New Pricing, Access to Tirzepatide Available Through Self-Pay Options

Eli Lilly and Company announced expanded access to tirzepatide (Zepbound) with the launch of 7.5-mg and 10-mg single-dose vials priced at $499 through the new Zepbound Self Pay Journey Program. This program, offered exclusively through LillyDirect Self Pay Pharmacy Solutions, also includes reduced pricing for the existing 2.5 mg and 5 mg vials. The new savings for self-pay patients provides a transparent, out-of-pocket option for patients by streamlining the supply chain and bypassing insurance.¹

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"The OAC applauds Lilly for another step forward in improving the affordability of obesity treatment," Joe Nadglowski, president and CEO of the Obesity Action Coalition, said in a news release. "However, we still have a long way to go in building a health care system that provides comprehensive care, coverage, and payment of such care for people with obesity that is free of weight bias."¹

Tirzepatide is the first and only dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist indicated to treat adults with obesity or overweight with at least 1 weight-related medical problem.¹ The FDA approved the injection for chronic weight loss in November 2023, in combination with a reduced-calorie diet and increased physical activity.² Additionally, tirzepatide received FDA approval in December 2024 for the treatment of moderate-to-severe obstructive sleep apnea and obesity, in combination with a reduced-calorie diet and increased physical activity.³

Tirzepatide is available in dosages of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg per single-dose pen. However, the recommended maintenance dosages are 5 mg, 10 mg, or 15 mg injected subcutaneously once weekly.¹

Despite its obtainability and rapid increase in demand in recent years, tirzepatide remains costly, leading to exclusion from certain health insurance plans, while others may include them with high copays or prior authorization requirements.⁴

"Every major medical organization and establishment recognizes obesity as a chronic disease, yet insurance and federal programs do not systematically cover people living with obesity for medical care—this needs to change," Patrik Jonsson, executive vice president and president of Lilly Cardiometabolic Health and Lilly USA, said in a news release.¹

With the new Zepbound Self Pay Journey Program, self-pay individuals with obesity could have access to more affordable prices for tirzepatide. The new savings reduce the price of the 7.5 mg ($599) and 10 mg ($699) doses to $499 per month at first fill, along with refills that occur 45 days prior to delivery. Additionally, the company announced that they are taking steps to lower the 2.5 mg dose to $349 per month and the 5 mg dose to $499 per month.¹

"Lilly is committed to working with all parties to solve this problem, and in the meantime, we'll continue to implement new options that improve the affordability and availability of our safe, approved, and studied Zepbound for patients who are being asked to pay out-of-pocket,” Jonsson said in a news release.¹

As the first point of contact for patients seeking access to GLP-1s, pharmacists play a crucial role in guiding patients who have concerns about pricing and affordability. Explaining coverage options and discussing cost-saving strategies are essential in finding the best solution for patients with concerns.⁵ Recommending manufacturer’s saving programs for individuals with commercial health insurance could offer tirzepatide at a discounted price. However, providing alternative solutions for individuals with Medicare and Medicaid is essential, as saving programs are not available through government-sponsored insurance.⁴

Pharmacists can also help navigate switching patients from their prescriber if their insurance covers a certain GLP-1 medication and not another.⁵ Recommending a lower dose or generic, if available, could be beneficial for cost savings—while emphasizing warnings against unsafe compounded GLP-1 medications.⁶

As always, staying up to date on shortages and issues related to GLP-1s is crucial to guide and educate patients that are concerned about accessibility and affordability.

REFERENCES

1. Lilly launches additional Zepbound vial doses and offers new savings for self-pay patients. Lilly Investors. News release. Published February 25, 2025. Accessed February 26, 2025. https://investor.lilly.com/news-releases/news-release-details/lilly-launches-additional-zepbound-vial-doses-and-offers-new

2. Antrim A. FDA Approves Tirzepatide for Chronic Weight Management. Pharmacy Times. Published November 8, 2023. Accessed February 26, 2025. https://www.pharmacytimes.com/view/fda-approves-tirzepatide-for-chronic-weight-management

3. Halpern L. FDA Approves Tirzepatide as First Treatment for Moderate-to-Severe Obstructive Sleep Apnea in Adults With Obesity. Pharmacy Times. Published December 20, 2024. Accessed February 26, 2025. https://www.pharmacytimes.com/view/fda-approves-tirzepatide-as-first-treatment-for-moderate-to-severe-obstructive-sleep-apnea-in-adults-with-obesity

4. How Much Does Zepbound (Tirzepatide) Cost Without Insurance? GoodRx. Updated September 20, 2024. Accessed February 26, 2025. https://www.goodrx.com/zepbound/weight-loss-tirzepatide-cost?label_override=undefined

5. GLP-1 medications and weight loss: Helping patients navigate beyond the trends. Wolters Kluwer. News release. Accessed February 26, 2025. https://www.wolterskluwer.com/en/expert-insights/glp-1-medications-and-weight-loss-help-patients-navigate-beyond-trends#:~:text=Help%20them%20understand%20that%20these,their%20medication%20at%20any%20point.

6. Hofmann J. Clinicians, Pharmacists Should Work to Ensure Safety Compounded GLP-1 Medications. Pharmacy Times. News release. Published October 23, 2024. Accessed February 26, 2025. https://www.pharmacytimes.com/view/clinicians-pharmacists-should-work-to-ensure-safety-compounded-glp-1-medications