Semaglutide — what it treats, what it costs

What it should cost to fill

Strength	Cash price	With a discount card
Injection pen — about 1 month	$950 – $1400	$900 – $1300
Rybelsus tablets — 30 days	$900 – $1200	$850 – $1150

Typical retail ranges, not quotes. What you are charged depends on the pharmacy and on how the claim is processed — which is exactly why it is worth asking.

Where the money goes

Coverage is the whole game here. Many plans cover it for diabetes and not for weight, and the two are the same molecule under different brand names — which brand is on the prescription can decide whether it is paid for.
Both manufacturers run savings programmes for commercially insured patients, and direct-to-patient cash pricing has come down substantially. Ask about both.
Be careful with compounded semaglutide sold online. It is not FDA-approved, and quality varies.

What else there is

Not recommendations. The tradeoff matters more than the name, and it is the part a prescriber will want to talk about.

Tirzepatide (Mounjaro, Zepbound)Same class

Similar class and price. Coverage differs between plans, so one may be affordable where the other is not.

Metformin, and the older diabetes drugsDifferent class

A fraction of the price. They do not produce the same weight loss or cardiovascular benefit, so whether this is a reasonable trade depends entirely on why you were prescribed it.

Worth asking

Which brand is on my prescription, and is that the one my plan covers?
If it is denied, will you appeal with my A1c and history?

Before you change anything.