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Zepbound, the newly approved drug for chronic weight management, is set to make a significant impact. Administered through weekly subcutaneous injections, the dosage gradually increases over four to 20 weeks, reaching target dosages of 5 mg, 10 mg, or 15 mg. This revolutionary treatment, featuring tirzepatide as its active ingredient (previously approved as Mounjaro for type 2 diabetes mellitus), is the first FDA-approved obesity therapy activating both GIP and GLP-1 hormone receptors.
Recognizing obesity and overweight as serious health risks associated with leading causes of death, including heart disease, stroke, and diabetes, the FDA has approved Zepbound as an adjunct to a reduced-calorie diet and increased physical activity for adults with a BMI ≥ 30 kg/m2 or ≥ 27 kg/m2 with at least one weight-related comorbid condition. It’s crucial to note that Zepbound should be used in conjunction with a reduced-calorie diet and increased physical activity. The drug is expected to be available in the US by the end of the year, marking a promising development in the field of chronic weight management.
Zepbound is expected to be available in the US by the end of the year
- Zepbound is priced at $1,060 per month, approximately 20% less than its competitor, Wegovy.
Patient Cost Variables:
- Actual patient costs depend on insurance coverage and potential discounts.
- Insurance coverage for Wegovy varies widely among providers.
Insurance Coverage for Zepbound:
- Those with commercial health insurance covering Zepbound may pay as low as $25 for one- or three-month prescriptions.
Discounts for Uninsured or Inadequately Covered:
- Commercially insured individuals without Zepbound coverage may pay as low as $550 for a one-month prescription, around 50% lower than the list price.
- Lilly offers a discount card to help offset expenses for those with commercial health insurance lacking coverage for Zepbound.
Savings Card Program:
- The savings card program becomes available in the days following the drug’s availability at U.S. pharmacies.
Considerations for Affordability:
- The list price doesn’t represent the typical out-of-pocket cost due to insurance coverage and discounts.
- Despite discounts, Zepbound may still be unaffordable for some patients.
- For more details on discounts or financial assistance programs for Zepbound, it’s recommended to contact the manufacturer or a healthcare provider.
Navigating the financial aspects of Zepbound involves considering insurance coverage, potential discounts, and utilizing available assistance programs for a more accurate understanding of the cost to patients.
- List Price:
- Zepbound’s list price is $1,059.87 for all six doses.
- Discounts and Coupons:
- Patients may be eligible for discounts and coupons.
- Commercial Savings Card Program:
- Lilly is implementing a commercial savings card program to enhance access to Zepbound.
- Commercially Insured with Zepbound Coverage:
- Eligible individuals may pay as low as $25 for a 1-month or 3-month prescription.
- Commercially Insured without Zepbound Coverage:
- Eligible individuals may pay as low as $550 for a 1-month prescription, approximately 50% lower than the list price.
- Variable Patient Costs:
- The actual amount patients pay depends on their insurance coverage and potential discounts.
- Additional Support for Uncovered Insurance:
- For those with commercial health insurance lacking Zepbound coverage, Lilly offers a discount card to help offset expenses.
Zepbound Discount Card Program
- Discount Card Program Details:
- The discount card program for Zepbound comes with terms, conditions, and limitations.
- Eligibility Restrictions:
- The offer is not valid for patients without commercial drug insurance.
- Patients whose prescription claims for Zepbound are eligible for reimbursement by governmental programs (e.g., Medicaid, Medicare, Medicare Part D, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any State Patient or Pharmaceutical Assistance Program) are excluded from the offer.
- Void Where Prohibited:
- The offer is void where prohibited by law.
- Subject to Change:
- It’s noted that the discount card program is subject to change or discontinuation without notice.
- Card Activation Requirement:
- To avail of the benefits, card activation is required.
In essence, while the discount card program aims to enhance accessibility, there are specific criteria and conditions to be aware of. Patients should review the terms carefully to ensure they meet the eligibility requirements and comply with any stipulations outlined in the program.
Zepbound, a new FDA-approved weight management drug, is injected weekly to treat obesity or overweight with comorbid conditions. Priced at $1,060 monthly, 20% lower than its competitor, Wegovy, actual patient costs vary based on insurance and discounts. Lilly provides a discount card for those commercially insured without Zepbound coverage, aiming to alleviate expenses. Despite discounts, Zepbound might be unaffordable for some; contacting the manufacturer or healthcare provider is recommended for information on discounts or financial assistance programs.