Zepbound (Tirzepatide) for Chronic Weight Management: Uses, Side Effects, and Cost
Eli Lilly's weight-loss drug, Zepbound (tirzepatide).
Key takeaways:
- Zepbound, a new weight loss drug, targets two key hormone receptors (GIP and GLP-1) to help reduce excess weight.
- Mounjaro and Zepbound (generic name tirzepatide) are approved to treat several type 2 diabetes and weight loss, respectively.
- The latest: Eli Lilly, the maker of Zepbound, recently announced that the two lowest doses of the drug will be available at a reduced cost of $400 and $550 and won't be covered by insurance.
Aiming to address demand for its weight loss drug Zepbound (tirzepatide), Eli Lilly announced it would cut the cash price of the drug in half and begin distributing the medicine in single-use vials for its two lowest recommended doses – 2.5 mg and 5 mg.
A four-week supply of the 2.5 mg single-dose vials of Zepbound will now cost $400 and the 5 mg dose will cost $550. While still pricey, the monthly cost for all dosages previously was $1,060. The company also announced the Zepbound vials will be sold from its telehealth and online pharmacy site LillyDirect.
The vials won't be covered by insurance or qualify for the company's savings program.
Some people who use the drug have been calling for distribution by vial to reduce the delays in distribution caused in part by the process of manufacturing auto-injector pens. The higher doses (7.5 mg, 10 mg, 12.5 mg, and 15 mg) will not be included in the new program. All Zepbound doses will still be sold as auto-injector pens, though the lower doses are only offered at a reduced price in vial form.
What is Zepbound?
Zepbound is a once-weekly injectable medication available as an auto-injector pen at six different doses (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg) and, as of August 2024, in vials for the two smallest doses.
Tirzepatide was previously approved as Mounjaro to treat type 2 diabetes in the U.S. and Europe. It’s also currently being investigated in numerous trials for diabetes-related conditions like chronic kidney disease, obstructive sleep apnea, and cardiovascular disease.
Zepbound joins Wegovy as the second incretin-based therapy for chronic weight management. Notably, Zepbound is the first dual incretin agonist to be approved for obesity. As a dual agonist, Zepbound targets two incretin hormone receptors – GIP and GLP-1 – to address underlying causes of excess weight.
How does Zepbound fit into obesity treatment?
“The introduction of these medications is transformational in the care of patients with obesity,” said Dr. W. Timothy Garvey, director of the Diabetes Research Center at the University of Alabama. “These medications effectively treat a broad array of obesity-related complications and thus substantially augment our ability to improve quality of life and the health of patients.”
According to Dr. Vanita Aroda, director of diabetes clinical research at Brigham and Women's Hospital, this new generation of powerful weight loss medications may change how people with obesity think about long-term health goals.
With a wide array of options for managing excess weight, Aroda said there can be a greater emphasis on achieving person-centered goals. These could include improved mobility, performing household tasks, exercising, or playing with grandchildren, for instance.
Prior to the approval of Wegovy (semaglutide) in 2021, there were a limited number of weight loss drugs available. Looking beyond Wegovy and Zepbound, there are several other drugs in development that provide even greater weight reduction and may have fewer side effects than the currently approved medicines.
“The present days are very bright indeed for weight loss drugs and the future is even brighter," said Dr. Charles Alexander, an endocrinologist and diaTribe’s scientific and medical advisor.
What does the research on Zepbound show?
Zepbound has been studied in several clinical trials in the SURMOUNT program, which includes four completed trials and multiple ongoing studies.
The FDA approval of Zepbound for chronic weight management was based on data from the SURMOUNT-1 and SURMOUNT-2 trials, which included nearly 3,500 participants in total.
Key findings from the SURMOUNT studies include:
- In SURMOUNT-1, participants on the highest dose of Zepbound (15 mg) lost 21% of their body weight (about 52 pounds) from an average starting weight of 231 pounds.
- Roughly 1 in 3 participants in SURMOUNT-1 taking the highest dose of Zepbound lost over 25% of their body weight.
- In SURMOUNT-2, participants taking Zepbound 15 mg achieved weight reductions of 16%, losing an average of 34 pounds.
- Nearly half of all SURMOUNT-2 participants on Zepbound were able to lower their A1C to what is considered a normal level, 5.7%.
- Zepbound also led to improvements in triglyceride and cholesterol levels, blood pressure, and fasting insulin levels.
- Higher doses of tirzepatide reduced the progression from prediabetes to type 2 diabetes by about 90% in people with overweight or obesity.
In people with type 2 diabetes, tirzepatide has been shown to lower uACR (a measure of kidney function) and also has heart benefits.
Ongoing studies are investigating how Zepbound affects long-term cardiovascular health and works in specific populations, such as Asian people with obesity who don’t have type 2 diabetes.
Does Zepbound have side effects?
Similar to other GLP-1 receptor agonists, gastrointestinal issues are the most common side effects of Zepbound. In clinical trials, most participants reported some side effects, but they tended to be short-lasting and mainly occurred during the dose escalation period. Side effects may include:
- Nausea
- Vomiting
- Diarrhea
- Decreased appetite
- Constipation
- Abdominal pain
- Indigestion
A healthcare provider should be contacted right away if someone taking Zepbound experiences severe stomach pain or pain that won’t go away, a serious allergic reaction, changes in vision, or mental changes that are new, worse, or cause worry.
Who can be prescribed Zepbound?
At this time, Zepbound has only been approved for weight management among adults with obesity, or an average body mass index (BMI) of 30 or greater.
It’s also approved for adults with overweight (BMI of 27 or greater) who have conditions like hypertension (high blood pressure), high cholesterol, type 2 diabetes, obstructive sleep apnea, or heart disease.
Zepbound is currently being studied in younger populations but has not yet been approved for children and teens or people with type 1 diabetes.
How do Zepbound discount programs work?
Lilly offers a savings card to reduce out-of-pocket costs for Zepbound for people with commercial insurance. This would reduce the price to as low as $25 for a one to three-month supply using insurance that covers Zepbound.
For those who don’t have coverage for Zepbound, the cost would be around $650 for a one-month supply of the auto-injector pens.
Learn more about weight management and diabetes here: