Zepbound vs. Mounjaro: Cost, coverage, and differences explained

In this article:

• What’s the difference between Zepbound and Mounjaro?
• How much does Zepbound cost without insurance?
• How much does Mounjaro cost without insurance?
• Zepbound vs. Mounjaro insurance and cost comparison
• Does insurance cover Zepbound?
• Does insurance cover Mounjaro?

In this article

• What’s the difference between Zepbound and Mounjaro?
• How much does Zepbound cost without insurance?
• How much does Mounjaro cost without insurance?
• Zepbound vs. Mounjaro insurance and cost comparison
• Does insurance cover Zepbound?
• Does insurance cover Mounjaro?

Zepbound and Mounjaro are both prescription weekly injections that help lower blood sugar and suppress appetite. They share the same active ingredient, tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist, but Zepbound is FDA-approved for weight loss and obstructive sleep apnea (OSA) in adults, while Mounjaro is FDA-approved to treat Type 2 diabetes in adults. 

Because they contain the same active ingredient, some people might wonder whether one of these brand-name drugs is cheaper. Zepbound has a higher list price, but the price you actually pay depends on factors such as insurance coverage and the medical necessity of the drug.

What’s the difference between Zepbound and Mounjaro?

There is very little difference between Zepbound and Mounjaro. They are the same medication sold under different brand names for different FDA-approved uses. 

“Both are tirzepatide, and from my own experience—yes, I’ve taken both, for weight loss—same exact effects. No difference. Just a different box and a different battle with the pharmacy,” says Dr. Barbara Sparacino, MD, a triple board-certified psychiatrist and founder of The Aging Parent Coach. “Mounjaro definitely has more name recognition—like the celebrity cousin who got famous first. But once people hear that Zepbound is literally the same medication just with a different FDA indication, they’re like, ‘Wait, why didn’t someone just say that?’”

Zepbound and Mounjaro are even administered the same way, via once-weekly subcutaneous injections. Dosages for both start at 2.5 milligrams (mg) once weekly, gradually increasing to maintenance doses between 5 mg and 15 mg per week. These drugs both lower blood sugar levels, support chronic weight management, and cause the same side effects. The most common side effects are gastrointestinal issues, such as nausea, vomiting, and constipation.

That said, these prescription medications are sold under different brand names for different FDA-approved and insurance-covered purposes. “Zepbound is generally provided for individuals as a weight loss prescription, and Mounjaro is generally prescribed if the patient has Type 2 diabetes,” says Maura Fowler, RDN, CPH, a pediatric and sports nutritionist. 

Zepbound is currently FDA-approved to be used along with a reduced-calorie diet and regular exercise for the following reasons:

• To reduce body weight in people with obesity
• To reduce body weight in people who are overweight and have at least one weight-related health condition, such as hypertension (high blood pressure) or high cholesterol
• To treat moderate-to-severe obstructive sleep apnea (OSA)

Mounjaro, on the other hand, is only FDA-approved for one purpose: Blood sugar control in people with Type 2 diabetes. “Most of my patients are more [interested in weight loss] and are trying to prevent Type 2 diabetes, so they lean toward Zepbound more, knowing they have a better chance of receiving this prescription over Mounjaro,” says Fowler.

Related: Zepbound dosage | Mounjaro dosage

How much does Zepbound cost without insurance?

The average retail price of Zepbound is $1,512 per 4, 5 mg/0.5 mL prefilled pens, which is a one-month supply. However, the list prices the manufacturer sets are not always what people pay. Your out-of-pocket cost can be lowered even more with a SingleCare coupon. Costs may also vary by pharmacy and location. 

How much does Mounjaro cost without insurance?

The current list price of Mounjaro is $1,481 for 4, 5 mg/0.5 mL prefilled pens. Of course, your out-of-pocket cost of Mounjaro might be different. List prices can vary by location and pharmacy, and your out-of-pocket cost may be reduced through insurance, a coupon, or a prescription discount card.

Does insurance cover Zepbound?

Some insurance plans may cover Zepbound, but coverage varies by company and policy. It can be difficult to get insurance coverage for weight loss drugs, but insurers may cover Zepbound when prescribed for sleep apnea rather than weight loss, since this drug is also an FDA-approved OSA treatment.

Patients may need to request prior authorization and meet strict eligibility criteria, even if Zepbound is on their insurance policy’s drug formulary (the list of covered drugs). For instance, specific Aetna policies cover Zepbound for weight loss only if the patient has a body mass index (BMI) of 30 or more and has already tried a six-month weight loss plan that included diet changes and exercise. 

In general, Medicare and Medicaid don’t cover drugs for weight loss. However, specific drug coverage varies by state and policy, and it’s possible that Zepbound could be approved for a non-weight-related indication, such as severe OSA.

Does insurance cover Mounjaro?

Some insurance companies cover Mounjaro for Type 2 diabetes, but insurance coverage varies by policy. Though some healthcare providers prescribe Mounjaro off-label for weight loss, it is very unlikely to be covered since weight management isn’t an FDA-approved use of Mounjaro. 

Even when a health plan does cover Mounjaro, stipulations often apply. Patients may need prior authorization or step therapy, which involves trying lower-cost or generic alternatives before coverage kicks in.

Some Medicare Part D plans also cover Mounjaro, though only for diabetes treatment. Prior authorization and step therapy may also be required for Medicare and Medicaid coverage of Mounjaro. 

Bottom line

Your out-of-pocket cost for Zepbound vs. Mounjaro depends on insurance coverage and the condition the drug has been prescribed to treat. Though it may be tempting to try to get one drug over another because of a lower price point, it’s important to remember that only a healthcare provider familiar with your medical history, medical condition(s), and other medications can offer medical advice on the best GIP/GLP-1 or GLP-1 agonist for you. In Dr. Sparacino’s experience with Zepbound and Mounjaro, the “better” drug is “less about clinical superiority and more about coverage, coupons, and how many prior [authorizations] your soul can withstand.”