GLP-1 Therapy Out-of-Pocket Cost Calculator

Project the monthly and total cash outlay for GLP-1 medications once insurance reimbursements and manufacturer savings cards are applied, and pinpoint the month a savings programme maxes out so you can budget for dose escalations and renewals.

Retail pharmacy list price per pen before insurance, manufacturer coupons, or savings cards.
Percent of the list price your insurance covers after deductibles, step therapy, and prior authorisation hurdles.
Monthly manufacturer savings-card value applied to the patient share (enter 0 if none).
Number of months you expect to remain on the GLP-1 therapy at the entered dosage.
Defaults to no cap. Enter the maximum total savings-card benefit allowed under the programme if applicable.
Defaults to 1 pen per month. Adjust to the average pens needed once titration is complete.

Educational budgeting tool only. Confirm coverage, copays, and manufacturer programme rules with your insurer and pharmacy.

Examples

  • $925 list price, 35% coverage, $350 card, 8 months, $1,400 cap, 1 pen ⇒ Average monthly $426.25 USD; total $3,410.00 USD; insurance pays $2,590.00 USD; card covers $1,400.00 USD; savings $3,990.00 USD; card exhausted after month 4.
  • $875 list price, 55% coverage, $250 card, 9 months, unlimited card, 1.5 pens ⇒ Average monthly $340.63 USD; total $3,065.63 USD; insurance pays $6,496.88 USD; card covers $2,250.00 USD; savings $8,746.88 USD; card applies every month.

FAQ

How do I reflect a dosage increase?

Adjust the pens-per-month input to the average number of pens you expect to use each month once titration is complete or if your provider increases the dose mid-year.

Does the calculator account for deductibles?

Enter the coverage percentage that applies after your deductible. For months before coverage kicks in, set coverage to 0% to see the worst-case cost and rerun the tool once the deductible is met.

What if the savings card amount changes mid-year?

Re-run the calculator with updated savings card values for the applicable months, then sum the outputs to build your annual budget or copay tracker.

Can I convert the total to weekly cost?

Divide the total out-of-pocket amount by the number of weeks on therapy to see the equivalent weekly spending or by 30.4 for an average monthly figure.

Additional Information

  • Insurance coverage lowers the list price first, and the calculator itemises the insurer contribution so you can validate explanation of benefits statements.
  • The optional savings-card cap tracks lifetime programme limits and flags the month the benefit is fully consumed or confirm when assistance spans the entire course of therapy.
  • Pens per month lets you reflect titration schedules that require multiple pens as dosage increases, capturing the real-world cost of maintenance doses.
  • Savings versus list price compares your net spend to paying the full pharmacy cash price with no insurance or card support, highlighting the value of coverage.
  • Average monthly cost blends months with and without assistance so you can plan flexible healthcare budgets or FSA contributions.

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