GLP-1 Therapy Annual Out-of-Pocket Planner

Estimate your annual spend on GLP-1 medications such as Ozempic, Wegovy, Mounjaro, or Zepbound. Provide the monthly list price, insurance coverage percentage, planned months on therapy, and any copay assistance to surface your net monthly obligation, yearly out-of-pocket total, insurer contribution, manufacturer support applied, and share of the list price you still cover. Optionally include recurring supplies or telehealth fees to capture the full budget.

Retail pharmacy price for one month of GLP-1 medication before insurance.
Percentage of the list price your insurer covers after deductible and coinsurance.
Number of monthly fills you expect in the next 12 months (round to the nearest whole month).
Manufacturer copay card or coupon applied to each monthly fill.
Defaults to $0. Add recurring supplies, clinic fees, or telehealth subscriptions if applicable.

Medication pricing and coverage vary widely. Confirm exact benefits with your insurer and pharmacy before ordering.

Examples

  • $960 list price, 60% coverage, 10 months, $150 copay support ⇒ Monthly patient cost after support: $234.00 • Annual patient out-of-pocket: $2,340.00 • Insurer payment over 10 months: $5,760.00 • Annual manufacturer assistance applied: $1,500.00 • Annual add-on costs included: $0.00 • Patient share of list price each month: 24.38% • Total savings versus paying list price: $7,260.00
  • $1,250 list price, 40% coverage, 12 months, no copay support, $35 add-ons ⇒ Monthly patient cost after support: $785.00 • Annual patient out-of-pocket: $9,420.00 • Insurer payment over 12 months: $6,000.00 • Annual manufacturer assistance applied: $0.00 • Annual add-on costs included: $420.00 • Patient share of list price each month: 60.00% • Total savings versus paying list price: $5,580.00

FAQ

How do I include HSA or FSA reimbursements?

Subtract the amount you plan to reimburse from your annual patient cost result to see how much cash you still need to set aside or change the add-on field to a negative number representing reimbursements.

Can I project dose increases later in the year?

Run separate scenarios with updated list prices and months to reflect each dosing tier, then combine the totals for a blended annual number. This mirrors how many plans require step-up dosing.

What if my insurance coverage changes midyear?

Use the months on therapy input to model each coverage phase separately—for example, six months at the old percentage and six months at the new percentage—then add the two annual patient totals together.

Can I include one-time initiation or lab costs?

Yes. Add the one-time cost to the add-on field for the first month and set months on therapy accordingly, or keep a separate tally for upfront expenses that do not recur.

Additional Information

  • Coverage percentage is capped between 0% and 100% and applies before manufacturer copay support is deducted.
  • Patient share percentage reflects the portion of the list price you still cover after insurance and assistance but before optional add-ons.
  • Optional add-on costs let you bake in recurring supplies, clinic visits, delivery fees, or telehealth subscriptions.
  • Savings versus list price compares the full retail cost for the entered months against what you actually pay after insurance, support, and add-ons.
  • If copay support exceeds your remaining obligation, the tool caps it so the patient cost never drops below zero before add-ons.

Related calculators