Determining the final out-of-pocket cost for Zepbound and Wegovy is complex, as it depends on a number of variables beyond the medication's list price. While Zepbound (tirzepatide) has historically had a lower list price than Wegovy (semaglutide), recent changes to manufacturer pricing and savings programs have created a more level playing field for many patients. The key factors to consider include your insurance coverage, eligibility for manufacturer savings cards, and whether you are paying cash for the medication. For many patients, particularly those without insurance coverage, the most recent manufacturer price reductions have made the maintenance costs of the two medications very similar.
Manufacturer List Price vs. Discounted Cost
It is crucial to differentiate between the medication's official list price and the discounted price offered through manufacturer programs, especially for patients paying out-of-pocket. The list price is the amount set by the manufacturer, which is often irrelevant for insured patients and significantly higher than the price cash-paying patients now have access to via special programs.
- Wegovy List Price: The manufacturer's list price for Wegovy remains high, around $1,349 per month.
- Zepbound List Price: Zepbound's list price is lower than Wegovy's, around $1,059.87 per month.
- Direct-to-Patient Cash Price: In early 2025, Eli Lilly and Novo Nordisk both introduced significant price cuts for cash-paying customers through their online pharmacy services. For Zepbound, the starter dose was dropped to $349 per month, with maintenance doses priced at $499 per month via LillyDirect. Wegovy's maker dropped the price for all doses to $499 per month through NovoCare Pharmacy. Note that some of these deeply discounted options may require using vials and syringes instead of the more convenient prefilled pens.
The Critical Role of Insurance Coverage
The most significant factor in determining your final cost is your insurance coverage. Many health plans, both commercial and government-based, still do not cover weight-loss medications, viewing them as elective. However, coverage policies vary dramatically, and some plans may cover these medications with restrictions.
- Commercial Insurance with Coverage: For patients with commercial insurance that covers Zepbound, a manufacturer savings card can lower the monthly cost to as little as $25. For Wegovy, some commercially insured patients may pay as little as $0 per month, though savings cards have maximum limits.
- Commercial Insurance without Coverage: If your commercial insurance plan does not cover weight-loss medications, you may be eligible for manufacturer savings programs that reduce the cash price. As noted above, this can lower the cost to $499 per month for Wegovy and $349 to $499 per month for Zepbound, depending on the dose.
- Medicare and Medicaid: Patients on government-funded healthcare programs are generally not eligible for weight-loss medication coverage, and savings cards cannot be used in conjunction with these plans.
Comparison of Zepbound and Wegovy Costs (as of mid-2025)
| Cost Factor | Zepbound (Tirzepatide) | Wegovy (Semaglutide) |
|---|---|---|
| Manufacturer List Price | ~$1,059.87/month | ~$1,349.02/month |
| Direct-to-Patient Cash Price | $349 (starter dose), $499 (maintenance dose) | $499 (all doses) |
| Commercial Insurance Co-pay | As low as $25/month with savings card (if covered) | As low as $0/month with savings card (if covered) |
| Insurance Coverage | Coverage varies significantly and is often restricted; prior authorization may be required. | Coverage varies significantly and is often restricted; prior authorization may be required. |
| Eligibility for Discounts | US residents with commercial insurance (different rules for insured vs. uninsured) | US residents with commercial insurance (different rules for insured vs. uninsured) |
Additional Considerations and Discounts
Even with manufacturer programs, patients should explore all available options to minimize costs. Other resources can potentially help reduce the financial burden of these medications.
- Discount Cards: Prescription discount cards from providers like SingleCare or GoodRx can offer significant savings. For example, as of July 2025, SingleCare noted potential savings on both medications.
- Pharmacy Shopping: Prices can vary between pharmacies, so it is often worthwhile to check multiple locations for the best rate. Services like GoodRx can assist in comparing pharmacy pricing.
- Prior Authorization: Many insurance plans require a prior authorization from your doctor. This is a specific request to approve a medication, and it can affect coverage and cost. Appeals are possible if initially denied.
- Medicare and Medicaid Alternatives: As coverage for weight-loss indications is generally excluded, some patients may be prescribed these medications for off-label use or a different covered condition (like type 2 diabetes), which can affect coverage rules. However, this varies and requires a doctor's determination.
Conclusion: Navigating the Complex Cost Landscape
The question of is Zepbound cheaper than Wegovy? no longer has a simple answer. While Zepbound has a lower list price, the most impactful factor for most patients is whether they are paying cash or have insurance coverage. For those without insurance, the 2025 manufacturer self-pay programs have made the monthly cost for maintenance doses identical at $499. For those with commercial insurance that covers weight-loss medications, manufacturer coupons can drop the cost significantly, potentially making one cheaper than the other depending on your plan's formulary and copay structure. Ultimately, a patient's final cost is determined by a combination of their specific insurance details and their eligibility for available manufacturer discount programs.
For more information on the complexities of insurance coverage for these and other weight-loss drugs, a resource like this guide from Healthinsurance.org can be helpful: Does health insurance cover drugs used for weight loss such as Ozempic, Wegovy, Mounjaro, and Zepbound?
