A Closer Look at Cost Structure of Ozempic and Other New Weight Loss Drugs
In this article, you'll get:
Okay, let's be honest: if these drugs do wonders, why is it so hard to get them for people like you and I? Because they are just so expensive. In the ever-evolving world of healthcare and pharmaceuticals, the introduction of innovative drugs like Ozempic, Wegovy, Mounjaro, and Zepbound has marked a significant milestone in the treatment of obesity and diabetes. These medications, while offering newfound hope for patients, also come with a hefty price tag that warrants a closer examination. It is essential for individuals considering these treatments to first consult with a healthcare provider for a prescription.
So, how many $ signs are we talking about exactly? Take people in the U.S. for example, as a visual thinker, I created this chart below to summarize what I found:
Ozempic: A Game Changer in Diabetes Management
Developed by Novo Nordisk, Ozempic (Semaglutide) is primarily used for the treatment of type 2 diabetes. It stands out due to its efficacy in improving blood sugar levels and promoting weight loss. The cost of Ozempic, however, can be a consideration for many:
At the time of writing, a single pen, which contains a month's supply, is priced at approximately $935 without insurance in the United States. While insurance coverage can significantly reduce this cost, it is crucial to note that the price can vary based on insurance plans and pharmacy locations.
If you have commercial or private insurance that covers Ozempic, Novo Nordisk may offer a Savings Card to save you up to $150 per month supply—in other words, a discount up to $150 a month up to 24 months. But you have a minimum payment of $25 per prescription fill. That means after applying the discount, the math shows you just need to pay $10, but Novo Nordisk will still ask you to pay $25.
Novo Nordisk also offers Ozempic at no cost through its Patient Assistance Program if you meet certain criteria such as being a US citizen or legal resident, and having a total household income at or below 400% of the federal poverty levels, no insurance coverage or government program enrollment such as Medicaid. Check their website for detailed information.
Wegovy: Paving the Way for Obesity Treatment
Wegovy, also based on semaglutide and developed by Novo Nordisk, is specifically targeted at chronic weight management. Approved by the FDA in June 2021, it has shown promising results in clinical trials. The pricing strategy for Wegovy is aligned with its unique positioning in the market.
A monthly supply is estimated to cost around $1,300 without insurance. Again, this is a list price, it might be some up and down depending on where you get it. Of course, if you have insurance, and it covers this, your monthly cost will be a different story.
Similar to Ozempic, Novo Nordisk offers a Savings Offer for people with commercial insurance. Here is how it works:
If your insurance covers Wegovy:
First 13 months, you can get a discount up to $225 per month supply. After applying the discount, your minimum pay can be $0 per month.
After 13 months, this discount becomes up to $200 per month discount. And your minimum pay becomes $25 per month after applying the discount. (That means if after your discount is applied, it seems you just need to pay $10, yet Novo will sill ask you to pay $25 as the minimum payment).
If your insurance does not cover Wegovy or totally self pay:
The saving is up to $500 per month.
Mounjaro: The New Contender
Mounjaro (Tirzepatide), introduced by Eli Lilly, is a relatively new entrant in the field, designed for managing type 2 diabetes. Its dual-action formula has garnered attention for its effectiveness.
The pricing of Mounjaro is also quite hefty, with a month's supply hovering around $1,069 as we are writing, without insurance coverage. As with other medications in this category, the actual out-of-pocket cost for patients can vary widely depending on their insurance specifics.
Similar to Ozempic and Wegovy from Novo Nordisk, Eli Lilly also offers Savings Card to patients with commercial insurance, if you are eligible. Here is how it works:
If your insurance covers Mounjaro, this offer can provide you with up to $150 per month discount, but your minimum payment is $25 per prescription fill. And the max savings a year is $1,800 (pretty much means you top the $150 for whole 12 month, aka. $150 x 12 = $1,800).
If you insurance does not cover Mounjaro, you may get up to $573 savings per month. And you max savings per year is $3,438, which equals to pretty much 6 months of max savings. The savings is deep but the length of the offer is a bummer for sure.
Unlike Novo Nordisk, Eli Lily doesn’t seem to offer no-cost option for low income patients for Mounjaro.
Zepbound: The Emerging Option for Obesity Treatment
Zepbound (Tirzepatide), the least known among the four, is an emerging medication in this space recently approved by FDA for obesity treatments.
As a direct competitor to Wegovy, Zepbound is listed slightly lower at around $1,060 per month without insurance.
Savings card option is like Mounjaro.
For the lucky few whose commercial insurance covers Zepbound, you can get monthly discount up to $150 with a separate max of $1,800 per year (generally means $150 x 12 months). The minimum payment is $25 per prescription fill.
If your commercial insurance does not cover Zepbound, the monthly discount can be up to $563 per month, and a separate max of $7,319 per year. This is bigger than Wegovy’s similar discount.
Note: The prices and programs mentioned are estimates based on U.S. market and subject to change. For current pricing, please consult healthcare providers and local pharmacies.