Wegovy is climbed, not started. The pen strengths are 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg, with a 7.2 mg high-dose strength above them, and a patient moves up in steps over months so the gastrointestinal effects have time to settle.
Every dosing chart on the internet stops there. Here is the same ladder with the money on it, and then the number nobody publishes: what the first year actually costs.
Your dose and how fast you move between strengths are decisions for the clinician who prescribed this. The ladder below is Novo's published schedule and pricing, reproduced so you know what to expect.
The ladder
The flat middle column is the useful part. $349 covers 0.25 mg and it covers 2.4 mg.1 On the brand, going up a dose does not put your bill up, and asking to sit at a strength for an extra month costs nothing.
What year one actually costs
Here is where the sticker price misleads, and it misleads downward as often as upward.
Novo's terms, quoted:1
Patients new to the Wegovy Savings offer or NovoCare Pharmacy pay $199 for each month of 0.25 mg & 0.5 mg. Offer for 2 monthly fills through December 31, 2026, then $349 per month.
NovoCare
Novo counts a month as one box of four weekly pens, "a 28-day supply",3 so 52 weeks of doses takes 13 boxes, not 12. A new self-pay patient starting today does not pay $349 for all 13. They pay:
| Boxes (28 days each) | Dose | Rate | Subtotal |
|---|---|---|---|
| 1 to 2 | 0.25 / 0.5 mg | $199 | $398 |
| 3 to 13 | climbing to 2.4 mg | $349 | $3,839 |
| Year one | $4,237 |
What a first year of self-pay Wegovy, 13 boxes, costs a new patient on Novo's published rates. The sticker price alone would suggest $4,537. The difference is the two introductory fills.
Two caveats we would rather state than bury. The introductory rate runs through 31 December 2026, so a patient starting later in the year gets fewer of those fills before it lapses. And it applies to patients new to the offer, not to everyone.
If a prescriber holds you longer at the lower strengths, the calendar stretches but the bill does not change after month two, because the price is flat. That is the practical benefit of flat pricing and it is worth understanding before you compare against a program that prices by dose.
The tablet is a different product, and cheaper
Wegovy is also sold as a daily tablet, at different strengths and a different price: from $149 a month rather than $349. If you are choosing on cost, that comparison matters more than anything on the pen ladder, and we covered the pill and what it costs separately.
The schedule itself
From the FDA label:2
Administer WEGOVY injection once weekly, on the same day each week, at any time of day, with or without meals.
FDA label, via DailyMed
No empty stomach, no particular hour. Pick a day that you will actually remember and rotate injection sites with each dose.
What this costs against the alternatives
The brand is one route and not the cheapest one. The molecule, compounded, is a different proposition at a different price and a different regulatory status:
