Walmart pharmacies accept GoodRx, SingleCare, RxSaver, and most major discount cards. Presenting the coupon at checkout often reduces the price to $780–$900 per month, sometimes lower than Walmart’s standard cash price.
Does LillyDirect offer a better cash price than Walmart?
LillyDirect typically prices Trulicity at $850–$950 per month with free home delivery, which is usually higher than Walmart’s cash price ($795–$925) or Walmart with a discount card ($780–$900). Use LillyDirect mainly for convenience if local prices are significantly higher.
Are there any legitimate ways to get Trulicity below $780 per month without insurance?
Occasional pharmacy promotions or regional discounts can dip below $780 briefly, but $780–$900 is the realistic sustained cash-pay range in 2025–2026 using the best available coupons at Walmart or Costco. Samples from your doctor can provide free pens for a few months while you arrange ongoing savings.
Will moving to a higher dose of Trulicity increase my monthly cost without insurance?
No—the cash price per carton is the same for all strengths at Walmart and other retailers. Switching from 1.5 mg to 3.0 mg or 4.5 mg does not raise the monthly out-of-pocket amount when paying cash.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.