General Discussion

Through my employer insurance (Aetna POS flavor insurance with Express Scripts), my husband pays $35 for a month supply of Ozempic; no coupon from the manufacturer, he is prescribed to treat type 2 diabetes and a few other conditions that require weight maintenance.
As other people mention, the VA has a negotiated price for people who have it prescribed.
There's also manufacturer's coupons - even if you're on Medicare (or Medicare advantage), if your doctor prescribes it as a necessity, you should be covered with a reduced cost -well under $350 - by the coupon; we went through that between 2005 and 2011 with Humira for a Psoriatic Arthritis condition before the insurance company allowed it on the formulary.
BTW, if you go to Costco in Canada, the average 90 day Ozempic prescription costs....$175 Canadian.
In Mexico, it's around $200 -$300 USD.
Currently, GoodRX has a deal with Novi-Nordisk to supply generic Ozempic to self-paying customers for around $500 a month (vice $1k), and if you were prescribed it, they will drop the price down to as little as $25 a month depending on your insurance policy or if your doctor has an plan arrangement with them.

There has always, always been a huge mark-up in the United States when it comes to the price of drugs, and lots of various excuses given....

"Research Costs" - The most expensive exploratory initial and breakthrough research is done at teaching hospitals, medical schools, and government run research facilities, and subsidized by governments and some university benefactors, and the pharmaceutical companies typically get the drug patented by picking up and paying for dosage efficacy and deployment testing but...okay. There are some costs...just not the entirety, or even a significant majority of the costs of research.

Legal and (US specific) Advertising Costs - well, now... that can be pretty expensive, especially since a company really needs get the most eyeballs on their new wonder drug while they still own the patent.
The US is one of the few countries that allows the advertising of prescription drugs to the general public. Most other countries allow informational presentations to prescribers. But not to potential patients.
Because your doctor, your pharmacist, is supposed to be scientifically trained and knowledgeable enough to understand when a particular chemical or therapy will work for your condition, and not usually be blinded by magical thinking or potential snake oil promises just to "make you feel better".

Manufacturing, QA, packaging, and shipping costs?
Yes, those are costs, but there are economies of scale, of leveraging common practices, that can cut those costs immensely. Anyone who's taken couple Business courses, whether or not they majored in Business, has walked through various scenarios on how to cut costs...

Basically, the US has pretty much been the Feed Trough for pharmaceutical companies since the 1970's and 70's, when Advertising regulations were loosened by the FDA and Commerce Department.