HealthRX.com · Printable cost worksheet
Online weight loss injection cost comparison worksheet
Use this sheet to compare the total cost of the exact approved weight loss injection, dose and supply period from each seller before buying, and to bring the results to your prescriber or pharmacist.
Product and supply being compared
Write what the prescription says, not a headline monthly price.
Exact product name on prescriptionWrite the brand or generic name exactly as printed
Dose strength being quotedWrite the strength on the quote and the strength on the prescription
Dosing frequencyWrite weekly or daily as the product label states
Length of supply comparedWrite the same supply period for every seller
Dose step up plan from prescriberWrite each later strength and when the prescriber expects it
Before you compare prices
Complete these before you accept any quote.
- Confirm the product is one of the FDA-approved weight-management injections named in the article
- Note that Wegovy tablets and Foundayo tablets are non-injection products and are not the same as injections
- Check whether the seller asks for screening and a prescription from a licensed doctor
- Confirm the pharmacy name, address and state license before paying
- Note any shipping, handling or refrigeration fees added to the total
- Check that the label spelling and pharmacy details match what the seller states
- Bring the completed comparison table to your prescriber or pharmacist
Price comparison across sellers
Use the same supply period for each row.
| Seller name | Product and strength | Total for supply | Shipping or fees | Red flags seen |
|---|---|---|---|---|
Questions to ask before you buy
- Which approved product do you recommend for my situation?
- What is the total cost of the full supply period you prescribe?
- How will the cost change when my dose steps up?
- Does my insurance cover this exact product and strength?
- Is there a covered alternative if this product is not covered?
- Which pharmacies in my state can fill this prescription?
- What should I do if the medicine arrives damaged or without instructions?
- Who can I contact with questions after I receive the medicine?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.