Update (Oct 2025): Costco pharmacies are now offering Wegovy and Ozempic for $499/month (4-week supply) to members who pay cash and present a valid prescription. Yeah, you read that right.
Why Costco Is Making This Move
Let’s be real—this isn’t charity. Costco partnered with Novo Nordisk because they saw an opportunity to shake things up. Here’s what’s driving this:
- Making FDA-approved GLP-1 pens actually accessible. For years, patients have been stuck between insurance denials and sky-high list prices. Costco’s flat $499 removes the guessing game.
- Putting pressure on compounding pharmacies. Remember when compounded semaglutide was the only affordable option? Now that supply is stabilizing and the FDA is cracking down harder, Costco is positioning brand-name drugs as the safer, legitimate choice.
- Transparency wins customers. No insurance hassles, no prior authorizations, no surprise bills. Just a simple price and a prescription.
Does This Threaten Medspa GLP-1 Revenue Streams?
Honestly? Yes and no.
It absolutely threatens your margin on the medication itself. But here’s the thing: it doesn’t touch the real value you bring to the table—patient management, customized protocols, follow-ups, coaching, lab monitoring, side effect management, and actually helping people keep the weight off.
Big box pharmacies compete on price. They’re selling pens. You should be selling results.
Key Differences: Pen Sales vs. Program-Driven Care
| Aspect | Retail Pharmacy / Costco | High-Quality Medspa Program |
|---|---|---|
| Drug price | Flat $499 (prescription + pay cash) | Often bulk-purchased with tighter margins, some savings passed to patient |
| Monitoring & safety | Minimal (basic pharmacy counseling) | Lab work, side effect management, dose adjustments, actual oversight |
| Support & adherence | Patient navigates alone | Health coaching, nutrition guidance, GI protocols, strength training, relapse prevention |
| Outcome focus | Weight loss number on a scale | Body composition, metabolic health markers, long-term sustainability |
Strategies Medspas Should Use to Stay Ahead
1. Lead with Structure, Not Shots
Stop selling injections. Start selling 12- to 24-week programs that include GLP-1s (whether you dispense them or coordinate with pharmacies) plus nutrition coaching, skin tightening, lab monitoring, and a tapering plan. The drug becomes one tool in your toolbox, not the entire product.
2. Position Safety, Authenticity & Trust
This is your moment to differentiate. Emphasize that you use FDA-approved brand pens, not compounding formulations with murkier safety profiles. Consider adding an explainer on your website: “Why We Don’t Use Compounded Semaglutide” that references FDA warnings. That’s a positioning advantage that’s really hard to commoditize.
3. Flexible Pricing Models
Not everyone needs the same level of support. Consider offering:
- Program only: Client sources the pen from Costco or their preferred pharmacy. You provide oversight, coaching, labs, and protocols.
- All-inclusive: You bundle the pen with monitoring, side effect protocols, and adjuncts like GI support formulas, supplements, B12 injections, etc.
- Maintenance / off-ramp: After GLP-1 treatment ends, continue metabolic coaching, strength training, and relapse prevention to help patients maintain their results.
4. Use Group Education & Community
Monthly group sessions, Q&A forums, and peer support increase adherence and make patients feel less alone. It also lowers your per-client cost for education delivery—win-win.
5. Be Data-Driven & Outcome-Oriented
Track body fat percentage, visceral fat, labs (A1C, lipids), and adherence rates. Show patients dashboards. Market your results, not your dosages. “We helped 87% of our clients maintain their weight loss 12 months post-treatment” is way more compelling than “We offer semaglutide.”
Risks & Realities You Can’t Ignore
Let’s not sugarcoat this. There are real challenges:
- Side effects are real. Nausea, GI issues, and rare but serious risks like pancreatitis mean you need solid monitoring protocols in place.
- Patient expectations can be unrealistic. Some people think GLP-1s are magic. Create honest, upfront messaging about what these medications can and can’t do.
- Access and affordability still matter. Even at $499, that’s out of reach for a lot of people. Consider payment plans or tiered service offerings.
- Regulation and liability aren’t going anywhere. Stay compliant with local prescribing rules. Document everything—consent forms, side effect protocols, monitoring schedules.
Costco entering the GLP-1 market changes the battlefield for drug margins, but it doesn’t kill the medspa opportunity. Not even close.
The winners will be the ones who lean hard into clinical value, patient experience, and sustainable outcomes—the stuff that can’t be replicated by a big box store.
If you’re running a medspa with weight management programs, now is the time to audit your messaging, tighten your protocols, and double down on the value that can’t be commoditized. Because cheap pens are coming.
Superior outcomes? Those still belong to you.