How Much Does Zepbound Cost?

The exact price depends on dosage, pharmacy, location, insurance coverage, and available savings programs. Fully understanding the various factors affecting cost helps patients accurately budget for this important treatment.

Recently approved by the FDA, Zepbound shows great promise for effectively managing blood sugar and reducing appetite when combined with diet and exercise. But the high retail price raises potential affordability concerns for many patients considering the treatment. With the right insurance plan, manufacturer discounts, pharmacy choices, and financial assistance, accessing Zepbound can be made more affordable.

How Much Does Zepbound Cost?

Zepbound, a new diabetes and weight loss medication, costs approximately $1,060 to $1,200 for a 1 month 30-day supply of the common 10mg dose without insurance, when purchased through major national retail pharmacy chains like CVS, Walgreens, RiteAid, and Walmart.

This variation in upfront cost stems from each individual pharmacy’s drug markup policies, geographic location, and the specific dosage prescribed by the patient’s doctor.

For comparison, other popular GLP-1 receptor agonist diabetes and weight loss drugs like Ozempic, Wegovy, and Mounjaro retail for $850 to $1,300 for a monthly supply without insurance coverage. So Zepbound is competitively priced but still extremely expensive for most patients to afford long-term at full retail cost.

However, manufacturer copay discount programs, patient assistance programs, insurance coverage, and choosing lower cost pharmacies can significantly reduce Zepbound’s out-of-pocket cost for eligible patients.

According to Drugs.com, Zepbound costs $25 for a 1-month or 3-month prescription if you have commercial insurance and use a Zepbound savings card. Without insurance, the cost is significantly higher, with a 2.5 mg vial priced at $349 and a 5 mg vial at $499 per month through LillyDirect Pharmacy Solutions. These prices reflect recent reductions aimed at making the medication more accessible to self-pay patients.

On Lilly’s official pricing information, the list price of Zepbound is $1,086.37 per fill, but actual costs vary based on insurance coverage. With commercial insurance, patients may pay as low as $25 for a one- or three-month supply. For those without insurance, Lilly offers direct purchase options through LillyDirect, with prices adjusted to make the medication more affordable.

The article on Investopedia highlights that Eli Lilly has reduced the price of Zepbound for self-pay patients. The 2.5 mg dose now costs $349 per month, and the 5 mg dose is priced at $499 per month. Additionally, Lilly introduced 7.5 mg and 10 mg vials available for $499 per month when refilled within 45 days through the Zepbound Self Pay Journey Program. These changes aim to increase accessibility for patients without insurance coverage.

According to CNBC, Eli Lilly is offering higher doses of Zepbound through LillyDirect, with the 2.5 mg vial priced at $349 and the 5 mg vial at $499 per month. The 7.5 mg and 10 mg vials are also available for $499 when refilled within 45 days, increasing to $599 and $699, respectively, if refilled outside this timeframe.

Lastly, US News reports that Eli Lilly reduced the price of Zepbound’s starter dose to $349 per month, with larger doses available for $499 per month through the self-pay program. This move aims to make the medication more accessible to those without insurance coverage.

What is Zepbound?

Zepbound contains the active drug tirzepatide, classified as a GLP-1 receptor agonist. Manufactured by global pharmaceutical company Eli Lilly, it works by mimicking the natural hormone GLP-1 to help regulate blood sugar levels after meals. It also suppresses appetite by slowing digestion and increasing feelings of fullness.

The FDA approved prescription Zepbound in May 2022 for treating chronic weight management in adults with obesity or overweight, and managing blood glucose for adults with Type 2 diabetes. Large scale clinical trials demonstrated Zepbound’s effectiveness for significant weight loss, HbA1c reduction, and overall glycemic control.

Zepbound is administered via easy self-injection once per week, available in 5mg, 10mg, and 15mg dose options. Generally, higher prescribed doses lead to increased weight loss results. Patients inject Zepbound using an provided pen below the skin into the abdomen, thigh, or arm.

Health Insurance

Unfortunately, health insurance coverage for Zepbound can vary widely depending on each patient’s specific insurance plan, the insurer, and benefits details. Both private insurance and government programs may cover a portion of the cost, but often with some restrictions or limitations.

Private Insurance – Currently, only some private insurance plans cover Zepbound prescriptions, either as a general prescription benefit or specifically under diabetic care. However, many major insurers still officially classify Zepbound primarily as a weight loss drug rather than for diabetes, and exclude it from formulary coverage for that reason. Prior authorization paperwork and documentation is often required for coverage.

You might also like our articles on the cost of weight loss injections, Ozempic, or Red Mountain Weight Loss.

Medicare Part D – Zepbound is still not covered or reimbursed under most Medicare Part D prescription plans. However, Medicare recipients can file appeals and submit documentation in order to potentially gain individual approval on a case-by-case basis for coverage.

Medicaid – State Medicaid programs have some flexibility in covering newer weight loss treatments like Zepbound. But coverage varies widely depending on location, and prior authorization is commonly required from the prescribing doctor to confirm medical necessity.

For insured patients, confirming specific benefits and prescription coverage details with their insurance provider is crucial. With the right plan and approved prior authorization, copays can cost as little as $25 for Zepbound. But without coverage approval, out-of-pocket costs remain near full retail pricing of over $1,000 per month.

Zepbound Discount Programs and Savings

Zepbound Savings Card – For eligible insured patients, the Zepbound manufacturer Eli Lilly offers a copay savings card that can reduce monthly out-of-pocket costs to as little as $25. Restrictions apply, verify coverage through Lilly’s website or doctor’s office.

Zepbound Free Trial Prescription Card – This provides a one-time trial Zepbound prescription at no cost to the patient, allowing them to start treatment and determine effectiveness before purchasing. Must meet program conditions.

GoodRx and SingleCare Prescription Discounts – These popular prescription price comparison platforms list discounted Zepbound pricing ranging from $730 to $800 per month supply depending on the dosage. Represents significant average savings of around 30% off full retail costs.

Patient Assistance Programs – Nonprofit organizations like the PAN Foundation and NeedyMeds offer Zepbound for little to no cost for insured and underinsured patients that meet financial need eligibility requirements and qualify through an application process.

Choosing lower cost pharmacies like Costco’s mail order pharmacy and Walmart’s ReliOn lineup also reduces monthly costs. Stacking multiple discounts and assistance programs provides maximum savings on Zepbound.

Factors Affecting Zepbound’s Price

• Prescribed Dosage and Frequency – Higher 10mg and 15mg dose vials cost more than the 5mg dose. Less frequent usage also lowers costs.
• Pharmacy Pricing Variations – Online mail order and wholesale pharmacies offer lowest pricing. Local independent pharmacies vary widely in pricing markup policies.
• Geographic Region – Some differences exist in medication costs regionally between states, rural vs urban locations, etc.
• Availability of Coverage – Lack of insurance coverage leads to paying full high retail list pricing. Prior authorization is key.
• Manufacturer Discounts – Eli Lilly offers copay cards for insured patients to reduce copays to as low as $25 per fill.
• Generic Availability – Currently no generic Zepbound alternative exists, only the brand name version from Lilly.
• Financial Assistance Eligibility – Uninsured or underinsured lower-income patients struggle most with affordability without assistance.

Get Zepbound at the Lowest Price

1. Verify your insurance plan’s prescription coverage and get prior authorization from your doctor if required by your insurer. This ensures lowest copays.
2. Enroll in available manufacturer discount programs like Lilly’s Zepbound Savings Card and trial offer while insurance coverage is pursued.
3. Use prescription price comparison sites to find the pharmacy with the lowest monthly pricing on Zepbound near you.
4. Consider using lower cost alternative GLP-1 medications like Mounjaro or Ozempic if prescribed by your physician.
5. Apply to nonprofit assistance programs like NeedyMeds and PAN Foundation if monthly costs remain unaffordable based on financial eligibility.
6. Ask your doctor about samples and discuss the clinically optimal dosage and injection frequency for your situation to minimize costs.

With the right insurance plan, prudent pharmacy selection using pricing tools, stacking multiple discounts and financial assistance options, the innovative diabetes and weight loss treatment Zepbound can become a more affordable option accessible to a wider range of patients in need.

Is the Price of Zepbound Worth it?

For those struggling with obesity or type 2 diabetes, Zepbound provides a powerful new weapon to fight these chronic metabolic conditions and improve health when combined with lifestyle adjustments. But high monthly costs place a heavy burden on many households.

For patients with insurance coverage, Zepbound offers good value by reducing dangerous health complications like heart disease, kidney damage, and stroke risk that stem from diabetes and obesity. But uninsured patients face difficult affordability tradeoffs and access barriers.

In time, wider coverage and generic availability should improve access to this breakthrough medication for more patients. But until then, the full value proposition will remain complicated given the current high pricing.

Expert Insights

Dr. Priya Monroe, Endocrinologist:

“I recommend patients start by checking their insurance formulary for Zepbound coverage and copays. Filing an appeal or prior authorization is crucial if initially excluded. There are also great resources to find discounts.”

Gina Thompson, Patient Advocate:

“Don’t assume Zepbound is unaffordable. Between manufacturer coupons and nonprofit groups offering free medication, most patients can find help accessing this treatment through some channel.”

Phillip Chang, Pharmacist:

“I always advise patients to compare pricing between local pharmacies, mail order, and online platforms. Even within the same zip code, I’ve seen a $300 difference in monthly costs.”

Final Words

While the retail cost of Zepbound is quite expensive, manufacturer savings cards and insurance coverage can dramatically reduce monthly out-of-pocket pricing. Patients should thoroughly explore all options to find the most budget-friendly solution for accessing this new medication.

Answers to Common Questions

How long can you leave Zepbound out of the fridge?

Zepbound can be kept at room temperature below 86°F for up to 14 days. Any unused medication must be discarded after 2 weeks outside the refrigerator to maintain drug integrity.

What not to take with Zepbound?

Patients should avoid NSAIDs like ibuprofen when taking Zepbound, as the combination increases the risk of kidney problems. Also discuss any diuretics, insulin, and other diabetes medications with your doctor.

Can you take Zepbound every other week?

No, Zepbound is only approved for once-weekly administration. Taking it less frequently than prescribed reduces effectiveness and is not recommended. Follow your doctor’s exact dosing instructions.