Tirzepatide Cost: Mounjaro and Zepbound Pricing Guide [2026]

Tirzepatide (Mounjaro for diabetes, Zepbound for weight loss) is highly effective but expensive. Understanding full costs—retail pricing, insurance coverage, copay assistance programs, compounded alternatives, and cost optimization strategies—helps you access this medication affordably.

Brand-Name Tirzepatide Pricing: Mounjaro vs Zepbound

Mounjaro (tirzepatide for type 2 diabetes) and Zepbound (tirzepatide for chronic weight management) are manufactured by Eli Lilly and have essentially identical retail pricing despite different indications. This is common in pharmaceuticals: the same drug formulated for different FDA-approved indications has comparable pricing.

Retail price for both Mounjaro and Zepbound: approximately $900-1,500 per month for a 4-week supply (four pre-filled pens). Monthly cost varies slightly by pharmacy and your specific dose. Starting doses (2.5 mg pens) may cost slightly less per pen than maintenance doses (15 mg pens), but monthly costs for a month's supply are similar across dose levels.

Breaking this down: Each pen costs approximately $225-375 depending on pharmacy and dose. A 4-week supply requires 4 pens (one per week). Monthly cost: $900-1,500. Annual uninsured cost: $10,800-18,000. This is substantial for most patients, which is why understanding insurance coverage and assistance programs is critical.

Retail pricing has remained relatively stable since Zepbound's approval in 2023, though slight variation exists by pharmacy. CVS, Walgreens, and Rite Aid charge full retail or negotiated rates. Mail-order pharmacies and internet pharmacies may offer slightly lower prices. Using discount codes (GoodRx, SingleCare, or manufacturer copay cards) typically reduces costs substantially.

Insurance Coverage for Mounjaro (Diabetes Indication)

Insurance coverage for Mounjaro in type 2 diabetes has expanded substantially since its FDA approval in May 2022. Most major insurers (United Healthcare, Aetna, Blue Cross Blue Shield, Cigna, Humana, Kaiser) now cover Mounjaro for diabetes management. However, specific coverage policies vary by plan and region, and prior authorization is often required.

Coverage typically requires: failure of at least one other diabetes medication (usually metformin or a second-line agent), documented medical necessity, and prior authorization through your insurer. Some plans offer preferential coverage (lower copay) if you try Ozempic (semaglutide) first—a practice called step therapy. Other plans approve Mounjaro without step therapy, particularly for patients with obesity plus diabetes.

Once approved, typical copay ranges are $35-150 per month depending on your specific plan and coverage tier. Tier 1 (preferred) coverage offers $35-50 copays. Tier 2 or specialty tier coverage ranges $100-150. Some plans require percentage coinsurance (you pay 10-20% of the medication cost) rather than a flat copay. Your specific plan details determine your exact out-of-pocket cost.

Coverage approval timeline: After your prescriber submits a prior authorization request, most insurers respond within 3-5 business days. Some respond within 24 hours. Ask your doctor's office to expedite authorization if needed. During the approval period, your pharmacy can discuss payment options or temporary purchasing while authorization processes.

Coverage maximization strategy: Contact your insurance before filling your prescription. Ask explicitly: "Is Mounjaro covered for type 2 diabetes?" and "What is my copay?" Review your plan's formulary online. If not covered, contact your doctor and request prior authorization submission highlighting medical necessity. Many initial denials are reversed on appeal.

Insurance Coverage for Zepbound (Weight Loss Indication)

Insurance coverage for Zepbound (tirzepatide for weight loss) in 2026 remains more restrictive than Mounjaro coverage, though it has expanded significantly since 2023. Major changes have occurred: several large insurers now cover weight loss medications including Zepbound, whereas most historically did not. However, coverage is not universal, and policies vary substantially by insurer and plan.

Major insurers covering Zepbound for weight loss (2026): United Healthcare, Aetna (select plans), Blue Cross Blue Shield (varies by state), Anthem, Humana (select plans), and regional/local insurers. However, "coverage" often means approval for only select patient populations meeting specific criteria. Coverage requirements typically include: BMI ≥30 (or BMI ≥27 with weight-related comorbidities like hypertension, type 2 diabetes, sleep apnea, cardiovascular disease), documented previous weight loss attempts through diet/exercise, and prior authorization.

Additionally, some insurers cover Zepbound only when prescribed by specific provider types (weight loss specialists, endocrinologists, cardiologists) or only for specific comorbidities (never for pure cosmetic weight loss). Coverage for otherwise healthy individuals seeking weight loss may be denied despite meeting BMI criteria. This varies dramatically by plan.

If insurance denies coverage, you have options: request a peer-to-peer review (your doctor speaks directly with the insurance medical director), submit an appeal with detailed documentation of BMI, comorbidities, and previous weight loss attempts, or ask your insurer for a formulary exception. Many initial denials can be overturned with proper documentation and appeals.

Typical copay if approved: $35-250 per month. Most plans that cover Zepbound place it in a specialty tier with higher copays than standard tiers. Some plans require percentage coinsurance rather than flat copays. Before pursuing prior authorization, contact your insurer to understand your exact cost if approved—sometimes the copay makes the medication unaffordable anyway.

Eli Lilly Copay Assistance: The $25 Monthly Option

Eli Lilly's Mounjaro Savings Card and Zepbound Savings Card are the most impactful cost reduction programs for insured patients. Both programs offer approximately the same benefit: $25 copay per prescription (four pens per month = $25/month total for insured patients regardless of their actual insurance copay).

Eligibility for the copay card: You must have commercial insurance (not Medicare, Medicaid, or VA benefits). The card applies on top of your insurance, covering your copay amount. If your insurance copay is $35-150, the Eli Lilly card brings your cost down to $25. If your insurance copay is lower than $25, you pay your actual copay (no additional benefit). If you have no insurance, you don't qualify for the copay card alone but may qualify for patient assistance.

Duration: Copay cards typically last 24 months (through June 2026 for cards issued in 2024). After 24 months, you can request a renewal if eligible. This provides 2 years of $25 monthly copays, making annual cost $300—dramatically lower than retail pricing or higher insurance copays.

Enrollment process: Visit mounjaro.com (for diabetes) or zepbound.com (for weight loss). Click on "Savings Card" or "Copay Assistance." Answer eligibility questions (commercial insurance confirmation). Download or digitally activate the card. Provide the card number to your pharmacy when filling your prescription. The process takes 5-10 minutes and can be completed before your first prescription is filled.

Real-world impact: Most patients using the Mounjaro/Zepbound copay card pay exactly $25 monthly ($300 annually) regardless of retail pricing or higher insurance copays. This single program makes tirzepatide affordable for the vast majority of commercially insured patients. If you have commercial insurance and can afford a $25 copay, you can afford Mounjaro or Zepbound.

Eli Lilly Patient Assistance Programs for Uninsured Patients

Eli Lilly offers Patient Assistance Programs (PAP) for uninsured and underinsured patients who can't afford tirzepatide. Eligible patients receive free medication, covering all costs. This program is less publicized than copay cards but is equally important for those without commercial insurance.

Income eligibility requirements: Patients earning up to 300% of the federal poverty level (approximately $42,000 annually for an individual, $87,000 for a family of four in 2026) are eligible. These thresholds are adjusted annually. The program accounts for household income and family size. Some programs allow higher income limits depending on debt and expenses.

Enrollment process for Mounjaro PAP: Call 1-844-668-6372 or visit mounjaro.com/patient-assistance. Complete eligibility questions about insurance status and income. Submit documentation (tax return or recent pay stubs). Upon approval (typically within 3-5 business days), the program mails medication directly to you or your pharmacy, with all costs covered by the program. No copay, no out-of-pocket expenses.

Enrollment for Zepbound PAP: Call 1-844-956-4632 or visit zepbound.com. The process is identical: eligibility verification, income documentation, and approval within days. Monthly medication is provided at no cost.

Important limitation: Patient Assistance Programs typically provide free medication but don't cover doctor visits or lab work. Patients must have access to a healthcare provider willing to prescribe tirzepatide (which some community health centers or telehealth providers offer). Some programs can help connect patients with providers if needed.

Compounded Tirzepatide: Lower-Cost Alternative

Compounded tirzepatide is prepared by licensed compounding pharmacies using the raw tirzepatide API (active pharmaceutical ingredient) rather than brand-name pens. Compounding is legal under FDA regulations when performed by licensed compounders with a valid physician prescription. Compounded tirzepatide typically costs 30-50% less than brand-name versions.

Compounded tirzepatide pricing: Typically $200-400 per dose (per injection) depending on concentration and compounder. A 4-dose monthly supply costs $800-1,600 for starting doses. At maintenance doses, pricing may increase slightly to $1,200-2,000 monthly because patients use higher doses (10-15 mg) requiring more raw product. Annual cost: $10,000-24,000 depending on dose and compounder.

Comparison: Compounded tirzepatide at $1,500/month versus brand-name Zepbound at $1,200/month with copay card ($25/month) means compounded is actually more expensive than brand-name with assistance. However, compounded tirzepatide is significantly cheaper than uninsured brand-name retail pricing ($900-1,500/month without copay assistance).

Compounder selection is critical: Quality varies dramatically. Reputable compounders have GMP (Good Manufacturing Practice) certification, quality testing, and accountability. Many internet pharmacies sell low-quality compounded tirzepatide with variable concentration and purity. Before using compounded tirzepatide, verify your compounder: ask about GMP certification, third-party testing for purity/sterility, manufacturing credentials, and references.

Risks of compounded tirzepatide: Lower FDA oversight (no FDA quality guarantee), potential sterility issues (contamination risk), variable concentration (you may receive underdosed or overdosed medication), and lack of insurance coverage (you pay out-of-pocket). Brand-name tirzepatide with copay assistance is typically preferred due to guaranteed quality and lower effective cost with the $25 copay card.

International Tirzepatide Pricing and Availability

Tirzepatide is available internationally in many countries including Canada, UK, Australia, and others. Pricing varies significantly by country. Canadian Mounjaro costs approximately CAD $200-300 per pen (USD $150-225) compared to USD $225-375 in the US, making it substantially cheaper. UK pricing through NHS is covered by the national healthcare system for eligible diabetes patients.

However, importing tirzepatide from other countries into the US carries legal and safety risks: importing medications requires FDA approval (which isn't granted for personal importation of expensive medications), shipping from international pharmacies may violate laws, and you lose quality guarantee and liability protection. This option is not recommended due to legal/safety risks despite potential cost savings.

For patients considering international options due to cost: explore copay assistance and patient assistance programs first. These are typically much simpler and safer than international sourcing. If still unaffordable, discuss compounded tirzepatide with your prescriber as a legitimate lower-cost alternative.

Pharmacy Comparison and Price Negotiation Strategies

Pharmacy pricing varies: major chains (CVS, Walgreens, Rite Aid) typically charge standard retail or negotiated rates with insurance. Specialty pharmacies (used by insurance) negotiate lower rates. Mail-order pharmacies (Amazon Pharmacy, PillPack) may offer discounts. Using GoodRx or discount cards can significantly reduce prices at any pharmacy.

Strategy: Before filling at your default pharmacy, check GoodRx.com or SingleCare.com for discounted pricing. Enter your prescription details (medication, dose, quantity). Compare prices across multiple pharmacies in your area. Some charge $200/pen; others charge $350/pen for identical medication. Choose the pharmacy with the lowest GoodRx price.

Additional strategy: If using insurance + copay card, phone ahead to your pharmacy to confirm they accept Eli Lilly copay cards. Most do, but confirmation prevents issues at the counter. If your insurance requires a specialty pharmacy, your doctor's office will direct you there automatically.

Negotiation: Some patients call their pharmacy and ask "What is your cash price for Mounjaro pens?" Some pharmacies will negotiate or match competitor pricing for high-cost medications. It never hurts to ask politely if they can match a lower price you found elsewhere. The worst response is no; the best response is substantial savings.

Medicare and Medicaid Coverage Considerations

Medicare (Part D Prescription Drug Coverage): Coverage for Mounjaro and Zepbound varies by specific Medicare Advantage plan and Prescription Drug Plan chosen. Some plans cover Mounjaro for diabetes; others don't. Coverage for Zepbound is much less common on Medicare plans. You must check your specific plan's formulary or call your plan to confirm coverage.

If covered by your Medicare Part D plan: Your costs depend on the plan's cost structure. Most Medicare plans place Mounjaro/Zepbound in the specialty tier with higher copays. Typical cost: $100-250 monthly depending on plan. Donut hole (coverage gap) considerations: at higher spending levels, you may enter the donut hole where you pay higher percentages temporarily, then reach catastrophic coverage at very high spending levels.

Medicaid coverage: Medicaid is state-administered, so coverage varies dramatically by state. Some states cover Mounjaro for type 2 diabetes when clinically appropriate; many don't. Zepbound coverage through Medicaid is rare. Contact your state Medicaid program to verify if Mounjaro or Zepbound is covered in your state.

Medicare patients ineligible for copay cards: Eli Lilly's copay card program excludes Medicare beneficiaries. Medicare patient assistance programs exist but are less generous than commercial copay cards. Discuss cost with your doctor; they may have samples, research studies you can join, or other programs available through their practice.

Total Cost of Tirzepatide Therapy: Budget Planning

Best-case scenario (insured with copay card): $25/month medication cost + $100-500 annual doctor visits + $0 (if insurance covers baseline labs) = $300-1,000 annually. This is the most common scenario for patients with commercial insurance.

Moderate-cost scenario (insured without copay card): $100-150/month insurance copay + $100-500 annual doctor visits + lab costs = $1,400-2,500 annually. This scenario occurs if you don't enroll in copay assistance or have high insurance copays.

High-cost scenario (uninsured): $1,200-1,800/month for medication if using discount cards (GoodRx) or retail pricing, plus $500-1,500 annual doctor visits, plus lab costs = $16,000-25,000 annually. This scenario motivates exploring patient assistance programs or compounded alternatives.

Budget planning: Start by assuming $25-150 monthly medication cost (insurance copay), then add annual doctor visit costs ($200-600 for initial visit and quarterly follow-ups) and baseline laboratory testing ($200-500 for initial labs, periodic rechecks). Most patients spend $300-2,000 annually on tirzepatide and monitoring combined. This is comparable to or less expensive than many chronic disease management costs and is substantially less than obesity-related healthcare costs long-term.