The reimbursement of Wegovy and Mounjaro has significantly changed the bill for some patients since June 15, 2026. But the word “reimbursed” can be misleading: it means neither automatic free treatment nor coverage for everyone who may be prescribed these medicines. Depending on medical criteria, the prior care pathway and the dosage used, out-of-pocket costs can still be substantial.

To understand what Wegovy and Mounjaro reimbursement really changes, it is most useful to start with concrete cases. In France, the announced reimbursement rate is 65% for patients who meet the conditions. This makes it possible to compare the theoretical cost before and after coverage, while bearing in mind that actual amounts may vary depending on the product and dosage.

Who can actually qualify for reimbursement?

The first threshold is the initial BMI. Reimbursement applies to adults aged 18 or over with a BMI of at least 40 kg/m². It may also apply to people with a BMI of at least 35 kg/m² with an associated disease.

The comorbidities mentioned include type 2 diabetes, high blood pressure and sleep apnea. Other conditions, such as dyslipidemia, cardiovascular disease, NASH or certain disabling joint disorders, appear depending on the publication. As the lists are not perfectly identical, it is better to have your specific case confirmed by an authorized physician rather than drawing your own conclusion from a list found online.

BMI alone is not enough. Before obtaining this coverage, the patient must have undergone six months of properly conducted nutritional care, with weight loss of less than 5%. The first reimbursed prescription must then come from an authorized professional or facility: notably a CSO, a university hospital (CHU), an SMR facility with a nutrition designation, or an endocrinologist working with a CSO. The primary care physician may handle renewals afterward.

In other words, someone with a BMI between 27 and 35 without a comorbidity may remain in a situation where the medicine can be prescribed but must be paid for in full. This is probably the most important distinction: being eligible for a prescription and being eligible for reimbursement do not cover the same patients.

How much is actually left to pay?

Reported Wegovy prices range from €146.91 to €195.10 per pen depending on dosage, excluding dispensing fees. For Mounjaro, the range is €176.10 to €433.80. With 65% coverage, the patient in principle pays the remaining 35% of the applicable reimbursement basis.

As a simple calculation, 35% of €195.10 is about €68.29, while 35% of €433.80 is about €151.83. These calculations clearly illustrate the order of magnitude published by The Conversation, which estimates out-of-pocket costs at between €50 and €150 per month depending on the product and dosage.

Another annual estimate shows the difference over time. For Wegovy titrated up to 2.4 mg, the stated cost is about €2,171 per year at full price, versus about €760 after 65% reimbursement. For Mounjaro titrated up to 15 mg, the estimate falls from about €4,556 per year to €1,595. Based on these estimates, that represents theoretical annual savings of about €1,411 for Wegovy and €2,961 for Mounjaro.

The key point is therefore not simply “65% reimbursed.” For treatment continued over twelve months, eligibility can shift the patient's personal bill from several thousand euros to a few hundred euros or a little over €1,500, depending on the medicine and treatment regimen considered.

What about complementary insurance or ALD status?

It is tempting to give an out-of-pocket figure “with complementary insurance,” but there is no single reliable amount here: supplementary coverage depends on the policy and no common quantified level has been established. You therefore need to ask your insurer directly what it covers of the amount remaining after French Health Insurance reimbursement.

RNPC also reports 100% coverage for some patients with ALD status, but this information is not consistently confirmed by the other available references. In an individual case, checking with French Health Insurance and the prescriber therefore remains essential before assuming that the out-of-pocket cost is zero.

France, Belgium: the cheapest country is not necessarily the one you might expect

Belgium provides an interesting contrast. Wegovy is not reimbursed there for obesity following the decision of June 3, 2026, while Mounjaro is reimbursed only for type 2 diabetes, not for obesity alone. Yet Belgian Wegovy prices recorded in August 2026 range from €144.82 to €189.48 per month, or €1,738 to €2,274 per year, entirely paid by the patient.

The comparison shows why the listed price and the final cost must be distinguished. A medicine may have a lower sticker price in one country but ultimately cost the patient more if no reimbursement exists. In France, for an eligible person, the estimated annual cost of €760 for Wegovy is far below the unreimbursed annual Belgian range.

For Germany, no serious numerical comparison can be made here: no sufficiently documented German price is available in the references used. Giving a figure merely to complete an international table would create artificial precision. It is better to leave this entry open than to compare unverified figures.

How can you check eligibility without wasting time?

The process can be summarized in a few practical checks. The aim is to arrive at the medical appointment with the information needed to determine quickly whether the reimbursement criteria are met.

• Check your initial BMI: the threshold is 40 kg/m², or 35 kg/m² when an eligible comorbidity is present.
• Review associated diseases: they should be discussed with the physician, especially when the situation does not match the most clearly cited cases.
• Document the six months of nutritional care: reimbursement requires a properly conducted program with weight loss of less than 5%.
• Obtain the initial prescription from an authorized prescriber: the primary care physician alone does not issue this first reimbursed prescription.
• Keep the required form: a document confirming that the conditions are met must accompany the prescription each time the medicine is dispensed at the pharmacy.
• Ask your complementary insurer: specifically ask whether it covers the portion remaining after French Health Insurance coverage and within what limits.

This last step is worth taking before the first dispensing. A difference of a few dozen euros per month quickly becomes significant during prolonged treatment. It is therefore more useful to ask the complementary insurer for an answer about this specific medicine and reimbursement level than to settle for a general statement such as “pharmacy covered.”

The real calculation to make before starting

Since June 15, 2026, the question is no longer simply whether Wegovy or Mounjaro is “reimbursed in France.” You need to combine BMI, comorbidities, nutritional care pathway, authorized prescriber, dosage and complementary coverage. Two patients using the same medicine can therefore face very different costs.

For an eligible patient, available estimates show a major reduction in annual cost: about €760 versus €2,171 for Wegovy, and €1,595 versus €4,556 for Mounjaro in the cited titration scenarios. For a patient who does not meet the criteria, the 65% coverage disappears and the price remains entirely their responsibility. This difference, much more than the general reimbursement announcement, should guide budget calculations before treatment begins.