The GLP-1 economy in five minutes: verified drug prices, and the business behind them.
The flattering number.
Three cardiovascular results landed in one month, from Lilly and from Novo. In every one, the number being shown to you is not the number the company agreed in advance would count.
THE SKIM
- Three cardiovascular results landed this month, and in each one the number in the press release is not the number the company agreed in advance would count.
- The FDA approved a heart label for Mounjaro on August 28 on a trial where Lilly’s own release says superiority “was not established.”
- Two of the four sellers listing the pill at $149 stop that price on August 31. The one carrying our floor publishes no end date, so we check that morning.
On August 28, 2026, the FDA approved Mounjaro to lower the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes. Lilly’s own release, in the same document, says superiority “was not established.”
Both sentences are true. That gap is this edition.
The floor
THE FLOOR
United States
$149 USD/mo
Wegovy pill, NovoCare
Canada
C$88 CAD/mo
Apo-Semaglutide, Costco
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Cheapest verified price we hold per market, promotional and introductory offers excluded.
Every figure above, and every other price we hold, is on the price board with the date we checked it and the method we used.
The flattering number
THREE HEART RESULTS IN ONE MONTH: what each company measured, and what each one showed you instead.
Three cardiovascular results landed on this beat in a single month, from both companies, on three different drugs. In every one, the figure being promoted is not the figure agreed in advance.
Start with the word that makes this readable. Pre-specified means the company said before the trial which number would count. You commit up front, so you cannot go looking for a better one afterwards.
Mounjaro, August 28. The FDA approved the heart label on SURPASS-CVOT, 13,299 people over a median four years. The trial was not built to show Mounjaro was better. Its main goal was non-inferiority, meaning not meaningfully worse, and the comparison drug was Trulicity, an older Lilly medicine, rather than a placebo. The result was a hazard ratio of 0.92, an 8% lower rate, with a confidence interval of 0.83 to 1.01. That range includes 1.00, the value meaning no difference at all, so the 8% is not statistically significant. Lilly says it plainly: “Superiority to dulaglutide was not established.”
STEER, Novo’s answer. Semaglutide against tirzepatide, 10,625 patients per group, reporting semaglutide cut serious heart events by 57%. That 57% is the per-protocol analysis, counting people who stayed on treatment as directed. Intention-to-treat, counting everyone assigned at the start, gives 29%. Same study, both numbers. And STEER is not a trial: it is a retrospective look back through an insurance claims database, hosted on Novo’s own science site, so it cannot establish that one drug beats the other.
TRIUMPH-3, Lilly again. Retatrutide, in 1,949 people picked for already having heart disease, where a benefit should be easiest to find. The pre-specified results: a hazard ratio of 0.82 on the broader heart endpoint, 1.12 on the narrower one. Every interval crosses 1.00. The 1.12 is numerically worse than placebo, on more events in the drug arm. The better-looking numbers come from a second analysis, which Lilly itself labels not pre-specified.
Here is the part that is hard to unsee. Novo is suing Lilly over comparative advertising, arguing in its own filing that Lilly’s ads lean on a trial run at doses that no longer reflect practice. No judge has ruled. And while that case waits, both companies are building heart claims out of the more flattering of two numbers they generated themselves.
Nobody in this category has yet shown a randomised win on cardiovascular outcomes with their own newest drug. Three tried this month.
Downticks
the week's business, in short
The other hook
On September 9, 2025, eleven months before Lilly sued anyone, the FDA wrote to a website selling compounded retatrutide, drugs mixed to order rather than made by the manufacturer, and told it the product was an unapproved new drug. It was one of dozens of such letters. That matters because it rests on a different law from the compounding rules everyone is watching. Those govern pharmacies. The unapproved-drug provisions reach anyone putting a product into US commerce, pharmacy or not. Whether the FDA uses that at scale, or stops at letters to offshore websites, decides whether the peptide channel is reachable at all.
Three catches in the $50 door
Medicare’s GLP-1 Bridge offers weight-loss drugs at a $50 copay, and it carries three qualifiers CMS states plainly and almost nobody repeats. The $50 does not count toward your true out-of-pocket total, the running tally that eventually moves Medicare’s drug coverage, Part D, into its cheapest phase. There is no low-income subsidy for it. And having a condition these drugs are already approved to treat, type 2 diabetes, moderate to severe sleep apnea or MASH, a form of fatty liver disease, makes you ineligible even if you meet every clinical criterion. Note where Mounjaro’s new heart label lands: in type 2 diabetes, on the far side of that wall.
Watching for
what moves next.
- The pill price, on the morning of August 31. NovoCare’s $149 price for the 4 mg Wegovy pill runs out that day and becomes $199, and Costco’s programme banner prints the same date. The federal listing that currently carries our floor publishes no end date at all. We check all three, and alert-holders hear the day any of them moves.
- The injunction ruling in Novo Nordisk’s case against Eli Lilly, day 12. Briefing closed on August 18, 2026. As of the last refresh of the court’s public case file available to us, dated August 28, there were 59 entries and no ruling. The clerk’s order says the motion “will be decided on the papers and no appearances are required,” so it can arrive any morning without a hearing. Two recent entries are typed as motion hearings, which would cut against that, and neither document was readable at press time.
- Sevmia, day 62 approved and unsold in Canada, and Novo’s own twins at day 251. We re-checked Health Canada’s Drug Product Database, its public listing of every drug cleared for sale, on August 30: 22 product listings approved and none carrying a market date.
That is the brief. Same time Wednesday.
Updated September 2, 2026: this edition framed the injunction motion as one that could be decided without a hearing, on the clerk’s automated on-the-papers language, and noted two docket entries typed as motion hearings that we could not read. A filing published on September 1 shows a hearing did take place, and that Novo Nordisk gave a closing argument at it, on August 28, 2026, two days before this edition was published. The hearing had already happened when we said it might not. Corrections will always be here.