Zepbound (tirzepatide) is an FDA-approved prescription medication for chronic weight management and obstructive sleep apnea (OSA) in adults with obesity. As a dual GIP and GLP-1 receptor agonist, it can be highly effective, but its high list price makes it inaccessible for many without financial assistance. Navigating the options can help significantly lower your out-of-pocket expenses.
Manufacturer Savings and Assistance Programs
Eli Lilly, the manufacturer of Zepbound, offers several programs to help patients afford their medication. Eligibility and savings amounts vary based on insurance status.
The Zepbound Savings Card
The Zepbound Savings Card is a key resource for commercially insured patients. This is not available for those with government-funded insurance like Medicare or Medicaid.
- With commercial insurance coverage for Zepbound: Eligible patients can pay as little as $25 for a one- to three-month prescription. Maximum annual savings of up to $1,950 apply.
- With commercial insurance that does not cover Zepbound: Eligible patients can still receive a discount, with savings of up to $469 off a one-month prescription. The card has a separate maximum annual savings limit and can be used for up to seven fills per calendar year.
LillyDirect Self-Pay Pharmacy Solutions
For patients who are uninsured or whose insurance doesn't cover Zepbound, LillyDirect offers a pathway to receive the medication directly from the manufacturer. A notable feature is the option to purchase Zepbound vials, which are often cheaper than the pre-filled pens. As of early 2025, pricing for vials was $349 per month for the 2.5mg starter dose and $499 per month for 5mg, 7.5mg, 10mg, 12.5mg, and 15mg doses. This program is available to everyone, regardless of insurance status.
Lilly Cares Foundation Patient Assistance Program
The Lilly Cares Foundation offers free medication to qualifying low-income, uninsured individuals for up to 12 months. To be eligible, patients must meet specific income and other criteria. This is a crucial option for those with limited financial resources and no insurance coverage.
Insurance and Pharmacy Strategies
Beyond manufacturer programs, several tactics can be employed to reduce the cost of Zepbound in conjunction with insurance or through smart pharmacy choices.
- Verify insurance coverage: Always check with your insurance provider to understand their specific formulary for Zepbound. Ask about copay, coinsurance, and whether prior authorization is required.
- Navigate prior authorization: Most insurers require prior authorization before covering Zepbound. Your doctor must submit paperwork to justify the medical necessity of the prescription. If denied, your doctor can submit an appeal.
- Use prescription discount cards: Websites like GoodRx, SingleCare, and WellRx offer coupons that can significantly lower the retail price of Zepbound, especially for those paying out-of-pocket.
- Compare pharmacy prices: The cost of Zepbound can differ between pharmacies. Use online tools or call around to find the best price at local or warehouse pharmacies.
- Opt for a mail-order pharmacy: Some insurance plans offer lower copays for mail-order prescriptions. Platforms like LillyDirect also offer mail-order options directly from the manufacturer.
- Request a 90-day supply: Once you've reached a stable dose, a 90-day supply may reduce costs and trips to the pharmacy, provided your insurance approves it.
- Leverage HSAs and FSAs: Zepbound costs can be reimbursed using Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), provided your doctor submits a Letter of Medical Necessity.
Exploring Alternative Medications
If Zepbound remains unaffordable or inaccessible, discussing alternative medications with your healthcare provider is a viable strategy. While some alternatives may be less effective for weight loss, they might be more affordable. It's also important to note that Zepbound is currently the only dual-receptor agonist on the market.
Comparison of Zepbound and Alternatives
| Feature | Zepbound (Tirzepatide) | Wegovy (Semaglutide) | Mounjaro (Tirzepatide) | Contrave (Naltrexone/Bupropion) |
|---|---|---|---|---|
| Mechanism | Dual GIP and GLP-1 agonist | GLP-1 agonist | Dual GIP and GLP-1 agonist | Opioid antagonist / antidepressant combination |
| FDA-Approved For | Weight management, OSA | Weight management | Type 2 diabetes | Weight management |
| Dosage | Once-weekly injection | Once-weekly injection | Once-weekly injection | Oral tablet, taken daily |
| Typical Weight Loss | Higher efficacy demonstrated vs Wegovy | Effective, but potentially less weight loss than Zepbound | Comparable weight loss to Zepbound (off-label) | Typically less effective than injectable options |
| Cost Potential | High retail cost, but significant manufacturer savings possible | High retail cost, some savings available via Novo Nordisk | High retail cost, savings possible via manufacturer for diabetes indication | Lower retail cost, dedicated patient support program offers significant discounts |
Conclusion
While Zepbound's list price is high, numerous pathways exist for patients to reduce their costs. For commercially insured individuals, the Zepbound Savings Card can lower the copay to as little as $25. For the uninsured or those with non-covered commercial insurance, the LillyDirect self-pay vial program offers a substantially lower price than retail. Patients with low incomes may also qualify for the Lilly Cares Foundation. Beyond manufacturer programs, utilizing pharmacy discounts, mail-order pharmacies, and exploring insurance options like prior authorizations can help manage expenses. For those unable to afford Zepbound, discussing alternative medications with a healthcare provider remains a critical step. By combining these strategies, patients can significantly ease the financial burden associated with Zepbound treatment. Learn more about the manufacturer's offerings by visiting the Zepbound coverage and savings page.
