What GLP-1 savings programs and discounts exist?

Map your situation to the tier that applies: Tier 1 — You have commercial insurance that covers the drug: manufacturer savings cards (Novo’s for Wegovy, Lilly’s for Zepbound) cap copays — commonly “as little as $25/month” up to annual maximums. Rules: commercial insurance only (federal anti-kickback law bars Medicare/Medicaid use), the drug must be on formulary, and caps reset yearly. If your copay is over $100, you’re likely leaving card money on the table — enroll on the manufacturer site in five minutes. Tier 2 — No coverage, want brand: the direct-to-patient pharmacies are the post-2024 game changer: NovoCare ships Wegovy around $499/month; LillyDirect’s Zepbound single-dose vials run ≈$349–$499 by dose — the syringe-instead-of-pen trade that saves hundreds. No insurance involved, no PA fights. Tier 3 — Cash-pay, price-first: the compounded telehealth lane ($199–$450 including clinical services) remains the floor among regulated options (how it’s legal and what you trade), with program vetting doing the safety work. Below that sits only generic liraglutide — older drug, daily shots, real discount. The small-ball stack (works on top of any tier): - HSA/FSA — pre-tax dollars on prescriptions and telehealth fees; effectively 20–30% off for most. - Dose economics — on per-dose-priced programs, the lowest effective dose and maintenance microdosing cut bills proportionally; clinically legitimate when you’re holding results. - GoodRx et al. — checks in minutes, but discounts on GLP-1s are typically marginal; don’t anchor a plan on them. - Patient assistance programs — Novo and Lilly both run income-based PAPs; eligibility is restrictive but free drug exists for those who qualify. Government insurance footnote: Medicare/Medicaid rules are their own maze — covered here — and remember savings cards are off-limits there entirely.