Tirzepatide, sold under the brand names Mounjaro and Zepbound, has garnered significant attention for its effectiveness in treating Type 2 diabetes and supporting weight loss. However, for those without insurance, understanding the cost of tirzepatide is essential.

At Genesis Lifestyle Medicine, we prioritize patient-centric care and want to provide you with the necessary information to make informed decisions about your health. In this article, we’ll explore how much tirzepatide costs without insurance, the factors influencing its price, and what options might be available to you to lower these costs.

What is tirzepatide?

Tirzepatide is a relatively new injectable approved by the FDA in 2022 for treating Type 2 diabetes. Manufactured by Eli Lilly, tirzepatide is a dual GLP-1 and GIP receptor agonist, which helps regulate blood sugar levels and appetite by mimicking hormones in the gut. As a result, it improves blood sugar control and contributes to significant weight loss in many patients.

The two primary formulations of tirzepatide are Mounjaro and Zepbound. While Mounjaro is approved for Type 2 diabetes, Zepbound received FDA approval in 2023 for chronic weight management. Both medications use the same active ingredient but are prescribed for different purposes. Understanding their cost structure, especially without insurance, is critical for anyone considering them for either condition.

Tirzepatide without insurance: the cost breakdown

For those without insurance coverage, the cost of tirzepatide can be substantial. On average, a monthly supply of Mounjaro or Zepbound costs between $1,000 and $1,200, depending on the pharmacy and your location. A monthly supply typically includes four pre-filled pens, meaning an annual out-of-pocket expense for tirzepatide can exceed $12,000.

Without insurance, individuals are responsible for covering the entire list price, making this medication a significant financial burden for many. While these prices are average estimates, the actual amount you pay may vary based on several factors, including where you live, the pharmacy you choose, and any discounts or savings programs available to you.

What affects the cost of tirzepatide?

Several factors can influence the price of tirzepatide without insurance:

• Location: The cost of medications often fluctuates based on geographic location. For example, prescription drugs tend to be more expensive in cities like Los Angeles compared to places like Denver. This variation is due to differences in local economies, pharmacy pricing structures, and state regulations.
• Pharmacy choice: Even pharmacies within the same city can offer different prices for tirzepatide. Some may charge closer to the lower end of the spectrum, around $1,000, while others may price it at $1,200 or more.
• Prescription use: Insurance companies tend to cover tirzepatide only for its FDA-approved use in treating Type 2 diabetes. If you’re prescribed Mounjaro or Zepbound for weight loss, your insurance may not cover the cost, leaving you responsible for paying out of pocket. For weight loss, Zepbound might be a better alternative to Mounjaro.

Are there any savings programs for tirzepatide?

If you’re paying for tirzepatide out of pocket, there are ways to reduce the cost. Eli Lilly, the manufacturer of both Mounjaro and Zepbound, offers a savings card for eligible patients with commercial insurance, potentially lowering your costs. While the savings card is typically geared toward those with insurance, some programs may still offer assistance if you're uninsured.

Additionally, asking your healthcare provider about free samples can be a practical step if you’re considering tirzepatide but are hesitant about the high upfront cost. Many providers may have access to sample pens, allowing you to try the medication before committing to a prescription.

Is there a generic version of tirzepatide?

At this time, no generic version of tirzepatide is available. Both Mounjaro and Zepbound are brand-name medications, which means the costs are typically higher than they would be for a generic alternative. As tirzepatide is a relatively new medication, it may take several years before a generic version becomes available on the market. Until then, patients must rely on brand-name pricing unless they qualify for assistance programs or discounts.

Alternatives to tirzepatide for diabetes and weight loss

If tirzepatide is not affordable for you without insurance, there may be other medications that can offer similar benefits at a lower cost. For Type 2 diabetes, GLP-1 receptor agonists such as semaglutide (sold under the brand names Ozempic and Wegovy) are widely prescribed and may offer comparable results for both diabetes management and weight loss.

While these medications are not cheap either, they may be more affordable than tirzepatide and have similar insurance coverage options. Discussing your options with your healthcare provider is essential to ensure you’re on the right treatment plan for your needs and financial situation.

The bottom line: Is tirzepatide affordable without insurance?

Tirzepatide, in both its Mounjaro and Zepbound formulations, is an expensive medication without insurance. For those managing Type 2 diabetes or seeking weight loss solutions, paying $1,000 to $1,200 per month out of pocket may seem out of reach.

At Genesis Lifestyle Medicine, we understand the importance of finding the right treatment for your health. Our team of medical professionals can guide you through your options and help you explore cost-saving solutions or payment options to make tirzepatide and other essential medications more affordable for your specific health goals. To learn more, contact us today!