How much is Zepbound without insurance?
Key highlights
- According to the manufacturer, the list price for Zepbound is $1,059 for a 28-day supply of Zepbound. The price can vary depending on your insurance coverage, your eligibility for the savings card program, and the pharmacy you purchase from.
- Your out-of-pocket costs for Zepbound can be much lower if you have insurance coverage or are eligible for the manufacturer savings card from Eli Lilly.
- Lilly offers the lower-strength Zepbound vials 2.5 mg and 5 mg for almost half the cost of the pens, regardless of your insurance.
- If you have commercial insurance, with or without coverage for Zepbound, you may be able to get Zepbound for a reduced price through the manufacturer’s savings card program. People with government insurance such as Medicare or Medicaid are not eligible for the program.
- Other weight loss medications may be less expensive than Zepbound so it’s important to understand which medications your insurance plan covers.
Nearly 40% of American adults have obesity and 10% have severe obesity, which potentially leads to other chronic health conditions like type 2 diabetes, high cholesterol, hypertension (high blood pressure), and sleep apnea.
While many people are unable to lose weight and keep it off with diet and exercise alone, weight-management medication is essential for sustainable health outcomes. Zepbound (tirzepatide) is a new weight loss drug that was recently approved by the FDA (U.S. Food and Drug Administration) for chronic weight management in adults with obesity or overweight.
The list price for Zepbound auto-injector pens is about $1,059 for a 28-day supply. The manufacturer also offers lower-strength single-dose vials (2.5 mg and 5 mg) for about half the price of the pen through LillyDirect.
Approximately 15 million adults in the United States may be taking weight-loss medications by 2030, representing about 13% of eligible adults with obesity or overweight. However, weight-loss medications can be expensive, especially for those without insurance, and not all insurance plans cover them.
Learn more about how much Zepbound costs out-of-pocket without insurance and how to save on Zepbound with or without insurance coverage.
What is Zepbound?
Zepbound (tirzepatide) is part of a new class of groundbreaking medications known as dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists.
It was FDA-approved in 2023 for chronic weight management in adults with obesity or overweight and at least one weight-related condition.
It’s a once-weekly injectable prescription drug that contains the same active ingredient as Mounjaro (tirzepatide). Mounjaro was FDA-approved in 2022 for controlling blood sugar levels in adults with type 2 diabetes.
The most common side effects of tirzepatide are gastrointestinal-related such as nausea, vomiting, and diarrhea.
Clinical trials for tirzepatide, the active ingredient in Mounjaro and Zepbound, have shown superior weight loss results compared to other GLP-1 weight loss drugs including semaglutide (the active ingredient in Wegovy, Ozempic, and Rybelsus), including a recent head-to-head trial. In a clinical trial conducted by Eli Lilly in 2022, participants taking Zepbound lost an average of 15-25% of their body weight (an average of 34 to 48 pounds) within 72 weeks, and about one-third of participants taking the highest strength (15 mg) lost up to 25% of their body weight or more than 58 pounds.
Eli Lilly recommends patients start with the lowest dosage and work with their providers to gradually titrate to the higher dosages as their body gets used to the medication. People taking Zepbound may find that their weight loss stops or plateaus at some point, and people who stop taking weight loss medications typically regain most of the weight they initially lost so long-term use of the medication is typically recommended.
What is the brand/generic name for Zepbound?
The generic name of Zepbound is tirzepatide, its active ingredient. Tirzepatide is also marketed by Eli Lilly under the brand name Mounjaro, for the treatment of type 2 diabetes. Neither Mounjaro nor Zepbound have a generic alternative available on the market at this time. As Zepbound was recently approved by the FDA in 2023, the manufacturer Eli Lilly & Co. will have extended patent rights and there will likely be no generic version available for many years.
Is Zepbound similar to Mounjaro?
Yes. Zepbound has the same active ingredient (tirzepatide) as Mounjaro and is manufactured by the same pharmaceutical company, Eli Lilly. The main difference is that Mounjaro is FDA-approved for type 2 diabetes and Zepbound is FDA-approved for chronic weight management. Mounjaro is commonly prescribed off-label for weight loss.
How much does Zepbound cost without insurance?
Without insurance, the cost of Zepbound auto-injector pens is about $1,059 for a 28-day supply without insurance or manufacturer savings card discounts, according to Eli Lilly. However, this is the list price and not necessarily the price you will pay at the pharmacy which can be anywhere from $1,000 to $1,500.
Zepbound single-dose vials cost $399 for a 28-day supply of 2.5 mg/0.5mL and $549 for a 28-day supply of 5 mg/0.5mL through LillyDirect’s online direct-to-consumer telehealth platform.
Unfortunately, there are no generic or biosimilar alternatives to Zepbound and other GLP-1/GIP medications available at this time.
There is currently no patient assistance program available.
Why is Zepbound so expensive?
Zepbound, like other brand-name drugs that are still protected by patent laws, has no price competition from generic or biosimilar alternatives. The manufacturer, Eli Lilly, has a monopoly on supplying Zepbound until its patent expires. The prices of brand-name drugs in the United States are 4.22 times higher than other countries on average.
The patent on Zepbound (tirzepatide) is expected to expire in 2036 which is the earliest possible date generic alternatives can be sold in the United States. The price for generic tirzepatide should be significantly less than the brand-name drug as multiple generic manufacturers will compete for market share.
Does insurance cover weight loss drugs like Zepbound?
It depends on your insurance plan. Coverage varies by insurance plan and many plans don’t cover weight loss drugs including Zepbound, including plans provided by Medicare and Medicaid.
Some plans may provide coverage with prior authorization. Check your plan’s drug formulary by logging into the member portal or calling your insurance provider directly to find out if Zepbound is covered and if prior authorization (“PA”) is required before coverage is approved. The phone number of your insurance provider should be on the back of your insurance card.
Your healthcare provider may need to document your weight and body mass index (BMI), to verify that you meet the clinical guidelines for using Zepbound including a body mass index (BMI) of 30 or greater, or 27 or greater and at least one weight-related condition such as type 2 diabetes, high blood pressure, obstructive sleep apnea, or high cholesterol. If you were diagnosed with type 2 diabetes, your insurance plan may cover Mounjaro which contains the same active ingredient, tirzepatide, and is more likely to be covered by your insurance plan as it’s FDA-approved for type 2 diabetes.
Even if you have insurance coverage, your out-of-pocket or copay amount can vary based on your plan’s coverage maximums and deductibles.
According to the manufacturer, Eli Lilly & Co., Zepbound may be covered by various types of insurance including:
Medicare
Weight loss drugs including Zepbound are not covered by Medicare Part D plans. However, Wegovy was recently FDA-approved in 2024 for reducing cardiovascular risks in adults who are obese or overweight with a cardiovascular condition, so Wegovy is covered under Medicare Part D when prescribed for preventing heart attack, stroke, or other severe cardiovascular health conditions in people who are obese or overweight. Some retiree health plans may cover weight loss medications.
Medicaid
Coverage for Zepbound under Medicaid varies by state. You can use the Eli Lilly website to check coverage through the Medicaid insurance plan in your state. Click on “Insurance through Medicaid” and select your state in the “Medicaid office” dropdown. If you are denied coverage by Medicaid, you can appeal the decision with the help of your healthcare provider.
U.S. Department of Veteran Affairs (VA)
VA may cover weight loss medications. Speak with your local VA provider about coverage and options.
Government employee benefits
Coverage varies by city, state, local municipality, or the federal department you work for.
TRICARE®
Some TRICARE® plans may cover Zepbound. Your healthcare provider can request a coverage review, similar to a prior authorization, for TRICARE® to determine if it will provide coverage. Speak with your TRICARE® provider directly to verify coverage and options.
As of July 1, 2023, 16 states cover weight loss medications (12 of which cover Saxenda, Wegovy and Zepbound):
- California
- Connecticut
- Delaware
- Hawaii
- Kansas
- Louisiana
- Michigan
- Minnesota
- Mississippi
- New Hampshire
- Pennsylvania
- Rhode Island
- South Carolina
- Texas
- Virginia
- Wisconsin
The KFF report states that South Carolina plans to add coverage for obesity medications at the end of 2024, and Connecticut has a legislative mandate to add coverage which has not yet been implemented. It’s expected that more states will add coverage for obesity medications in the future.
The American Medical Association (AMA) has been vocal about the need for insurance companies to add coverage for weight loss medications.
How much is Zepbound with insurance?
Zepbound cost with insurance depends on your insurance plan. To find out if Zepbound is covered by your plan, review the drug formulary or call the phone number on the back of your insurance card and ask if Zepbound is covered and additional coverage details including associated copays and deductibles.
If Zepbound is not listed on the drug formulary, your healthcare provider can write an appeal letter on your behalf requesting an exception and that Zepbound be covered.
How to save on Zepbound
There are multiple ways for you to save on the cost of Zepbound with or without insurance:
Zepbound Savings Card
If you have commercial insurance and don’t have any form of government insurance (including Medicare, Medicaid, or any form of state-sponsored or federally-sponsored health insurance), you may be eligible for the Zepbound Savings Card provided by the manufacturer, Eli Lilly.
- Commercially insured with coverage for Zepbound: If your commercial insurance covers Zepbound, you can pay as low as $25 for a one-month supply (28-day) or three-month supply (84-day) Zepbound prescription.
- Commercially insured without coverage for Zepbound: If your commercial insurance does not cover Zepbound, you can pay as little as $650 for a one-month (28-day) prescription.
To learn more about the savings card program in more detail and check your potential eligibility, go to Eli Lilly’s Zepbound savings card website.
Zepbound has not yet been added to the LillyCares patient assistance program.
Compounded tirzepatide
Compounding pharmacies are offering compounded tirzepatide at a fraction of the cost of brand-name Zepbound. Compounded tirzepatide has the same active ingredient as Mounjaro and Zepbound.
You can access this compounded medication through the NiceRx Weight Loss Program if approved for a prescription by a healthcare professional. No insurance is required.
Zepbound coupons and discount cards
If you are paying out-of-pocket for Zepbound, you can save by using prescription discount cards at your local pharmacy, offered by companies like GoodRx and SingleCare.
Zepbound single-dose vials
The manufacturer, Eli Lilly, offers Zepbound single-dose vials to patients directly through its “self-pay” telehealth platform, Lilly Direct. The patient will need to draw the medication out of the vial with a syringe. The medication is administered with a needle and a syringe.
The current price is $399 for a 28-day supply (4 vials) of 2.5 mg/0.5mL doses and $549 for a 28-day supply (4 vials) of 5 mg/0.5mL doses through LillyDirect’s online direct-to-consumer telehealth platform.
Zepbound alternatives for weight loss
There are several other GLP-1 and non-GLP-1 alternatives to Zepbound that may be covered by your insurance, in case Zepbound is not, including:
- Wegovy (semaglutide)
- Saxenda (liraglutide)
- Contrave (bupropion/naltrexone)
- Xenical (orlistat)
- Alli (orlistat)
- Qsymia (phentermine/topiramate)
If Zepbound is not covered by your insurance plan, check with your insurance provider if they cover any of these weight loss drugs and if so, discuss these potential treatment options with your healthcare provider.
Bottom line
Zepbound can be an expensive medication without insurance coverage given there is no generic alternative available on the market. Fortunately, there are options for you to save on this medication including the Zepbound Savings Card (if eligible), compounded tirzepatide, and prescription discount cards. You can also discuss Zepbound alternatives with your healthcare provider and find out if any other weight loss medications are covered by your insurance plan.
