How Much Are Tirzapetide (Mounjraro) and Semaglutide (Ozempic) Without Insurance?
The table provides the average prices for a 28-day supply of various weight management medications along with their brand names. Tirzepatide, sold as Mounjaro, is the most expensive at $1,069.08. It is followed by Semaglutide, available in two forms: the injectable Ozempic at $1,070.46 and the oral Rybelsus at $999.04. More affordable options include Phentermine/topiramate branded as Qsymia at $223.44, and Bupropion/naltrexone known as Contrave at $175. For Orlistat, the prescription version, Xenical, is priced at $242.76, while the over-the-counter option, Alli, is considerably cheaper at $16.52.
Average Wholesale Price (AWP) of Branded Weight Loss Agents
| Medication | Average Price (28-day supply) |
|---|---|
| Tirzepatide (Mounjaro) | $1,069.08 |
| Semaglutide SC (Ozempic Injectable) | $1,070.46 |
| Semaglutide PO (Rybelsus Oral) | $999.04 |
| Phentermine/topiramate (Qsymia) | $223.44 |
| Bupropion/naltrexone (Contrave) | $175 |
| Orlistat (Xenical) | $242.76 |
| Orlistat (OTC Alli) | $16.52 |
Average Price for Compounded GLP-1
The cost for compounded GLP-1 ranges between $250-$400 a month with online providers like Henry and Mochi Health, and $60-$240 a month when getting directly from the pharmacy.
Can I Get GLP-1 Cheaper Overseas?
A comparison of the average daily cost at launch of different brands of semaglutide revealed that the daily cost of Wegovy was higher in the US compared to France and Germany. The price differences were significant, with the daily cost in France being 143% lower than in the US, and even lower in Germany, at 572% lower than the US.
How Much Is Tirzepatide With Insurance?
For weight loss
Several health insurance companies in the United States have tightened or halted coverage for the drug Ozempic and related medications, particularly when prescribed for weight loss.
For Diabetes Type 2
It's important to note that most private (commercial) insurance companies cover Ozempic for type 2 diabetes, but different insurance plans cover different medicines, and this can change over time. The coverage and cost depend on the specific plan and its benefits. Most Medicare prescription drug plans (Medicare Part D) cover Ozempic for the treatment of type 2 diabetes, but not for weight loss. Most GLP-1 agonists, including Ozempic, are usually covered by state Medicaid programs for the treatment of type 2 diabetes. However, when Ozempic is prescribed off-label for weight loss, it is often not covered by insurance. This is because the Affordable Care Act doesn’t mandate that health insurers cover obesity or overweight treatments.
For Insurance That Covers GLP-1
If your insurance covers GLP-1 and you have deductible, and it is deemed medically neccessary for you to receive GLP-1 therapy, you are responsible for a copay amount for every fill. GLP-1 drugs like Mounjaro and Ozempic are considered specialty drugs. The current average copay for specialty drugs in the U.S. is $338.9 per fill. Meaning if you are lucky to have insurance coverage for GLP-1, you will likely be paying $338.9 a month for the drug.
If your insurance has a co-insurance instead of copay, for example, if your co-insurance is 41% and the Mounjaro costs $1,069 a month, you are reponsible for $438. In this case, having a specialty drug copay is more advantageous.
| State | Specialty Drugs Copay/Fill | Specialty Drugs Co-insurance |
|---|---|---|
| AK | $333.3 | |
| AL | $283.5 | 50% |
| AZ | $348.1 | 49% |
| FL | $324.2 | 45% |
| IN | $342.4 | 33% |
| LA | $114.2 | 31% |
| MO | $413.6 | 37% |
| MS | $337.5 | 30% |
| NC | $339.5 | 48% |
| ND | $462.8 | 15% |
| OK | $375.6 | 43% |
| SC | $334.0 | 35% |
| TN | $308.0 | 38% |
| TX | $332.8 | 38% |
| WI | $366.7 | 50% |
| Grand Total | $338.9 | 41% |
How Can I Save on Tirzepatide?
The Mounjaro Savings Card Program offers significant financial savings on Mounjaro prescriptions and has specific end dates: December 31, 2024, for those with insurance coverage, and June 30, 2024, for those without.
For insured patients covered for Mounjaro, the card enables payments as low as $25 per prescription fill, with a monthly savings cap of up to $150 for a 1-month supply, $300 for a 2-month supply, and $450 for a 3-month supply. Annually, you can save up to $1,800 and use the card for up to 13 fills.
For those whose insurance doesn't cover Mounjaro, the savings card offers up to $573 off per month, with an annual savings limit of $3,438, and can be used for up to 6 fills per year. Lilly can change or discontinue the card terms without notice.
Fake GLP-1 On The Rise
Counterfeit GLP-1, the active ingredient in Ozempic and Mounjaro, has been a growing concern, with health authorities issuing warnings about fake products found in the US and abroad. Serious side effects of the counterfeit products included hypoglycemia and seizures, indicating that the counterfeit drugs contained insulin instead of semaglutide. The FDA has seized thousands of units of counterfeit Ozempic and warned consumers, healthcare practitioners, and pharmacies to check the product they have received and not distribute, use, or sell products labeled with specific lot and serial numbers. The agency has also advised that retail pharmacies should only purchase authentic Ozempic through authorized distributors.
Frequently Asked Questions
What is the average cost of Tirzepatide (Mounjaro) and Semaglutide (Ozempic) without insurance?
Tirzepatide (Mounjaro) costs approximately $1,069.08, and Semaglutide (Ozempic injectable) is around $1,070.46 for a 28-day supply without insurance.
How does the cost of Semaglutide compare internationally?
Semaglutide is significantly cheaper in countries like France and Germany compared to the U.S., with the cost being 143% and 572% lower, respectively.
What are the savings offered by the Mounjaro Savings Card Program?
The program allows insured patients to pay as low as $25 per prescription fill, with monthly savings capped at $150, $300, or $450 depending on the prescription duration. Annually, the maximum savings can reach up to $1,800.
What are the implications of counterfeit GLP-1 medications on the market?
Counterfeit GLP-1 medications have caused serious health issues, including hypoglycemia and seizures, due to the presence of insulin instead of semaglutide. Authorities have issued warnings and have taken measures to seize counterfeit products.
How does insurance coverage affect the pricing of GLP-1 drugs like Ozempic for different uses?
Insurance typically covers GLP-1 drugs like Ozempic for type 2 diabetes, but not for off-label uses such as weight loss, with coverage varying by plan and potentially changing over time.
What are the average copay and co-insurance rates for GLP-1 drugs in the U.S.?
The average copay for GLP-1 drugs as specialty medications is approximately $338.90 per fill, with co-insurance rates averaging around 41%.
What should consumers do if they suspect they have received counterfeit GLP-1 medication?
Consumers, healthcare practitioners, and pharmacies should verify product authenticity, especially the lot and serial numbers, and ensure they purchase from authorized distributors only.