Quick answer

Semaglutide 2.4 mg for weight (2021) — the 14.9%-mean STEP 1 drug — plus the label that changed coverage forever: cardiovascular risk reduction after SELECT (2024), the door that reopened Medicare. Approved down to age 12.

MoleculeSemaglutideLabelChronic weight management (2021) · CV risk reduction with established CVD (2024) · Adolescents 12+ (2022)Dose ladder0.25 → 2.4 mg weekly · single-dose pensKey trialsSTEP 1: −14.9% · SELECT: MACE −20% · STEP 4: regain on withdrawal · STEP TEENSCash laneNovoCare self-pay pharmacy — figures move; verify currentCounterfeit noteThe most-faked pen in the class — licensed channels only

Deeper data: the trial index holds every figure above with sources; the SELECT file, the adolescent evidence.

Wegovy is semaglutide at 2.4 mg weekly, labeled for chronic weight management — and, uniquely in the class, for reducing cardiovascular risk in people with established heart disease and excess weight.

Indications and evidence

Chronic weight management in adults (BMI ≥30, or ≥27 with a comorbidity) and in adolescents 12 and older meeting criteria; plus reduction of major cardiovascular events in adults with established cardiovascular disease and overweight or obesity — the 2024 addition earned by SELECT’s 20% relative risk reduction (explainer). Core efficacy: 14.9% average loss in STEP 1.

Dosing

Weekly injection titrated over roughly 16 weeks: 0.25 → 0.5 → 1 → 1.7 → 2.4 mg. The 1.7 mg step is a recognized maintenance fallback when 2.4 mg isn’t tolerated. Planning pregnancy means stopping at least two months in advance per the label (fertility file).

Buying channels

Insurance coverage varies widely and is the single biggest cost variable (coverage file). For cash payers, Novo’s direct self-pay pharmacy channel reset the brand floor in 2025 — verify the current monthly figure on NovoCare’s own pages. The cheapest verified figures of any kind in our ledger remain compounded flat rates, with all the legal-lane caveats attached.

Safety essentials

Class boxed warning and contraindications; GI-dominant side effects; gallbladder, pancreatitis, and surgical-disclosure cautions — all on the molecule page. No oral-contraceptive interaction warning, unlike tirzepatide.

Costs in practice

Three realistic tiers: covered with a manageable copay (the best outcome — pursue prior authorization before writing it off; tactics in the coverage file); the manufacturer’s direct self-pay pharmacy channel, which brought brand Wegovy to a flat cash figure well under list in 2025 (verify the current number on NovoCare’s pages); and the savings card for the commercially insured. The cardiovascular indication matters financially, not just clinically — it is the wedge that opened Medicare Part D coverage for qualifying patients, something the weight indication alone cannot do by statute.

Who it fits, who should look elsewhere

Wegovy is the default semaglutide answer for weight management and the only choice in the class for a patient whose priority is proven cardiovascular protection without diabetes. Patients chasing maximum average weight loss will find tirzepatide’s numbers higher (head-to-head); needle-averse patients should read the oral file and its ritual honestly before assuming tablets are easier.

References

Wegovy prescribing information — novo-pi.com. STEP 1, NEJM 2021; SELECT, NEJM 2023.