How Much Is 20 mg of Tirzepatide? A Detailed Cost Analysis for 2025

October 9, 2025 •

4 min read

With the list price for a month's supply of tirzepatide often exceeding $1,000, many patients are asking: how much is 20 mg of tirzepatide? [1.2.1, 1.4.1]. This analysis breaks down the costs associated with brand-name and alternative options.

Quick Summary

A detailed breakdown of tirzepatide pricing, including brand-name Mounjaro and Zepbound costs, the critical role of insurance, and the prices and risks associated with non-standard doses from compounding pharmacies.

Key Points

Non-Standard Dose: 20 mg is not an FDA-approved dosage for tirzepatide (Mounjaro/Zepbound); the maximum standard dose is 15 mg per week [1.3.2, 1.3.3]. Such doses typically come from compounding pharmacies.
High List Price: The list price for a one-month supply of brand-name tirzepatide (Mounjaro or Zepbound) is over $1,000 without insurance [1.2.1, 1.4.6].
Insurance is Crucial: Your actual out-of-pocket cost is primarily determined by your health insurance plan, which may require prior authorization [1.5.6].
Compounding Risks: Compounded tirzepatide can be cheaper but is not FDA-approved for safety, quality, or efficacy, and the FDA has issued warnings about its use [1.9.1, 1.9.4].
Savings Programs Help: Manufacturer savings cards can lower the monthly cost to as little as $25 for eligible, commercially insured patients [1.5.1, 1.5.6].
Dual-Action Mechanism: Tirzepatide works on both GIP and GLP-1 receptors, which distinguishes it from semaglutide (a GLP-1 only agonist) and may contribute to greater weight loss [1.5.1, 1.7.2].
Medicare Limitations: By law, Medicare Part D generally does not cover medications for weight loss alone, but may cover tirzepatide for type 2 diabetes or other approved indications like obstructive sleep apnea [1.8.1, 1.8.2, 1.8.3].

Understanding Tirzepatide and the '20 mg' Dosage Question

Tirzepatide is a dual-action GIP and GLP-1 receptor agonist used for managing type 2 diabetes and chronic weight management [1.5.1, 1.3.3]. It is sold under the brand names Mounjaro (for diabetes) and Zepbound (for weight loss) [1.3.1]. A crucial point of clarification is that the FDA-approved maximum weekly dose for both Mounjaro and Zepbound is 15 mg, administered via single-use pens in increments of 2.5 mg [1.3.2, 1.3.3].

Therefore, a '20 mg' dose of tirzepatide is not a standard, commercially available dosage from the manufacturer, Eli Lilly [1.3.2, 1.3.5]. This dosage amount typically originates from compounding pharmacies, which create customized versions of medications. While this can sometimes offer a lower-cost alternative, it's essential to understand that these compounded drugs are not FDA-approved and do not undergo the same review for safety, quality, or efficacy [1.9.1]. The FDA has issued warnings about the risks associated with compounded drugs, including incorrect dosing, the use of different salt forms of the active ingredient, and potential contamination [1.9.1, 1.9.4]. As of early 2025, the FDA ended its period of enforcement discretion for compounding tirzepatide as drug shortages were resolved, further complicating the legal landscape [1.6.1, 1.6.3, 1.9.3].

Factors That Determine Tirzepatide's Cost

The price you pay for tirzepatide is not straightforward and is influenced by several key factors:

Insurance Coverage: This is the most significant factor. Whether your insurance plan covers Mounjaro for diabetes or Zepbound for weight loss determines your out-of-pocket expense. Many plans require prior authorization [1.5.6].
Brand Name vs. Compounded: Brand-name Mounjaro and Zepbound have a high list price, while compounded versions are marketed at a lower cost, often starting from $299 to $449 per month through various online providers [1.2.2].
List Price: The manufacturer's list price for a one-month supply of Mounjaro is around $1,023-$1,080, and for Zepbound, it is approximately $1,060-$1,086 [1.4.1, 1.4.6, 1.5.1]. This is the price without any insurance or discounts.
Savings Programs: Eli Lilly offers savings cards for commercially insured patients, which can lower the monthly cost to as little as $25 [1.5.6]. For those without insurance coverage, programs like the Zepbound Self Pay Journey offer vials at discounted prices, such as $349 for a 2.5 mg dose [1.4.6, 1.5.1].
Pharmacy and Location: Retail prices can vary between different pharmacies and geographic locations [1.5.5].

Cost Breakdown: Brand-Name vs. Compounded

Without insurance, the cost of brand-name tirzepatide is substantial, typically over $1,000 per month [1.2.1]. For example, the list price for Zepbound is about $1,086 for a 28-day supply of four pens [1.4.6].

Compounded tirzepatide is often presented as a more affordable option. Prices can range significantly, with some telehealth services offering monthly plans from approximately $299 to over $500, depending on the dosage [1.2.2]. Some compounding pharmacies sell vials directly; for instance, a 20mg vial of compounded tirzepatide might be priced around $475, but this is for the raw product, not a prepared weekly dose [1.2.6]. However, the FDA warns that these products are not verified for safety or effectiveness and has received hundreds of adverse event reports related to compounded tirzepatide [1.9.1].

Comparison Table: Tirzepatide vs. Semaglutide

Tirzepatide is often compared to semaglutide (Ozempic, Wegovy), another popular GLP-1 medication.


Feature	Tirzepatide (Mounjaro/Zepbound)	Semaglutide (Ozempic/Wegovy)
Mechanism	Dual GIP and GLP-1 Receptor Agonist [1.5.1]	GLP-1 Receptor Agonist [1.7.4]
FDA-Approved Uses	Type 2 Diabetes, Chronic Weight Management, Obstructive Sleep Apnea [1.3.1, 1.3.3, 1.8.4]	Type 2 Diabetes, Chronic Weight Management, Cardiovascular Risk Reduction [1.8.1]
Avg. List Price (Monthly)	~$1,023 - $1,086 [1.4.1, 1.4.6]	~$997 - $1,349 [1.4.3, 1.7.4]
Max Standard Weekly Dose	15 mg [1.3.2]	2.4 mg (Wegovy) [1.7.4]
Reported Efficacy	Studies suggest tirzepatide may lead to greater weight loss than semaglutide [1.7.2]	Highly effective for weight loss and blood sugar control [1.7.4]

Potential Side Effects and Safety Considerations

The most common side effects for tirzepatide are gastrointestinal and include nausea, diarrhea, vomiting, constipation, and abdominal pain [1.3.1, 1.4.4]. These are often more pronounced during dose escalation [1.7.4]. Tirzepatide also carries a boxed warning for the risk of thyroid C-cell tumors, a risk observed in animal studies [1.4.4]. It is crucial to discuss all potential risks with a healthcare provider. The risks associated with unapproved compounded versions are less understood and may include issues with purity, sterility, and correct dosage [1.9.1, 1.9.4].

Conclusion: Navigating the Cost of Tirzepatide

To answer "How much is 20 mg of tirzepatide?" directly: this dosage is not available in an FDA-approved form and can only be sourced through compounding pharmacies, where prices and quality vary widely [1.2.2, 1.2.6]. The cost of standard, FDA-approved tirzepatide (up to 15 mg) is high, with list prices over $1,000 per month, but can be significantly reduced with good insurance and manufacturer savings programs [1.5.1]. Given the safety and legal warnings from the FDA regarding compounded versions, it is imperative that patients consult with a licensed healthcare provider to discuss the safest and most appropriate treatment plan for their needs and budget.

For authoritative information on the risks of compounded drugs, refer to the FDA's official page.

Frequently Asked Questions

A 20 mg dose is higher than the maximum 15 mg weekly dose approved by the FDA for Mounjaro and Zepbound [1.3.2]. Doses this high are typically from compounding pharmacies and have not been evaluated by the FDA for safety or efficacy. You should consult a healthcare professional before considering any non-standard dosage [1.9.1].

The list price for a one-month supply (four pens) of Zepbound is approximately $1,086 [1.4.6, 1.5.1]. The price you pay at the pharmacy may vary.

The list prices are very similar. Mounjaro's list price is around $1,023-$1,080, while Zepbound's is about $1,060-$1,086 per month [1.4.1, 1.4.6]. Your final cost will depend more on your insurance coverage than the list price difference.

The $25 per month price is typically available through manufacturer savings card programs for patients who have commercial insurance that covers the medication [1.5.6]. It is not available for uninsured patients or those on government plans like Medicare [1.4.6].

Tirzepatide is a dual-agonist that acts on both GIP and GLP-1 hormone receptors, while semaglutide acts only on GLP-1 receptors [1.5.1, 1.7.4]. This difference in mechanism may be why some studies show tirzepatide leads to more significant weight loss [1.7.2].

Compounding may be legal under specific circumstances, such as a drug shortage, but compounded drugs are not FDA-approved [1.6.4, 1.9.1]. The FDA has issued multiple warnings regarding the safety of compounded tirzepatide, citing risks of incorrect ingredients, contamination, and dosing errors [1.9.1, 1.9.4].

Generally, no. By law, Medicare Part D does not cover drugs solely for weight loss [1.8.1]. However, a plan may cover tirzepatide if it is prescribed for an FDA-approved condition like type 2 diabetes (Mounjaro) or obstructive sleep apnea (Zepbound) [1.8.2, 1.8.3].

The cost for compounded tirzepatide from online providers or telehealth services typically ranges from $299 to over $500 per month, depending on the dose and the provider [1.2.2].