Zepbound (Tirzepatide) for Chronic Weight Management: Uses, Side Effects, and Cost
Eli Lilly's weight-loss drug, Zepbound (tirzepatide).
Key takeaways:
- Zepbound 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 recently announced that the lowest dose of the drug will be available at $299, with the highest doses at $449.
Aiming to address demand for its weight loss drug Zepbound (tirzepatide), Eli Lilly is selling the starting dose of the medicine in four single-use vials – or one four-dose pen – to self-pay customers for $299.
Pricing for higher doses is capped at $449. The Zepbound vials and multidose KwikPens are available through the LillyDirect online pharmacy.
The vials won't be covered by insurance or qualify for the company's savings program.
What is Zepbound?
Zepbound is a once-weekly injectable medication available at six different doses (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg). It can be purchased as a single-dose vial, a single-dose auto-injector pen, or a four-dose KwikPen.
Tirzepatide was previously approved as Mounjaro to treat type 2 diabetes in the U.S. and Europe.
In the U.S., it has been approved as Zepbound not just for weight management, but also to treat obstructive sleep apnea.
In addition, there is evidence that tirzepatide may be beneficial for people with diabetes-related conditions like chronic kidney disease and heart disease.
Zepbound joins Wegovy as the second incretin-based therapy for chronic weight management. Notably, Zepbound is the first GLP-1 drug 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. 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.
Since those trials wrapped up, a retrospective analysis of Eli Lilly's Mounjaro trials suggested that tirzepatide may have protected the kidney health of people with type 2 diabetes, whether or not they already had chronic kidney disease.
More recently, tirzepatide helped people with obesity and obstructive sleep apnea breathe better at night, and it protected people with obesity and heart failure from worsening heart health.
Now, new studies are launching to investigate how tirzepatide affects colorectal cancer risk, breast cancer prognosis, and liver health. Obesity has been linked to both types of cancer as well as metabolic dysfunction-associated steatotic liver disease (MASLD), which is the progressive accumulation of excess fat on the liver that can ultimately cause the organ to fail.
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 been approved for weight management and for the treatment of moderate to severe obstructive sleep apnea 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.
Learn more about weight management and diabetes here: