Yahoo Sports New Weight Loss Drug Zepbound Cost Break Down: With and Without Insurance
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In early November, the Food and Drug Administration (FDA) approved Zepbound, a weight loss drug to help with chronic weight management in adults who have obesity or overweight. Now, the highly-anticipated medication is on the market—but what does Zepbound cost with and without insurance?
Zepbound, which is the brand name for tirzepatide, targets glucagon-like peptide 1 (GLP-1) agonists which stimulate the body to produce more insulin when blood sugars start to rise, along with something called glucose-dependent insulinotropic polypeptide (GIP) receptors. Tirzepatide was already FDA-approved for type 2 diabetes management under the name Mounjaro. Now, approved for weight loss under the name Zepbound, the drug is available in six doses—2.5, 5, 7.5, 10, 12.5, and 15 milligrams, according to Eli Lilly, which makes the injectable medication. Zepbound hitting the market raises a lot of questions, including cost. After all, these medications can be pricey and demand is expected to be high.
Meet the experts: Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center; Jamie Alan, Ph.D., an associate professor of pharmacology and toxicology at Michigan State University; Mir Ali, M.D., a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA.
“I got a barrage of questions the day that it got FDA approval,” says Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center. “Interest is extremely high.” With fellow weight loss medication Wegovy in short supply, it's fueling even more interest in Zepbound, Dr. Shah says.
Jamie Alan, Ph.D., an associate professor of pharmacology and toxicology at Michigan State University, agrees. “Patients are very excited,” she says. “This is going to be a great medication for the right patients.”
So, how much can you expect to pay for Zepbound right now? Here’s the deal.
How much does Zepbound cost with insurance?
It’s important to state upfront that insurance coverage is tricky. You can have health insurance and not have Zepbound covered by it, or your insurance may only cover some of the cost of the medication. There can also be differences in coverage between plans.
Ultimately, if you’re interested in taking Zepbound, it’s best to contact your health insurance company to ask about your particular plan’s coverage.
That said, Eli Lilly says that the drug can cost as little as $25 a month when you enroll in a commercial card savings program (more on that in a moment). It could also cost $550 a month for people with health insurance that doesn’t cover the drug.
Unfortunately, Medicare and Medicaid don’t cover weight loss medications like Zepbound, Dr. Shah says.
A representative for Eli Lilly did not immediately respond to Prevention’s request for comment.
How much does Zepbound cost without insurance?
Eli Lilly doesn’t specifically list a price tag for Zepbound without insurance. However, the company notes that people who have health insurance that doesn’t cover the medication, but who enroll in the commercial card savings program will pay about half the list price. The official Zepbound website also says that the savings program helps people with health insurance save up to $563 a month.
That would put the sticker price without insurance somewhere around $1,113 per month. (Worth noting: GoodRx has the lowest price of Zepbound currently listed at $1,025.67 when you pay out of pocket.)
Fellow weight loss drug Wegovy, which is also popular, costs $1,303 and up without insurance, per GoodRx.)
“The chances of finding somebody who can afford to pay over $1,000 for weight loss medication that doesn’t have health insurance is slim to none,” Dr. Shah says. “Accessibility is one of the biggest issues with these medications. They can provide such a great service for people and it's frustrating that not everyone can afford them.”
Mir Ali, M.D., a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA., agrees. “Unfortunately, for patients who don't have insurance, they’ll have to pay the full amount,” he says. But, Dr. Ali says some patients may be able to get a form of Tirzepetide “from a compounding pharmacy at a lower cost.” (It’s worth noting that compounded medications are not FDA-approved—read more on this here).
Do you need a prescription for Zepbound?
Yes, you need a prescription for Zepbound and other weight-loss drugs. “These are not benign medications,” Shah says. “They have a lot of potential side effects that are very well noted and we also don't have much in the way of long-term data.”
Dr. Shah says it's "very important" to take weight loss medications like Zepbound under the guidance of a doctor who is comfortable prescribing them.
Is there a Zepbound savings card?
Yes. Savings cards are common with newer medications as a way to help patients save money while trying out a drug, Alan says. “This can save you some money on your prescription,” she explains. “The exact savings will vary depending on what your insurance covers.”
The savings card can be helpful because many health insurance companies won’t cover new medications like Zepbound right away, Dr. Shah says. “There is a lag time for insurances to start fully covering these and the savings card helps bridge the gap,” he says. Dr. Ali says they can also be helpful if your health insurance only partially covers the cost of the medication. “I’ve had patients tell me that their copay is $500 a month, even with insurance,” he says.
To sign up for the savings card, you’ll need commercial insurance and a prescription, per Eli Lilly. The card can be used to save up to $1,800 on Zepbound a year and may be used for up to 13 prescription fills in a calendar year. Worth noting: The card expires and the savings ends on December 31, 2024.
The Zepbound website has information on how to sign up for the savings card if you’re interested.
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