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Key takeaways
Insurance coverage for Zepbound varies by plan. In most cases, coverage requires meeting a specific set of criteria and going through an eligibility authorization process with your prescriber and insurance plan.
At an average cost of about $1,500 per month, even with significant discounts, you can expect to pay close to $1,000 monthly or more for Zepbound and similar drugs.
There are other weight loss drugs that may cost less than Zepbound. It’s worth understanding your insurance benefits when making decisions with your prescriber about the right therapy for you.
Zepbound is a brand-name, prescription-only injectable medication indicated for the treatment of obesity and chronic weight management. Zepbound’s active ingredient is tirzepatide, and it is classified as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. Zepbound’s active ingredient, tirzepatide, leads to significant weight loss in clinical studies. The average retail list price for Zepbound is about $1,515 per box (four 0.5 ml pens) containing 2.5 mg per 0.5 ml. There are no over-the-counter (OTC) equivalents or comparable alternatives, and insurance coverage of Zepbound can be difficult to navigate for some. There are some ways to obtain Zepbound at a more affordable price.
What is the brand name/generic for Zepbound?
Zepbound’s generic name is tirzepatide, its active ingredient. Tirzepatide is also marketed under the brand name Mounjaro, but that product’s labeling is specific to the treatment of diabetes. Neither Zebound nor Mounjaro has a generic equivalent available on the market. Zepbound was approved by the U.S. Food and Drug Administration (FDA) in November 2023. Because the manufacturer, Eli Lilly and Co., will have patent rights for an extended period, it will likely be many years before a generic version is available.
Is Zepbound covered by insurance?
Insurance coverage of Zepbound and many other weight loss medications may require many steps. Often, each plan will have a specific set of coverage criteria. Your prescribing healthcare provider will need to work with the insurance company to prove the drug’s medical necessity. This process is often referred to as prior authorization. This can include providing documentation that an individual has tried other cost-effective weight loss strategies, such as diet and behavioral therapy, prior to approval of a drug like Zepbound.
In addition, your prescriber may have to provide proof of a body mass index (BMI) over 30, or BMI over 27 with other comorbid conditions related to weight. These may be weight-related medical problems like high blood pressure or high cholesterol. In general, insurance coverage of Zepbound and similar drugs is tricky to work through and understand. One caveat may be a concurrent diagnosis of Type 2 diabetes. In this case, you may be able to get Mounjaro (containing the same active ingredient) covered by insurance successfully due to its FDA-approved indication for treating diabetes.
Even with a successful authorization for coverage, the patient’s out-of-pocket or copay responsibility can vary a great deal based on coverage maximums, deductibles, and copay structure.
How much does Zepbound cost without insurance?
Zepbound ultimately may not be covered by your insurance plan, so it is important to know what to expect if you are considering paying retail prices for Zepbound. Zepbound is available in multiple strengths and it must be titrated to an effective yet tolerable dose. Most patients will end up taking somewhere between 5 mg and 15 mg once weekly. One box of Zepbound contains 4 pens, and the dose is contained in the contents of one pen given once weekly. One box will, therefore, last 28 days.
You should expect the full retail price of Zepbound to be over $1500 per 28 days, even at the lowest dose. This comes out to about $375 per injectable dose. Pricing between the various strengths is relatively similar.
Unfortunately, there are no generics for Zepbound or for any similar drugs in the GLP-1 and GIP/GLP-1 classes. However, it is still possible to save a significant amount off the retail price.
SingleCare offers significant discounts for Zepbound, and your access to these discounts won’t cost you anything. With SingleCare, you can access a 28-day supply of Zepbound starting at about $935 at participating pharmacies. The prices quoted by different pharmacies can vary a great deal, but with SingleCare, you can access the agreed discounted price for all participating pharmacies in your area, allowing you to choose the best deal. This will save you from going door to door to every pharmacy or having to call around.
Compare Zepbound prices to related drugs |
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|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Zepbound (tirzepatide) | $1,511 per 4, 0.5 mL of 2.5 mg/0.5 mL pens | $934 per 4, 0.5 mL of 2.5 mg/0.5 mL pens of brand-name Zepbound | See latest prices |
| Wegovy (semaglutide) | $1,840 per 4, 0.75 mL of 2.4 mg/0.75 mL pens | $1,235 per 4, 0.75 mL of 2.4 mg/0.75 mL pens | See latest prices |
| Saxenda
(liraglutide) |
$1,810 per 5, 3 mL of 18 mg/3 mL pens | $1,160 per 5, 3 mL of 18 mg/3 mL pens | See latest prices |
| Qsymia (phentermine/ topiramate) | $263 per 30, 7.5-46 mg capsules | $162 per 30, 7.5-46 mg capsules | See latest prices |
| Contrave (bupropion/ naltrexone) | $831 per 120, 8-90 mg tablets | $630 per 120, 8-90 mg tablets | See latest prices |
| Adipex-P (phentermine) | $107 per 30, 37.5 mg tablets | $6 per 30, 37.5 mg tablets (generic) | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs, if available. Click the link under “Savings options” to see the latest drug prices.
How to get Zepbound without insurance
Paying for Zepbound with inadequate or no insurance coverage can be challenging for some. The manufacturer, Lilly, does offer some assistance options through a Zepbound savings card for those with commercial insurance, but not everyone, including beneficiaries of Tricare, Medicare, and Medicaid, is eligible to participate. There are still options to lower the price and make Zepbound more affordable.
- SingleCare has consistently saved patients from paying high dollar, uninsured prices for prescription drugs. Not only will SingleCare save you money at any participating pharmacy, it will tell you which local pharmacy has the best price. Simply present your free SingleCare card and receive the best possible price. For Zepbound, you can save over $500 per month.
- There are no generics for Zepbound or any drug in the same class. However, other oral medications are approved to treat obesity and aid in weight loss. These oral drugs tend to have lower out-of-pocket costs than the injectable Zepbound, but their results in clinical trials for weight loss generally have not been comparable to those for Zepbound. One option, phentermine, is generic and much more affordable, but phentermine may not be appropriate or effective for everyone.
- Weight loss and obesity drugs are typically not made available through patient assistance programs or manufacturers for no cost. However, if you have a concurrent diagnosis of Type 2 diabetes mellitus, you may be eligible for similar drugs marketed for that indication. These may include Mounjaro (tirzepatide), Ozempic (semaglutide), or Trulicity (dulaglutide).
