40 of 103 GLP‑1 packages have a federal acquisition cost, priced per pen
Only 40 of 103 GLP-1 packages have a federal acquisition cost. We convert each NADAC rate per millilitre into a GLP-1 cost per pen. See the full table.
Published Aug 16, 2026 · Updated Oct 7, 2026
40 of 103 GLP-1 packages listed in the FDA National Drug Code directory have a CMS acquisition cost that resolves to a price per package, as of the NADAC file effective October 7, 2026.1 CMS publishes a rate per pricing unit — per millilitre for the injectables — and a pen holds 3 mL, so a usable figure is the NADAC rate multiplied by the FDA pack size. This is the only public acquisition-cost figure per pen; manufacturers publish list and cash prices, which are different numbers. What resolves here is what a pharmacy pays to buy the product, not a retail price.
Key findings
1. Per millilitre, the range is 20.6 times wide. Per package, it is 2.5 times
This is the whole reason the page exists. CMS publishes NADAC as a rate per pricing unit, which for the GLP-1 injectables is a millilitre.1 Across the 40 packages that price, that rate runs from $33.13 to $681.26 per millilitre — a 20.6 times spread. Multiply each rate by the pack size the FDA lists for that same product code2 and the spread collapses to 2.5 times: $526.49 to $1,306.89 for a package a pharmacy actually orders. A per-millilitre comparison between two GLP-1s is not a price comparison. It is a comparison of how concentrated they are.
2. The dearest millilitre is not the dearest box
BYETTA 5 MCG DOSE PEN INJ carries the highest per-unit rate on the file at $681.26 per ml, but that package holds only 1.2 ml, so it costs $817.52.12 VICTOZA 2-PAK 18 MG/3 ML PEN has a per-unit rate of $87.75 — a fraction of it — across 6 ml, for $526.49 a package. The cheap-per-millilitre product is roughly 64.4% of the expensive one's package price rather than the small fraction the unit rate implies.
3. 40 of 103 listed packages resolve to a price at all
The FDA's National Drug Code directory lists 103 GLP-1 packages we track.2 40 of them — 38.8% — have a NADAC rate and a pack size that can both be read, which is what a per-package figure requires.1 The rest are dropped rather than estimated. A package fails this test when CMS has surveyed no rate for it, or when the FDA's pack description cannot be parsed into a number of pricing units without guessing. The mean package cost across the ones that do resolve is $1,062.78.
4. Across 13 dated files, the rates barely move
CMS republishes NADAC weekly, and we hold 13 dated files of it, spanning February 2025 to October 2026.1 Take the 34 product codes that appear in at least four of them and compare each code's earliest file with its latest: 27 rose, 7 fell, and the mean change is +0.8%. Acquisition cost for these products is close to flat, which is worth knowing before anyone reads a single week's file as news.
5. What this cost is, and what it is not
NADAC is the survey of what retail pharmacies pay to acquire a drug.1 It is not the manufacturer's list price, not a negotiated net price after rebates, and not what anyone pays at a counter. It is the closest thing to a wholesale cost that exists in public federal data, and it is published per pricing unit because that is what CMS needs it for. Turning it into a price per pen is arithmetic on two federal files, and it is the only place we know of where that arithmetic is published.
Every record behind the figure (40)
The complete list, so the count can be checked rather than taken on trust. Names link to the page for that record where one is published.
How this figure is derived
Two files, joined on the eleven-digit National Drug Code. From CMS we take the latest NADAC rate per unit for each code, effective 6 October 2026.1 From the FDA's NDC directory we take the same code's package description and parse it into a number of pricing units — an Ozempic pen described as 3 mL is 3 units at a per-millilitre rate.2 Package cost is the product of the two.
A package is included only when both halves resolve. No rate, or a package description we cannot parse into a unit count without inventing one, and the row is dropped. That is why 40 of 103 listed packages appear, and the gap is stated on the page rather than closed with an estimate.
Compounded preparations are absent by construction, not by choice. They have no National Drug Code, so CMS never surveys them and no federal acquisition cost exists for them at any price.
Before quoting this number
Each of these changes what the figure means. They are numbered so a quotation can name the one it breaks.
- A pharmacy acquisition cost is what a pharmacy pays a wholesaler. It is not a retail price, not a manufacturer list price, and not what a patient pays.
- A package with no NADAC rate, or whose pack size cannot be parsed from the FDA listing, is excluded rather than estimated. That is why the two counts differ.
- Compounded preparations have no National Drug Code and no NADAC rate, so they do not appear here at all.
- 1.CMS National Average Drug Acquisition CostThe weekly survey of what retail pharmacies pay to acquire each drug, per pricing unitCenters for Medicare & Medicaid Services↩
- 2.FDA National Drug Code directoryLabeler, product and package listings, including pack sizeU.S. Food and Drug Administration↩
NADAC figures are pharmacy acquisition costs, not retail prices and not what you will pay. This content is educational and is not medical advice.