Zepbound Vial Pricing: A Closer Look
Eli Lilly offers Zepbound in single-dose vials, which can be a more accessible option than the pre-filled injector pens, particularly for those without insurance coverage. These vials are available through LillyDirect Self Pay Pharmacy Solutions and the Zepbound Self Pay Journey Program.
Through these programs, the monthly cash price for a four-week supply of Zepbound single-dose vials varies by dose:
- The 2.5 mg dose costs $349.
- The 5 mg dose costs $499.
- Higher doses (7.5 mg, 10 mg, 12.5 mg, 15 mg) are available for $499 for the first fill and subsequent refills within 45 days. Regular pricing for these doses ranges from $599 to $1,049 if refill terms are not met.
It's important to remember that these vial options are for cash payment only and are not eligible for insurance coverage.
Zepbound Vials vs. Pens: Cost and Convenience
Zepbound is available as both single-dose vials and pre-filled injector pens. The form chosen affects both cost and administration. Vials require manual injection with a separate syringe and needle, while pens are pre-filled with an attached needle.
Comparison Table: Zepbound Vials vs. Pens
| Feature | Zepbound Vials | Zepbound Pens |
|---|---|---|
| Cost (without insurance) | $349-$499/month (with manufacturer offer) | $1,086.37/month list price; average retail $1,280-$1,500/month |
| Insurance Coverage | Not eligible; cash-only | Eligible; coverage varies by plan |
| Coupon Eligibility | Not eligible for coupons like the Savings Card | Eligible for manufacturer coupons (e.g., Zepbound Savings Card) |
| Administration | Manual injection with separate syringe and needle | Pre-filled with attached needle |
| Availability | LillyDirect Self Pay Pharmacy Solutions and Ro | Any pharmacy stocking the pens and weight loss programs |
Vials offer a significantly lower cash price for those paying out-of-pocket. However, commercially insured individuals whose plans cover Zepbound may find pens more affordable, especially with a manufacturer savings card, potentially reducing the cost to as low as $25 per month.
Factors Influencing Zepbound Cost and Savings Opportunities
Several factors impact the final cost of Zepbound:
- Insurance Coverage: Coverage varies, often requiring prior authorization, and many plans don't cover weight loss medications. Coverage may be more likely if prescribed for FDA-approved conditions like obstructive sleep apnea in adults with obesity. Medicare and Medicaid typically do not cover Zepbound for weight loss.
- Manufacturer Savings Programs: The Zepbound Savings Card can lower the cost for eligible commercially insured patients, potentially to $25 per month if their plan covers it. If the plan doesn't cover Zepbound, the card may reduce the cost to around $650 for a one-month supply. These programs usually exclude government-funded healthcare.
- Pharmacy Discounts: Retail prices can vary between pharmacies. Discount cards from websites like GoodRx and SingleCare can also lower out-of-pocket costs but typically cannot be combined with insurance.
- Patient Assistance Programs: Programs like Lilly Cares Foundation or those from organizations such as the Patient Access Network Foundation (PAN) and the HealthWell Foundation may offer assistance to uninsured or underinsured individuals based on income.
- Treatment Duration: Zepbound is often a long-term treatment, so total costs can add up. Maintaining weight loss on lower doses can impact long-term expenses.
Conclusion
For patients without insurance, Zepbound vials, especially through Eli Lilly's self-pay programs, offer a more affordable option compared to pens. The Zepbound Self Pay Journey Program provides reduced pricing for various doses, making the full range potentially more accessible. Understanding the cost differences between vials and pens, insurance coverage details, and available savings programs is essential. Consulting healthcare providers, pharmacists, and insurance representatives is recommended to determine the best approach for managing Zepbound costs. Staying informed about discounts and assistance programs can help alleviate the financial burden of this medication.
chart(results=[], type="FINANCE")