Mounjaro (tirzepatide) is a prescription medication that has gained significant attention for its effectiveness in managing type 2 diabetes and weight loss. Approved by the FDA, Mounjaro works by targeting GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptors, helping regulate blood sugar levels and promoting weight loss.
While Mounjaro is an innovative treatment, many patients wonder about its cost, particularly how much they would need to pay out of pocket. The price of Mounjaro varies based on factors such as insurance coverage, pharmacy discounts, and eligibility for savings programs. In this article, we’ll break down the costs, including what you can expect to pay if you don’t have insurance, how insurance may affect your costs, and potential ways to save on Mounjaro.
Mounjaro’s List Price: How Much Does It Cost Without Insurance?
The out-of-pocket cost of Mounjaro without insurance can be quite high. As of 2024, the list price (also called the wholesale acquisition cost) for Mounjaro is approximately $1,023 per month for a supply of four weekly injections. This price is for the standard dosage but may vary depending on the specific dose prescribed by your healthcare provider.
Factors Affecting the Cost Without Insurance
If you are paying for Mounjaro out of pocket, the final cost at the pharmacy can vary based on:
- Pharmacy Pricing – Different pharmacies may have slightly different pricing structures. Some may offer discount programs or membership savings.
- State Regulations – Pricing may vary slightly by state due to local regulations on drug pricing.
- Dosage Adjustments – If your doctor prescribes a higher dose or changes your prescription, the cost per month may increase.
If you do not have insurance or do not qualify for savings programs, Mounjaro can be a significant financial burden. However, there are several ways to reduce the cost, which we’ll explore later in this article.
How Much is Mounjaro with Insurance?
Insurance coverage for Mounjaro varies depending on your provider and specific plan. Generally, the cost of Mounjaro with insurance can range from $25 to several hundred dollars per month, depending on factors such as deductibles, copays, and formulary placement.
Commercial Insurance Coverage
Many commercial insurance plans (such as those provided by employers or purchased through the marketplace) cover Mounjaro for patients with type 2 diabetes. However, insurance policies may have restrictions:
- Prior Authorization Requirements – Some insurance companies require your doctor to submit a request explaining why Mounjaro is medically necessary.
- Step Therapy – Some plans may require you to try other diabetes medications first before covering Mounjaro.
- Coverage Tiers – Prescription medications are categorized into tiers, with Tier 1 drugs being the cheapest and higher-tier drugs requiring more out-of-pocket spending.
Patients with insurance that covers Mounjaro may pay anywhere from $25 to $150 per month, depending on their plan. However, some insurance plans may not cover Mounjaro at all, especially if it is prescribed for weight loss rather than diabetes.
Medicare and Medicaid Coverage
Medicare and Medicaid coverage for Mounjaro is more complex:
- Medicare Part D Plans – Some plans cover Mounjaro for type 2 diabetes, but the copay varies widely. Patients can expect to pay anywhere from $200 to $500 per month, depending on their plan.
- Medicaid – Coverage varies by state. Some Medicaid programs cover Mounjaro at a low copay, while others may not include it in their formularies.
If you have Medicare or Medicaid, it’s best to check with your provider or pharmacy to determine your specific out-of-pocket cost.
Ways to Save on Mounjaro
If you are concerned about the cost of Mounjaro, there are several strategies that may help reduce your out-of-pocket expenses.
1. Mounjaro Savings Card (Eli Lilly Savings Program)
Eli Lilly, the manufacturer of Mounjaro, offers a savings card for eligible patients with commercial insurance.
- Cost with Savings Card: Eligible patients may pay as little as $25 per month for up to 12 months.
- Eligibility: The program is typically available to those with commercial insurance but not for those on Medicare, Medicaid, or government-sponsored insurance.
You can check your eligibility and enroll in the savings program on the Mounjaro website or by asking your doctor for assistance.
2. Patient Assistance Programs
Eli Lilly also has a patient assistance program for those with limited income who cannot afford Mounjaro. This program may provide the medication for free or at a significantly reduced cost.
3. Prescription Discount Cards
Several third-party companies offer discount cards that may help lower the cost of Mounjaro. Some options include:
- GoodRx
- SingleCare
- Cost Plus Drugs
These programs do not provide insurance coverage but can offer significant discounts at participating pharmacies.
4. Switching to Alternative Medications
If Mounjaro is too expensive, talk to your doctor about alternative GLP-1 receptor agonists, such as:
- Ozempic (semaglutide) – Used for type 2 diabetes, similar mechanism to Mounjaro.
- Wegovy (semaglutide) – Approved for weight loss, similar effects on appetite and glucose control.
- Trulicity (dulaglutide) – Another option for managing type 2 diabetes.
While these medications have different pricing structures, some may be more affordable depending on your insurance coverage.
5. Checking Different Pharmacies
The price of Mounjaro can vary from one pharmacy to another. If you’re paying out of pocket, compare prices at different pharmacies, including:
- Major chain pharmacies (CVS, Walgreens, Rite Aid)
- Warehouse clubs (Costco, Sam’s Club) – sometimes offer lower prices for members
- Online pharmacies – Some reputable online pharmacies may offer better pricing
Final Thoughts: Is Mounjaro Affordable?
The out-of-pocket cost of Mounjaro can be quite high, particularly for those without insurance. While the list price is over $1,000 per month, many people can reduce their costs through:
- Insurance coverage
- Manufacturer savings programs
- Patient assistance programs
- Prescription discount cards
If you’re considering Mounjaro, talk to your doctor about your options and ask about financial assistance programs that may be available. By exploring different ways to save, you may be able to significantly lower the cost of your medication and continue receiving the benefits of this powerful treatment for diabetes and weight loss.
References
To provide accurate and up-to-date information on Mounjaro’s cost, savings programs, and insurance coverage, the following sources were consulted:
- Eli Lilly Official Website – Manufacturer information on Mounjaro pricing, savings programs, and patient assistance options.
- U.S. Food & Drug Administration (FDA) – Approval details, prescribing information, and regulatory status of Mounjaro.
- GoodRx – Current pricing data for Mounjaro across various pharmacies and available discounts.
- SingleCare – Prescription discount program offering cost comparisons for Mounjaro at different pharmacies.
- Medicare and Medicaid Services (CMS) – Information on coverage policies for Mounjaro under Medicare and Medicaid.
- American Diabetes Association (ADA) – Guidance on diabetes treatments, medication affordability, and financial assistance programs.
- Cost Plus Drugs – An online pharmacy that provides pricing transparency and lower-cost options for prescription medications.
- National Institutes of Health (NIH) – National Library of Medicine – Clinical studies and research articles on Mounjaro’s effectiveness and safety.
- Centers for Disease Control and Prevention (CDC) – Information on diabetes management, GLP-1 receptor agonists, and access to care.
- Walmart, CVS, Walgreens, and Costco Pharmacy Websites – Direct price checks and potential savings on Mounjaro at different pharmacy chains.
- https://www.walmart.com/pharmacy
- https://www.cvs.com
- https://www.walgreens.com
- https://www.costco.com/pharmacy
How to Use These References
These references provide valuable insights into the cost of Mounjaro, alternative savings strategies, and insurance policies. If you are considering Mounjaro and need to determine your exact out-of-pocket costs, check with your insurance provider, pharmacy, or the manufacturer directly for the most up-to-date information.
