Pharmaceutical Executive Editorial Staff

Patients with obesity are now able to access Zepbound (tirzepatide) with a prescription at retail and mail-order pharmacies across six dose strengths.
Eli Lilly and Company announced today that its obesity treatment Zepbound (tirzepatide) is now commercially available at pharmacies in the United States.1 Last month, the FDA approved Zepbound injection as the first and only approved treatment for obesity that activates both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) hormone receptors.2

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Patients with obesity are now able to access Zepbound with a prescription at retail and mail-order pharmacies across six dose strengths—2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg.
"Today opens another chapter for adults living with obesity who have been looking for a new treatment option like Zepbound," said Rhonda Pacheco, group vice president, Lilly Diabetes and Obesity, US, in a press release.1
The drug will have a list price of $1,059.87, which is approximately 20% less than the 2.4 mg semaglutide injection indicated for weight loss. Lilly announced a commercial savings card program to help increase access for patients who may benefit. Individuals with commercial insurance with coverage for Zepbound may be eligible to pay $25 for a one- or three-month prescription. Individuals with commercial insurance without coverage for Zepbound may be eligible to pay as low as $550 for a one-month prescription.
As of December 1, Zepbound was added to the National Preferred Formulary for Express Scripts and Cigna Healthcare. As of December 15, 2023, the drug will be added to Cigna Healthcare's commercial formularies, according to Eli Lilly.
Zepbound is indicated for adults with obesity with a BMI of 30 kg/m2 or greater, or overweight individuals with a BMI of 27 kg/m2 or greater who also have weight-related medical problems, including hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease.3
Preclinical and clinical trials have shown that dual GIP/GLP-1 agonist therapy produces superior glucose control and weight loss compared to selective GLP-1 receptor agonists.3 GLP-1 and GIP are classified as incretins, which are expressed throughout the body, in areas such as pancreatic beta cells and the gastrointestinal tract. GLP-1 and GIP have been found to increase insulin from beta cells and glucose uptake by muscles while lowering blood glucose. GLP-1 stimulates glucose-dependent reduction of glucagon from alpha cells, lowering glucose production from the liver, and reducing blood glucose.3
Zepbound’s mechanisms of action include stimulation of first- and second-phase insulin secretion and decreased glucagon levels in a glucose-dependent manner. Zepbound has been shown to inhibit gastric emptying, reduce fasting and postprandial glucose concentration, reduce food intake, and lower body weight in patients with type 2 diabetes, as well as increasing insulin sensitivity.3
Clinical trials have shown that coadministration of a GIP and GLP-1R agonist significantly elevates insulin response while suppressing glucagon secretion vs. separate administration of either hormone alone.3
"The availability of Zepbound in US pharmacies is the first step, but we have to work hand-in-hand with employers, government and healthcare industry partners to remove barriers and make Zepbound available to those who need it,” Pacheco said in the release.1 “We are excited to see growing coverage in the marketplace, giving millions of Americans access to Zepbound."