How much does orlistat cost per month?

Prescription Xenical at 120 mg runs about $200 to $400 a month. Alli, the over-the-counter version at 60 mg, runs about $40 to $60 a month. Prices vary by pharmacy and retailer.

What is the difference between Xenical and Alli?

They are the same drug at different strengths. Xenical is orlistat 120 mg on prescription. Alli is orlistat 60 mg over the counter. The Alli label limits it to overweight adults aged 18 and over, used alongside a reduced-calorie, low-fat diet.

Is Alli covered by insurance?

Over-the-counter purchases are generally not covered by insurance. That said, at about $40 to $60 a month, Alli is cheaper than the copay on many prescription weight loss medicines.

Are there hidden costs with orlistat?

One small one. Both labels recommend a daily multivitamin containing fat-soluble vitamins, taken at bedtime. That is because orlistat reduces how much of those vitamins your body takes up. Budget for it alongside the drug itself.

Why is orlistat so much cheaper than the GLP-1 drugs?

It has been approved since 1999 and has long been off patent, with an over-the-counter version available. The branded injectable GLP-1s are far newer, and still under patent. That is why their monthly prices run into four figures.

Xenical and Alli cost

What you'll actually pay

Alli 60 mg, over the counter

~$40–$60/mo

No prescription needed. Half the prescription strength.

Prescription Xenical 120 mg

~$200–$400/mo

Pharmacy retail range

If your plan covers it

Varies by plan

Over-the-counter Alli is not usually covered at all

Alli is the same active ingredient at 60 mg rather than 120 mg. The trial figures quoted on this site come from the prescription-strength studies.

Where orlistat sits

$0/mo$1,400/mo

Over-the-counter Alli $40–$60Prescription Xenical $200–$400Branded injectable GLP-1s $1,000–$1,086

Detailed pricing

Orlistat: prescription and over the counter

Orlistat: prescription and over the counter
Option	Cost/Month	Notes
Alli 60 mg (over the counter)	~$40–$60/mo	No prescription needed. Label limits use to overweight adults 18 and over.
Prescription Xenical 120 mg	~$200–$400/mo	Pharmacy retail range
With insurance	Varies by plan	Over-the-counter purchases are generally not covered

List prices from the manufacturer and pharmacy pricing recorded in the site's cost data, last checked September 2026. Both labels pair the drug with a reduced-calorie, lower-fat diet, and both recommend a daily multivitamin taken at bedtime.

Insurance coverage reality

Orlistat is unusual among weight loss medicines. The over-the-counter version removes the insurance question entirely. At $40 to $60 a month, Alli is bought like any other pharmacy product, and insurance generally does not cover over-the-counter purchases. For prescription Xenical, coverage varies from plan to plan, and many plans require prior authorisation. Budget for the multivitamin as well. Both labels recommend one daily, because orlistat reduces absorption of fat-soluble vitamins.

How to get the lowest cost

Consider the over-the-counter strength

Alli is orlistat at 60 mg rather than 120 mg, and runs about $40–$60 a month against $200–$400 for prescription Xenical. Discuss with your doctor or pharmacist whether it suits you.

Compare pharmacies

Both the prescription and over-the-counter versions vary in price between pharmacies and retailers. It is worth checking a few.

Budget for the multivitamin

Both labels recommend a daily multivitamin containing fat-soluble vitamins, taken at bedtime. It is a small but real ongoing cost.

Check coverage for the prescription version

If you are prescribed Xenical, ask your insurer whether orlistat is on the formulary and whether prior authorisation is needed.

Common questions

Written and maintained by one person · Built with agentic AI tools · Every number checked against the cited trial · Not medical advice

How this site is built →

Keep reading

Full Xenical and Alli overview →Xenical and Alli trial results →Xenical and Alli side effects →What to expect week by week →All drug prices side by side →All orlistat clinical evidence →

Next step most people take

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Built with agentic AI tools and not a substitute for medical advice

Last reviewed: September 2026

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Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment. Prices shown are United States self-pay or list prices and vary by insurance and country.