How Much Does Zepbound Cost Without Insurance?

Approximately 70% of U.S. adults are either obese or overweight, increasing their risk for serious conditions like high blood pressure, diabetes, and sleep apnea. While diet and exercise are first-line treatments, many people struggle to achieve meaningful weight loss and may benefit from taking weight loss medications.

Zepbound (tirzepatide), a new weight management medication by Eli Lilly, has shown promising results. However, the cost of treatment remains a barrier for many. Below is a breakdown of Zepbound pricing, insurance considerations, and savings strategies.

What Is Zepbound?

Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist that mimics the action of two hormones in the body, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). 

Zepbound has FDA approval for two main uses: 

• Chronic weight management in adults with obesity or adults who are overweight with one or more obesity-related health conditions.

• Moderate to severe obstructive sleep apnea (OSA) in adults with obesity.

How To Qualify For Zepbound

You can qualify for a prescription of Zepbound if you are an adult with obesity (BMI 30 kg/m2 or higher) or are overweight (BMI 27 kg/m2 or higher) with a weight-related medical condition such as hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease.

How Much Does Zepbound Cost?

Zepbound Cost Without Insurance

The list price of Zepbound is $1,086.37 per month. However, Eli Lilly offers a Self Pay Journey Program through LillyDirect, which costs:

• $349/month for 2.5 mg (starter dose)

• $499/month for 5 mg, 7.5 mg, or 10 mg (if refilled within 45 days)

These prices are available to everyone, including those on Medicare or Medicaid.

Zepbound Cost With Insurance

Those with commercial insurance and Zepbound coverage may pay as little as $25/month using the Zepbound Savings Card. This offer is only available to patients with commercial insurance, not government-funded plans.

Without coverage, the discounted price with the savings card is $650/month.

What Factors Affect Zepbound Costs?  

Dosage 

Zepbound (tirzepatide) is a once-weekly injection with a starting dosage of 2.5 mg.

Patients are increased to higher doses of 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg per 0.5 mL for continued weight loss. 

Insurance Coverage

• $25/month if you have insurance coverage for Zepbound

• $650/month without coverage but with a savings card

• $1086.37/month if you are uninsured and pay the full list price

Pharmacy Location  

Your out-of-pocket cost will depend on which pharmacy you get your prescription filled at because your insurance company may have negotiated a special price within a preferred pharmacy network. 

Additionally, how much you pay for your medicine will also depend on your copay or coinsurance. 

Zepbound vs. Other Weight Loss Drugs

List prices for other weight loss medications include:

Note: Ozempic and Mounjaro are sometimes prescribed off-label for weight loss, but are only FDA-approved for diabetes.

How to Get Zepbound at an Affordable Price   

Pharmacy Discounts  

You can save on Zepbound using a free prescription discount card like BuzzRx, accepted at over 60,000 pharmacies nationwide, including CVS, Walgreens, Kroger, and more.

To start saving, you can get your free BuzzRx prescription discount card HERE or download the free mobile app from the App Store. 

Manufacturer Savings Cards  

Drug manufacturers frequently offer brand-name drugs at discounted prices through manufacturer coupons and savings programs, including:

• Zepbound Savings Card: $25/month for those with coverage

• Self Pay Journey Program: $349-$499/month for all patients

Generic and Alternative Options

There is currently no lower-cost generic version available for Zepbound. Some people are using compounded Zepbound (tirzepatide) through specialty pharmacies. However, this carries the risk of inaccurate dosing, which can lead to worsened adverse effects, reduced efficacy, and contamination.

Eli Lilly's Pricing Strategy 

Zebound’s manufacturer, Eli Lilly, has a list price of $1086.37 per fill for Zepbound. However, there are ways to save on your medication, including:

• Insurance coverage ($25 per month).

• LillyDirect for self-pay patients paying cash for Zepbound ($349 to $499 per month).

• Eli Lilly’s Zepbound Savings Program for people without insurance or without Zepbound coverage ($650 per month).

Assistance Programs  

Eli Lilly’s Zepbound Savings Card can help uninsured patients get Zepbound for $650 per month. 

To qualify for Zepbound assistance programs, you must be at least 18 years old, have commercial drug insurance, a prescription for Zepbound consistent with FDA-approved product labeling, and be a resident of the United States or Puerto Rico.

Can You Get Zepbound Directly From Eli Lilly?

Yes, Eli Lilly has a telehealth platform called LillyDirect that offers exclusive discounts on Zepbound by supplying the medicine directly to patients. The price is $349 for a month’s supply of the 2.5 mg dose (initial starting dose) and $499 for a month’s supply of the 5 mg, 7.5 mg, and 10 mg doses. 

Self-Pay Options

Self-pay patients now have the added option to purchase Zepbound vials for the 2.5 mg, 5 mg, 7.5 mg, and 10 mg doses instead of the auto-injector pens, bringing the price down to $499 to $699 per month.

Insurance and Zepbound Coverage  

Why Is Zepbound So Expensive Even With Insurance?

Zepbound is so expensive, even without insurance, because it is a brand name only, meaning drug manufacturers market the brand-name medicine until the patent expires. Then other pharmaceutical companies can make lower-cost generic versions of the drug.

Why Won’t Insurance Cover Zepbound?  

Some insurance plans exclude Zepbound or require prior authorization for various reasons, including:

• Cost: Insurance companies are typically hesitant to cover expensive new drugs like Zepbound until they have proven to have significant benefits over cheaper alternatives. 

• Focus on Lifestyle Changes: Insurers often prioritize lifestyle changes (diet and exercise) over weight loss medications. 

• Off-Label Use: If your primary care doctor prescribes Zepbound for a purpose other than the FDA-approved product labeling (off-label use), many insurance plans will not cover it. 

• Prior Authorization: Many insurers require prior authorization, meaning your doctor must submit documentation to the insurer justifying the need for the medication before they will cover it.

• Specific Exclusions: Some insurance plans have specific exclusions for weight loss drugs as they are for lifestyle purposes and not considered a medical necessity. 

• Step Therapy: Some insurance plans require you to try other, less expensive weight loss medications before considering Zepbound. 

Does Insurance Pay For Weight Loss Injections?

Some commercial insurance plans may cover Zepbound and other weight loss injections. However, your doctor may need to get prior authorization and demonstrate to your insurance company why you need to take Zepbound, such as obesity and a health condition like high blood pressure, high blood sugar, or high cholesterol.

Medicare Part D, which provides prescription drug coverage, does not currently cover weight loss medications such as Zepbound. However, if you are prescribed tirzepatide for a medical condition such as obstructive sleep apnea, it may be covered.

Medicaid coverage for Zepbound, a dual GLP-1 and GIP weight loss medication, varies from state to state.