GLP-1 Updates: semaglutide / tirzepatide
It has been an exciting summer for our new GLP-1 weight loss medications, Wegovy (semaglutide) and Zepbound (tirzepatide). This information is current as of 9/8/2024.
Semaglutide
At this time, all doses of Wegovy are available at retail pharmacies. Further, all doses of Ozempic are generally available at retail pharmacies as well.
If you have insurance coverage for Wegovy, it is generally around $25 / month after applying the manufacturer’s coupon. Whether or not you have coverage is generally determined by your employer. Many large employers offer coverage; however, most of the smaller employers or those on plans purchased on the Colorado exchange usually do not have coverage. Further, federal employees have coverage.
Medicare will cover Wegovy, but only if you have a history of cardiovascular disease (meaning you have had an event).
The retail price for Wegovy is $1500 / month; however, there is now a coupon that makes Wegovy $650 / month. Not everybody can use the coupon – to see if you have Wegovy coverage and read about the savings card, click here.
Ozempic contains the same active ingredient – semaglutide – as Wegovy. It is approved for the treatment of type 2 diabetes. Most insurers do cover Ozempic, but only if you have diabetes. The retail price for Ozempic here in the US is ~$900 / month; however, sometimes we can coach you on how to use the Ozempic for 2 months vs. the intended 1 month, lowering your cost by 1/2. In addition, we have found numerous pharmacies that will sell Ozempic to our patients at half of the retail cost. To learn more, schedule an appointment with one of our CNC providers.
Tirzepatide
At this time, all doses of Zepbound are available at retail pharmacies. Further, all doses of Mounjaro are generally available at retail pharmacies as well.
If you have insurance coverage for Zepbound, it is generally around $25 / month after applying the manufacturer’s coupon. Regarding coverage, if you have coverage for Wegovy (see above), you also probably have coverage for Zepbound.
Medicare will NOT EVER pay for Zepbound at this time.
The retail price for Zepbound is $1100 / month; however, their coupon brings the cost down to $550 / month. In addition, Lilly has launched a direct-to-patient sales for Zepbound – the starting dose is available for $399 / month, and the second dose (5 mg) is available for $549 / month, even if you do not qualify for the coupon.
To read about the Zepbound insurance coverage and savings card, click here.
If you are interested in the direct-to-patient cash price of $399 / $549, click here.
Mounjaro contains the same active ingredient – tirzepatide – as Zepbound. It is approved for the treatment of type 2 diabetes. Many insurers now cover Mounjaro, but only if you have a diagnosis of type 2 diabetes.
