The answer
Price the care, not the drug. As of October 30, 2026, every major GLP-1 has a published manufacturer cash price, and your patient will have seen it before they reach your checkout. A program fee of $99 to $149 a month on top of a pass-through drug keeps roughly $63 to $111 of contribution per patient before marketing, by the model below. A $49 fee keeps about $14, which is a lead-generation business, not a clinic.
The January 1 list-price cut does not change that answer for cash-pay patients. It changes it for insured patients with high deductibles, which is a different and smaller funnel.
The prices patients will compare you against
| Product | Cash price per month | Source and conditions |
|---|---|---|
| Wegovy pen 0.25 and 0.5 mg | $199 for first 2 fills for new patients, then $349 | NovoCare; offer runs through December 31, 2026 |
| Wegovy pen 1, 1.7, 2.4 mg | $349 | NovoCare |
| Wegovy HD 7.2 mg | $399 | NovoCare |
| Wegovy pill 1.5 mg / 4 mg / 9 and 25 mg | $149 / $199 / $299 | NovoCare (the 4 mg $149 offer ended August 31) |
| Ozempic | $349 | Novo direct cash price |
| Zepbound vial or KwikPen 2.5 mg / 5 mg / 7.5 to 15 mg | $299 / $399 / $449 | LillyDirect, when refilled within 45 days |
| Foundayo 0.8 / 2.5 / 5.5 and 9 mg / 14.5 and 17.2 mg | $149 / $199 / $299 / $299 to $349 | LillyDirect; the top doses are $299 with a refill inside 45 days |
| CVS MinuteClinic visit | $29, no membership | Announced August 5, 2026 |
| Walgreens visit | $49 | 28 states, branded only |
| Amazon One Medical | $39 message, $59 video | No membership |
A note on Zepbound, because published numbers disagree. Some 2026 pages still show $349 for the starting dose and $499 for higher doses, which were LillyDirect's vial prices before Lilly cut them in December 2025. Ro's own Zepbound page lists $299 to $499 on its platform. LillyDirect's current page lists $299, $399 and $449, conditional on refilling within 45 days. Use LillyDirect's numbers, and tell patients about the 45-day condition, because a missed refill raises their price.
What January 1 changes
On February 24, 2026, Novo Nordisk announced that from January 1, 2027 the US list price (wholesale acquisition cost) of Wegovy 2.4 mg, the 25 mg Wegovy pill, Ozempic and Rybelsus falls to $675 a month. For Wegovy that is about half the current list price of $1,349.02 (Becker's). Novo said its direct self-pay prices are not affected.
Who that helps: insured patients whose out-of-pocket cost is tied to list price, meaning deductibles and coinsurance. A patient in a high-deductible plan who pays list until the deductible is met will see their January bill roughly halve. A patient paying $349 cash sees nothing.
Two other dates sit on top of it. The $199 introductory Wegovy fills run through December 31, 2026, so patients who start late in December may reach $349 sooner than they expect. Tell them in writing. And the Business Group on Health found 14% of employers have dropped or plan to drop GLP-1 weight-management coverage by 2027, so some patients who were insured this year become cash-pay patients in January. The coverage-loss funnel post covers how to catch them.
Our view: the list cut is good news to mention to insured patients and irrelevant to your pricing page. Do not market it as a price drop to cash patients. It is not one.
The margin math
Assumptions per patient per month, carried over from our margin model at 500 patients: provider review $20 blended, card processing 2.9% plus 30 cents (we use 3.2% of the fee), support $9 (one coordinator at $4,500 across 500 patients), platform $4 (a $2,000 flat fee across 500 patients). The drug is paid by the patient to NovoCare or LillyDirect and is not in your revenue.
| Program fee | $49 | $99 | $149 |
|---|---|---|---|
| Provider review | $20.00 | $20.00 | $20.00 |
| Processing at 3.2% | $1.57 | $3.17 | $4.77 |
| Support | $9.00 | $9.00 | $9.00 |
| Platform | $4.00 | $4.00 | $4.00 |
| Contribution per patient | $14.43 | $62.83 | $111.23 |
| Contribution margin | 29% | 63% | 75% |
| Patient's total monthly cost on Zepbound 5 mg ($399) | $448 | $498 | $548 |
| Patient's total on the Wegovy pill 1.5 mg ($149) | $198 | $248 | $298 |
Read the bottom two rows with the CVS row in mind. A patient on Zepbound 5 mg through CVS pays $29 once and $399 a month. You are asking for $99 to $149 more every month, so the fee has to buy something they can feel: dose management, a clinician who answers, side-effect help, refills that happen without re-onboarding. The CVS post makes that case at length.
At $49 the provider cost alone is 41% of the fee, and one extra dose-change consult in a month wipes out the contribution. We would not run a $49 program unless the patient is stable on maintenance and needs a check-in every quarter, not every month.
Why one all-in price breaks
Some brands want one number: "$399 a month, medication included." It reads well. It also needs you (or your pharmacy) to be the seller of the drug, and it breaks on titration.
A Zepbound patient moves from $299 at 2.5 mg to $399 at 5 mg to $449 from 7.5 mg upward. A Wegovy pill patient goes from $149 to $199 to $299. Bundle a flat $399 and your margin is $100 in month one, nothing in month two, and minus $50 from month three onward, at the doses where patients stay longest. Bundling also hides the drug price the patient has already seen in the CVS app or on TrumpRx, which costs trust. The manufacturer-direct post covers positioning when patients can buy the drug without you.
If you must bundle, bundle by dose tier and say so on the pricing page.
Three structures we would use for 2027
1. One care membership, drug at manufacturer price. $99 to $149 a month, with the manufacturer's price for each dose listed next to your fee and a link to the source. Same price in month one and month twelve. This is the default.
2. Two tiers by clinical intensity. An active tier at $129 to $149 for patients titrating or changing medication (monthly review, messaging, side-effect support), and a maintenance tier at $59 to $79 for patients stable on a dose (quarterly review, refills, messaging). Fee follows clinician time, and patients who reach goal have a reason to stay instead of leaving to save money.
3. Prepaid quarter at a stated saving. Optional, never default, cancellable with a pro-rata refund, renewal notice before every charge. It lowers billing events and chargeback exposure. Do not make it the only way to get the advertised price.
What we would not do: introductory prices that reset. Novo's $199 promo ends December 31 and a lot of patients will feel that jump in January. A brand that copies the pattern gets the same churn spike. Subscription design has the retention data behind that opinion.
What we are unsure about: whether Novo or Lilly cut cash prices again in early 2027. Both have cut them in the past twelve months. Price your fee so it still makes sense if the drug falls another $50, which is one more argument for keeping the two separate.
How Turbopills handles it
Turbopills bills your program fee as a subscription that starts only after the provider approves, supports multiple tiers and dose-based plan changes, issues renewal notices and itemized receipts, and routes the prescription to the pharmacy or manufacturer channel you choose, with status visible in the patient's portal. Changing a price or adding a maintenance tier is configuration, not engineering. We are in private beta and quote per program, so put our quote into the platform row above at your own volume before you believe the 63% and 75% margins.
FAQ
How much does Wegovy cost without insurance in 2027? Novo's self-pay price is $349 a month for most Wegovy pen doses and $399 for the 7.2 mg dose, and the pill runs $149 to $299. Novo said the January 1, 2027 list-price cut to $675 does not change these self-pay prices.
Does the Wegovy list price cut lower cash prices? No. It lowers wholesale acquisition cost, which matters to insured patients whose deductible or coinsurance is based on list price. Cash prices through NovoCare stay as published.
How much should a telehealth GLP-1 program charge? Most brands charge $99 to $149 a month on top of the medication. By our model that keeps about $63 to $111 per patient before marketing. A $49 fee leaves about $14 and works only for low-touch maintenance patients.
What does Zepbound cost on LillyDirect? $299 for 2.5 mg, $399 for 5 mg, and $449 for 7.5 mg through 15 mg per month for vials or KwikPen, when the patient refills within 45 days. Older pages showing $349 to $499 predate Lilly's December 2025 cut.