Weight-loss injection costs 2026
Between around 30 € and 490 € a month – and health insurance pays none of it. All pharmacy retail prices, the projection over twelve months and what you can claim for tax purposes. Prices according to the Lauer-Taxe (the German drug price database), as of 14 September 2026.
This article provides information on costs and reimbursement
It is not a substitute for medical advice, diagnosis or treatment and does not make any treatment recommendation. All products mentioned except Orlistat 60 mg are prescription-only and available only on a doctor's prescription. Whether drug therapy is an option is decided solely by your doctor.
Pharmacy retail prices at a glance
All products in this table are approved for weight reduction. The prices are uniform nationwide because prescription-only medicines are subject to the Drug Price Ordinance (Arzneimittelpreisverordnung).
| Medicine | Active ingredient | Pack | Price | per 4 weeks |
|---|---|---|---|---|
| Mounjaro 15 mg Lilly | Tirzepatide | 1 KwikPen (4 weeks) | 490.01 € | 481.94 € Highest maintenance dose. 1,445.81 € in a pack of three. |
| Mounjaro 5 mg Lilly | Tirzepatide | 1 KwikPen (4 weeks) | 277.60 € | 269.54 € Low maintenance dose. 808.62 € in a pack of three. |
| Wegovy 2.4 mg Novo Nordisk | Semaglutide | 1 pre-filled pen 3 ml (4 weeks) | 277.60 € | 277.60 € Target dose. Starting doses of 0.25 to 1.0 mg cost 172.73 €. |
| Saxenda Novo Nordisk | Liraglutide | 5 × 3 ml | 291.92 € | approx. 291.92 € Daily injection instead of weekly. |
| Nevolat Zentiva | Liraglutide | 5 pre-filled pens | from 129.77 € | approx. 129.77 € Saxenda generic, on the market since December 2025. |
| Mysimba Goodlife | Naltrexone/bupropion | 112 prolonged-release tablets | from 116.69 € | approx. 116.69 € Tablets, not an injection. |
| Xenical Cheplapharm | Orlistat 120 mg | 84 capsules (28 days) | from 50.95 € | approx. 50.95 € Re-import. Original 104.67 €. |
| Orlistat 60 mg Hexal, ratiopharm and others | Orlistat | 84 capsules (28 days) | from approx. 30 € | approx. 30 € Over the counter but pharmacy-only – no fixed price. |
Pharmacy retail prices according to the Lauer-Taxe, as of 14 September 2026, in each case the manufacturer's original PZN (pharmaceutical central number). Parallel imports and re-imports of the same strength may differ – for Wegovy 2.4 mg they are sometimes above 360 €.
What a year of therapy costs
Monthly prices alone are misleading because both GLP-1 products are introduced gradually. Wegovy is titrated up to the target dose over 16 weeks, Mounjaro over 20 weeks. The following calculation takes this into account:
| Therapy | per month | 6 months | 12 months |
|---|---|---|---|
| Mounjaro, titration up to 15 mg | 206.80 – 490.01 € | 2,232.02 € | 5,123.66 € |
| Mounjaro 10 mg (maintenance dose, pack of three) | 375.74 € | 2,254.44 € | 4,508.88 € |
| Saxenda 3 mg daily | 291.92 € | 1,751.52 € | 3,503.04 € |
| Wegovy, titration up to 2.4 mg | 172.73 – 277.60 € | 1,310.53 € | 2,976.13 € |
| Nevolat 3 mg daily (generic) | 129.77 € | 778.62 € | 1,557.24 € |
| Mysimba (tablets) | 116.69 € | 700.14 € | 1,400.28 € |
| Xenical (re-import) | 50.95 € | 305.70 € | 611.40 € |
| Orlistat 60 mg over the counter | approx. 30 € | approx. 183 € | approx. 366 € |
Own calculation based on the pharmacy retail prices. Wegovy titration: four weeks each at 0.25 / 0.5 / 1.0 mg, then 1.7 mg, then 2.4 mg. Mounjaro: four weeks each at 2.5 / 5 / 7.5 / 10 / 12.5 mg, from month six 15 mg. Excluding doctor and lab costs.
Why health insurance does not pay
The exclusion is written directly into the law. Section 34 (1) sentence 7 of Book V of the Social Code (SGB V) excludes from coverage drugs that serve “predominantly to cause weight loss or to curb appetite, to regulate body weight”. This is made concrete in Annex II of the Medicines Directive (Arzneimittel-Richtlinie), the so-called lifestyle list. The Federal Joint Committee (G-BA), the highest decision-making body of the statutory health system, expressly entered Wegovy there on 21 March 2024.
An obvious workaround is blocked: in the USA the regulator FDA granted semaglutide an additional cardiovascular indication – the European EMA, by contrast, rejected a corresponding extension of the indication. In Germany this leaves only the pure weight-management indication and the exclusion from reimbursement.
The Mainz Social Court confirmed this classification on 16 June 2025 (case no. S 7 KR 76/24). Commentators in the specialist literature criticise that comorbidities were not examined, but that does not change the legal position. Politically, health-insurance reimbursement is under discussion, but as of 14 September 2026 an amendment to § 34 SGB V has neither been passed nor come into force.
The price collapse for liraglutide
The most interesting cost development is happening away from the well-known names. Since December 2025, Nevolat, a liraglutide generic from Zentiva, has been on the market. It contains the same active ingredient as Saxenda and carries the same approval for weight reduction – but costs from 129.77 € instead of 291.92 € a month.
Over twelve months that is a difference of around 1,950 €. Liraglutide does have to be injected daily rather than weekly and achieves smaller weight losses in studies than semaglutide or tirzepatide. For self-payers, however, the price gap is large enough to raise it in the conversation with the doctor.
Prices are the same everywhere
Comparing pharmacies gets you nothing for prescription-only products: the Drug Price Ordinance under § 78 of the Medicines Act (AMG) sets a uniform nationwide pharmacy retail price. If you find different amounts online for the same strength, you are almost always looking at parallel imports or re-imports from other suppliers – which are sometimes more expensive than the original.
The only legal price lever for self-payers is the prescription bonus (“Rx-Bonus”) from mail-order pharmacies based in the EU. Depending on the provider it ranges between 2.50 and 20 € per medicine and applies to private prescriptions, self-payers, privately insured people and those exempt from co-payments – not to people on statutory insurance who redeem an e-prescription digitally. Measured against annual costs of 3,000 € and more, that is a footnote.
Incidental costs that are often forgotten
- Medical consultation: under item 1 of the German fee schedule for doctors (GOÄ) at the 2.3 times rate, 10.72 €; for a detailed consultation of over ten minutes (item 3) correspondingly more. Issuing the private prescription is included in the consultation item and may not be charged extra.
- Lab values: a check-up package with a full blood count, liver values, kidney values, blood sugar and lipid status costs around 57.50 € as a self-pay service.
- Pen needles: 100 needles cost between about 6 and 34 € depending on the brand. With weekly injections that is around 1.40 € a month, with daily use about 10 €. Health insurance does not cover them as part of this therapy.
- Cooling: all pens must be kept refrigerated (2 to 8 °C). For shipping, the insulated packaging is included in the price at the large mail-order pharmacies.
What health insurance covers instead
The reimbursement exclusion only affects medicines. Statutory health insurance does pay for three services around obesity:
DMP obesity. Since 1 July 2024 there has been a structured disease management programme for adults with a BMI of 30 to 35 plus at least one comorbidity, or a BMI of 35 and above. Participation is free of charge. The G-BA has, however, expressly stated that appetite-suppressing medicines cannot be part of the programme.
Oviva Direkt for obesity. This digital health app is prescribed on form 16 and paid for 100 % by statutory insurance. The insurer bears the list price of 243 € per 90 days; insured people pay nothing.
Nutritional counselling and prevention. Under § 43 SGB V, insurers usually subsidise nutritional counselling by up to 80 % for five to ten sessions; a medical certificate of necessity is required. In addition there are prevention courses under § 20 SGB V, usually two a year. The exact rates differ considerably between insurers – a phone call is worth it.
Tax-deductible?
A deduction as extraordinary expenses under § 33 of the Income Tax Act (EStG) is possible but subject to conditions: a diagnosed illness, medical necessity, a doctor's prescription. The tax office regularly demands an opinion from a public health officer (amtsärztliches Gutachten) and proof that the insurer did not reimburse. Weight loss for purely cosmetic reasons is not deductible. In any case, only the part above the reasonable burden threshold takes effect.
There is no supreme-court ruling on GLP-1 drugs specifically so far. How strictly the tax office demands the prior health-officer certificate depends on the individual case – keep the prescription, invoices and the insurer's rejection, and if in doubt get tax advice.
What else is coming in 2026 and 2027
Since 1 September 2026, Wegovy has also been available as a tablet – Germany was the first EU market. The 1.5 and 4 mg strengths cost 172.73 € per 30 tablets, 9 mg around 233 €. The 25 mg maintenance dose was not yet listed in the Lauer-Taxe (the German drug price database) at launch; the manufacturer cites a price level comparable to the pen.
The higher semaglutide dose of 7.2 mg has been approved in the EU since 17 February 2026, and approval of a dedicated 7.2 mg pen followed in July 2026. A German market launch including its price was still outstanding at the time of going to press. CagriSema from Novo Nordisk has been applied for but is not approved; Lilly's triple agonist retatrutide is not expected in Europe before 2027/2028. Only when several active ingredients compete can noticeably falling prices be expected – as Nevolat has shown with liraglutide.
A note on reports from the USA: the price cuts announced there – for example $149 a month for oral semaglutide – apply exclusively to the US market and have no effect on German pharmacy retail prices.
Frequently asked questions about the cost of the weight-loss injection
At the target dose of 2.4 mg, Wegovy costs 277.60 € for four weeks; the starting doses cost 172.73 €. Depending on the dose, Mounjaro costs between 206.80 € (2.5 mg) and 490.01 € (15 mg) per KwikPen for four weeks. Saxenda costs around 291.92 €, the generic Nevolat from 129.77 € a month.
Yes. In Germany, prescription-only medicines are subject to the Drug Price Ordinance (Arzneimittelpreisverordnung) under § 78 of the German Medicines Act (AMG) – the pharmacy retail price is the same nationwide. Comparing pharmacies is therefore not worthwhile for Wegovy, Mounjaro and Saxenda. Only over-the-counter Orlistat 60 mg is not price-fixed.
No. Section 34 (1) sentence 7 of Book V of the German Social Code (SGB V) excludes drugs for weight regulation from reimbursement. On 21 March 2024 the Federal Joint Committee (G-BA) expressly added Wegovy to Annex II of the Medicines Directive (“lifestyle drugs”). The Mainz Social Court confirmed this classification on 16 June 2025 (S 7 KR 76/24). No change in the law is in force in 2026 either.
Yes. Ozempic and Rybelsus are approved exclusively for treating type 2 diabetes and therefore do not fall under the lifestyle exclusion – for this indication they are reimbursable. If the same products are used off label solely for weight loss, the insurer does not cover the costs.
That depends on your policy and the individual case. The yardstick is medical necessity under § 192 of the German Insurance Contract Act (VVG). There is no general duty to reimburse: on 21 May 2026 the Nuremberg-Fürth Regional Court (8 O 4860/25) dismissed an insured person's claim for reimbursement of Mounjaro because, at a BMI of around 34, no medical treatment plan had been presented and cheaper measures had been skipped. Obtain written confirmation of cost cover before starting treatment.
No. The Beihilfe rules (the state aid scheme for German civil servants' healthcare costs) exclude expenses for drugs that serve predominantly to regulate weight – without exception, even at a high BMI. The only exception is for products with dual approval, if the doctor confirms on the prescription that the use is for treating diabetes.
Possibly, as extraordinary expenses under § 33 of the German Income Tax Act (EStG) – provided there is a diagnosed illness and the treatment is medically necessary and prescribed by a doctor. The tax office regularly demands an opinion from a public health officer (amtsärztliches Gutachten) and proof that the insurer does not reimburse. Only the amount above the reasonable burden threshold is deductible. There is no supreme-court ruling on GLP-1 drugs specifically so far; have your individual case reviewed by a tax adviser.
A medical consultation under item 1 of the German fee schedule for doctors (GOÄ) costs 10.72 € at the 2.3 times rate; a detailed consultation costs more. The private prescription itself may not be charged separately. A lab package for the initial diagnosis costs around 57.50 € as a self-pay service. Pen needles cost about 1.40 € a month with weekly injections, or around 10 € with daily use.
Since 1 July 2024 there has been a structured disease management programme (DMP) for obesity for adults with a BMI of 30–35 plus a comorbidity, or a BMI of 35 and above – free of charge for insured people. Medication is expressly not included. Also reimbursed are the digital health app Oviva Direkt (243 € per 90 days, free for insured people), subsidised nutritional counselling under § 43 SGB V and prevention courses under § 20 SGB V.
For risks and side effects, read the package leaflet and ask your doctor or pharmacist.
