Understanding the List Prices
At first glance, comparing the sticker price of Ozempic and Mounjaro provides a clear winner. Mounjaro, produced by Eli Lilly, has a list price of approximately $1,080 per monthly supply (four pre-filled pens), regardless of the dose. In contrast, Ozempic, manufactured by Novo Nordisk, has a slightly lower list price of about $998 per month, and this price also remains constant across different doses. However, a patient rarely pays the full list price, and the true cost is determined by many variables.
The Impact of Insurance Coverage
For most patients, the determining factor for cost is their insurance plan's coverage. Both Ozempic and Mounjaro are FDA-approved for the treatment of Type 2 diabetes. For this indication, many commercial, Medicare, and Medicaid plans offer some level of coverage, though specifics vary widely by plan and state.
Coverage for FDA-approved indications
- Type 2 Diabetes: If prescribed for Type 2 diabetes, a patient with commercial insurance can expect to pay a copay. This can be as low as $25 for eligible patients who use manufacturer savings cards. Without a savings card, copays typically range from $25 to $150 or more, depending on the plan.
- Medicare and Medicaid: Coverage for Ozempic or Mounjaro is usually offered for Type 2 diabetes patients, but eligibility and copay amounts depend on the specific plan and the patient's coverage stage.
Challenges with off-label use
While both medications are widely known for their weight loss benefits, prescribing them for this purpose is considered an “off-label” use. Insurance plans are much less likely to cover medications used off-label, leaving patients to pay the full retail price out-of-pocket. Separate products with the same active ingredients—Wegovy (semaglutide) and Zepbound (tirzepatide)—are FDA-approved for weight management, and coverage for these may be different.
Comparing Costs with and Without Insurance
To illustrate the cost difference, consider the following comparison table. Note that prices are estimates based on recent data and can vary by pharmacy, location, and plan.
| Feature | Ozempic (semaglutide) | Mounjaro (tirzepatide) |
|---|---|---|
| Manufacturer | Novo Nordisk | Eli Lilly |
| List Price (Monthly) | Approx. $998 | Approx. $1,080 |
| Retail Price Without Insurance (Monthly) | $1,000 - $1,200+ | $1,000 - $1,200+ |
| Cost with Commercial Insurance & Manufacturer Savings Card | As low as $25 | As low as $25 |
| FDA-Approved Indications | Type 2 Diabetes, CV risk reduction | Type 2 Diabetes |
| Active Ingredient | Semaglutide | Tirzepatide |
| Other Versions for Weight Loss | Wegovy | Zepbound |
How to Afford Mounjaro and Ozempic
Given the high retail prices, patients rely on several strategies to make these medications affordable.
Manufacturer savings programs
- Ozempic Savings Card: Eligible commercially insured patients can pay as little as $25 for a monthly prescription.
- Mounjaro Savings Card: Eli Lilly offers a savings card that can reduce the cost for eligible commercially insured patients to as low as $25 per month.
Patient assistance programs
For uninsured patients or those with government-sponsored insurance programs who meet certain income requirements, both Novo Nordisk and Eli Lilly have patient assistance programs. These can potentially provide the medication at no cost.
Using discount coupons
Websites like GoodRx offer coupons that can significantly reduce the cash price for Ozempic or Mounjaro. For instance, Ozempic may be available for around $499 per month with a discount card at certain pharmacies. Similarly, cash-pay options and discounted vial formats are available for tirzepatide products through programs like LillyDirect.
Considering alternatives
For individuals whose insurance does not cover Ozempic or Mounjaro, or for those concerned about cost, other treatment options are available. These may include generic medications like metformin or alternative GLP-1 receptor agonists, which might be more affordable or have broader insurance coverage. Additionally, discussing alternatives or exploring the FDA-approved weight loss versions (Wegovy or Zepbound) with a healthcare provider is a sensible step.
Conclusion: Which is the most expensive?
In the absence of any discounts or insurance, Mounjaro is typically more expensive than Ozempic, based on their respective list prices. However, this difference becomes largely irrelevant for commercially insured patients who qualify for manufacturer savings cards, as both can be obtained for a similar low cost of around $25 per month. For the uninsured or those prescribed the medication off-label, Mounjaro's slightly higher list price translates to a higher potential out-of-pocket cost, though pharmacy discounts can mitigate this. The most affordable option for any individual will depend entirely on their insurance plan, eligibility for assistance programs, and how the medication is being used. A healthcare provider is the best resource for navigating these complexities and exploring all options. For more information on Ozempic pricing, visit Drugs.com Ozempic Price Guide.
