Mounjaro Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Mounjaro medication with our help.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Mounjaro cost savings if eligible
If you are eligible for the Mounjaro patient assistance program you can receive your medication for free. Our monthly service fee of $49 per medication covers the cost of our services in applying for the program and requesting your ongoing refills on your behalf. If you obtain your Mounjaro through NiceRx, you will only pay $49 a month regardless of the retail price of your medication.
Am I eligible for the Mounjaro patient assistance program?
You could receive your Mounjaro without paying the full retail price if you meet the eligibility criteria for assistance. The eligibility requirements are set by the pharmaceutical companies that are providing assistance programs. At NiceRx, we review each application individually, although the main factors considered by most programs are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for Mounjaro patient assistance?
We do everything that we can to take the hassle and stress out of applying for patient assistance programs. Simply start by filling in our enrollment application. We will ask for details about your healthcare provider, your insurance, and your household income. This information is required by the pharmaceutical companies you are applying to for assistance. We may also be able to help you access patient assistance for other medications that you have been prescribed, so be sure to tell us about any medications you are taking as well as Mounjaro.
NiceRx will review the information you have provided, and if we determine that you may be eligible for assistance, we will seek to enroll you in the Mounjaro patient assistance program. We will handle the enrollment process for you by working with your healthcare provider and preparing all the required paperwork for your doctor to sign. We will also request your Mounjaro medication refills on your behalf for up to 1 year once you are enrolled in the program.
Is NiceRx a Mounjaro coupon provider?
At NiceRx, we help eligible individuals access the Mounjaro patient assistance program. This means that we are not a Mounjaro coupon, a Mounjaro discount card, or a Mounjaro copay card provider. We do not offer any medication trial offers, or free Mounjaro samples.
Can NiceRx help me get Mounjaro cheaper if I have insurance?
We may be able to help you if you have insurance, including if your insurance company will not pay for your Mounjaro medication, or if you have a high copay or coinsurance responsibility. We may even be able to assist if you do not have insurance. Please fill in our enrollment application to find out more.
How much does Mounjaro cost without insurance?
Mounjaro costs without insurance will vary depending on how much you buy and the retailer you buy it from. As a guide, Mounjaro will typically cost around $975 for four weeks of treatment. If you obtain your medication through NiceRx, you will pay a flat monthly rate of $49 per medication regardless of its retail price.
How much does Mounjaro cost with insurance?
The copay of Mounjaro will vary in line with the specific terms of your healthcare plan. For further details about what you may need to pay, your insurance provider or pharmacist will be able to calculate the copay costs with your current insurance.
What is Mounjaro?
Mounjaro is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Eli Lilly and Co. Mounjaro is classed as a GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist. GIP decreases food intake and increases energy expenditure which causes weight loss. When taken with a GLP-1 receptor agonist, it may result in greater positive effects on blood glucose and body weight.
Mounjaro is used to treat adults with type 2 diabetes mellitus. It is not for use in people with type 1 diabetes, pancreatitis, or to treat children under 18 years of age.
What doses of Mounjaro are available?
Mounjaro is available in injection form, in the following doses: 2.5 mg/0.5 mL, 5 mg/0.5 mL, 7.5 mg/0.5 mL, 10 mg/0.5 mL, 12.5 mg/0.5 mL, or 15 mg/0.5 mL single-dose pens.
Mounjaro is injected subcutaneously in the abdomen, thigh, or upper arm once weekly, with or without food. If you miss a dose, take the missed dose as soon as possible within 96 hours after the missed dose. If more than 4 days have passed, skip the missed dose and take your next dose on the regularly scheduled day.
Use Mounjaro alongside dietary changes and exercise to improve glycemic control and always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition.
Mounjaro active ingredients
FDA approval for Lilly’s Mounjaro was based on the SURPASS study, which compared Mounjaro with Ozempic, insulin glargine, semaglutide 1 mg, and insulin degludec. Participants who took Mounjaro experienced an average reduction in hemoglobin A1c, HbA1c (an indicator of blood sugar level). Participants who took a placebo saw an average increase in A1C levels.
Mounjaro side effects
The most common side effects of Mounjaro in clinical trials include:
- Nausea, vomiting
- Diarrhea, decreased appetite, constipation, indigestion, abdominal pain
In rare instances, Mounjaro can cause more serious side effects. These can include:
- Possible thyroid tumors, including thyroid cancer – do not use Mounjaro if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Inflammation of your pancreas (pancreatitis) – symptoms include severe pain in your stomach area that will not go away, with or without vomiting
- Low blood sugar (hypoglycemia) – Your risk for low blood sugar may be increased if you use Mounjaro with another diabetes medication such as a sulfonylurea or insulin
- Serious allergic reactions
- Kidney problems
- Severe stomach problems
- Changes in vision
- Gallbladder problems
Your doctor will assess the benefits of using Mounjaro against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Mounjaro to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Mounjaro drug interactions
Mounjaro can interact with other medications. These include:
- Insulin secretagogue – sulfonylurea or Insulin
- Oral medications
- Orally administered hormonal contraceptives
This list is not exhaustive and other prescription drugs may interact with Mounjaro.
You should not use Mounjaro if you:
- Are allergic to the active ingredient tirzepatide
- Are allergic to any of the other ingredients in Mounjaro
Talk to your doctor before using Mounjaro if you:
- Are taking any of the medications that could interact with Mounjaro
- Have or have had problems with your pancreas or kidneys
- Have severe problems with your stomach
- Have a history of diabetic retinopathy
- Are pregnant or plan to become pregnant – If you take oral birth control pills by mouth, you may be recommended another type of birth control for 4 weeks after you start Mounjaro and for 4 weeks after each increase in your dose
- Are breastfeeding or planning to breastfeed. It is not known if Mounjaro passes into your breast milk
Mounjaro is the trademark brand name for tirzepatide manufactured by Eli Lilly and Co. A generic version of tirzepatide is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Mounjaro savings through NiceRx.
Mounjaro manufacturer coupon
Eli Lilly offers a Mounjaro Savings Card to help eligible individuals affordable this medication. If eligible, you could pay as little as $25 for a 1-month (28 days and 4 pens) or 3-month supply (84 days and up to 12 months) of Mounjaro. The savings card is not available to government beneficiaries.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.