Trulicity starts at $389 a month self-pay, at every one of its four doses. That figure is Lilly’s own[3]. Ozempic costs $349 a month up to 1 mg[5]. At those doses Trulicity’s figure is $40 more. At Ozempic’s 2 mg dose, it is $110 less[5].
Two weekly GLP-1 drugs
Both are once-weekly injections for blood sugar control in type 2 diabetes[1][2]. Trulicity’s label also covers children 10 and older[1]. Each adds a heart indication[1][2]. Trulicity’s includes adults with multiple cardiovascular risk factors, not only established disease[1]. Ozempic’s adds a kidney indication[2].
Neither is labeled for weight loss. Semaglutide for weight is sold as Wegovy, a separate product with its own price.
Price by dose step
| Dose step | Trulicity | Ozempic |
|---|---|---|
| Start | 0.75 mg: from $389 | 0.25 mg: $199 (new patients, first 2 fills) |
| Second step | 1.5 mg: from $389 | 0.5 mg: $199 intro, then $349 |
| Third step | 3 mg: from $389 | 1 mg: $349 |
| Top dose | 4.5 mg: from $389 | 2 mg: $499 |
Trulicity starts at 0.75 mg, moves to 1.5 mg, then rises in 1.5 mg steps to 4.5 mg[1]. Each step waits at least four weeks[1]. Ozempic runs 0.25, 0.5, 1 and 2 mg, with at least four weeks per step[2].
Lilly’s card terms define a Trulicity month as 28 days and up to 4 pens[4]. Novo defines an Ozempic month as one box of one pen[5]. The full Trulicity picture is in Trulicity price; Ozempic’s is in Ozempic cost.
What SUSTAIN 7 found
SUSTAIN 7 randomly assigned 1,201 adults with type 2 diabetes on metformin[6]. It paired semaglutide 0.5 mg with dulaglutide 0.75 mg, and 1 mg with 1.5 mg[6]. It ran 40 weeks, open-label, funded by Novo Nordisk[6].
HbA1c fell 1.5 points on semaglutide 0.5 mg, against 1.1 on dulaglutide 0.75 mg[6]. At the higher pair it fell 1.8 against 1.4[6]. Weight fell 4.6 kg against 2.3 kg, then 6.5 kg against 3.0 kg[6]. Gastrointestinal events hit 43% and 44% on semaglutide, 33% and 48% on dulaglutide[6].
With insurance
Commercially insured patients with coverage pay as little as $25 with the Trulicity card[4]. It caps savings at $150 per 1-month fill and $1,950 a year[4]. It ends December 31, 2026[4]. Ozempic’s card also floors at $25[5]. It caps savings at $100 a month for up to 48 months[5].
Military families see a difference too. TRICARE covers both for type 2 diabetes with prior authorization[9]. It says Trulicity has the lower copayment[9]. The TRICARE rules are in does TRICARE cover Wegovy.
Medicare negotiation
CMS negotiated a Medicare price for Ozempic, Rybelsus and Wegovy together[8]. It takes effect January 1, 2027[8]. On January 27, 2026, CMS named Trulicity among 15 drugs for its third cycle[7]. That cycle’s prices apply from 2028[7]. In the 12 months to October 2025, 617,000 Medicare enrollees used Trulicity[7].
A negotiated price is not a copay. Your plan’s formulary and tier still set what you pay at the counter. Ozempic’s Medicare rules are in does Medicare cover Ozempic.
The newer rivals
Lilly’s newer diabetes drug is set against both in Mounjaro vs Ozempic and Trulicity vs Mounjaro. Compounded semaglutide is a different product, priced on the semaglutide price board.