Why is Mounjaro so expensive?

Table of Contents

Mounjaro is a powerful injectable drug that doctors prescribe to control blood sugar levels. However, this weekly injection can be costly.

The cost of Mounjaro may differ depending on several factors, such as your prescription dosage, health insurance status, and the pharmacy you choose to buy from.

This article explains why Mounjaro is so expensive in the United States and suggests ways to cut costs. From insurance to coupons and discounts, we highlight practical ways to reduce the financial burden of diabetes care for patients prescribed by Mounjaro.

What is Mounjaro?

Tirzepatide, or Mounjaro as it is scientifically named, is an innovative injectable drug created especially for individuals with type 2 diabetes. Its principal aim is to control blood sugar levels successfully.

The Food and Drug Administration (FDA) has endorsed Mounjaro as an effective medication for type 2 Diabetes. But you could boost its effectiveness with regular exercise and a good diet.

Mounjaro has attracted much attention for its effectiveness in helping people lose weight while managing type 2 Diabetes, thanks to its ability to suppress hunger and create a long-lasting feeling of fullness. It has become a popular medication for those suffering from obesity

Despite its prowess in helping people shed extra pounds, Mounjaro is not one of the FDA-approved medications for cosmetic or aesthetic weight loss procedures. Instead, its use is limited to those dealing with health issues like obesity and diabetes.

mounjaro

What is the Average Cost of Mounjaro?

The price of Mounjaro is not constant; it varies significantly between states and cities depending on the drugstore you
select. Generally speaking, Mounjaro costs about $1,023.04 for each injection. This average, though, is subject to significant fluctuations. Patients may have to pay far more in some states or towns, where the cost of an injection might reach $1,351.

Patients usually need four injections or more every month when considering the prescribed dosage. This adds up to
a significant out-of-pocket expense—more than $4,000 for each medication refill every few weeks. These expenses
highlight the importance of looking into insurance and savings plans to lessen the financial burden of Mounjaro treatments.

Why is Mounjaro so Expensive?

The brand-name medication Mounjaro, which is intended to help people with type 2 diabetes, has drawn attention due to its high price. The high cost of Mounjaro is caused by several factors, reflecting the difficulties involved in manufacturing and distributing the medication.
Thorough Testing

Mounjaro is properly tested to guarantee safety and efficacy. This extensive testing takes time and money. The initial production of Mounjaro is expensive due to the necessity for exact results and thorough investigations.

Patent Safeguard

Mounjaro, like many medications, is patented after testing. The producer has medicines under this patent as a shield that prohibits other companies from making or selling the formulation. This exclusivity allows the company to repay its significant R&D and testing expenses. While testing costs decrease with time, patent exclusivity keeps prices high.

Limited Competition

As long as the patent holds, Mounjaro has few competitors. With no generics, the company can monopolize the market and set higher prices to maximize profits. After the patent expires, competing pharmaceutical companies can introduce cheaper generic copies due to lower R&D expenditures.

Manufacturing Costs

Mounjaro manufacture requires specialized equipment, competent personnel, and strict quality control. Every batch must be precise and consistent, increasing production costs. These production expenditures, research, testing, and patent protection make Mounjaro expensive.

Mounjaro's high price stems from its complex research, development, testing, patent protection, limited competition, and manufacturing. The drug's high cost may strain patients' finances, but it also represents the investments in its safety, efficacy, and availability to improve diabetes care.

Is Mounjaro Available As A Generic?

No, a generic version of Mounjaro is not currently available. It is only available as a brand-name medication, which helps to preserve its unique position in the pharmaceutical industry.

Is Insurance Available for Mounjaro?

Not every insurance plan covers this prescription drug for all its uses. While some insurance may cover Mounjaro’s FDA-approved use for treating type 2 diabetes, most will not substitute its off-label use for weight loss. Since Mounjaro isn’t officially approved for weight loss, insurance might not be the best option if you consider using it to treat obesity.

The problem is that even though your plan theoretically covers Mounjaro, you might still need your healthcare provider’s additional clearance, and some doctors will not prescribe Mounjaro for weight loss. So, it is best to review the specifics of your insurance plan’s prescription drug coverage before proceeding.

If you don’t understand insurance terminology, a short call to your insurance company can help explain your coverage. Asking directly is the best way to find out, as every insurance plan
differs.

How to Ensure Your
Insurance Covers Mounjaro

Mounjaro is technically approved to treat type 2 diabetes, not obesity, so getting insurance coverage can be a bit of a maze if you’re trying to lose weight. Without insurance, the cost of Mounjaro can reach up to $1,200 per month, depending on the drugstore you use If you have type 2 diabetes and have commercial insurance, a Mounjaro Savings Card may reduce your monthly cost to just $25 for a month’s supply. Here are three actions to take if you’re trying to convince your insurance company to sponsor treatment for Mounjaro.

Speak with Your Medical Professional

Make sure Mounjaro is the right fit for you before venturing into insurance. To determine if this medicine is right for you, discuss it honestly with your doctor. After receiving a prescription, you can look into your insurance options.

Speak with Your Insurance Company

If you would like to understand the intricacies around coverage, you can contact your insurance provider. Specifically, enquire about Mounjaro and if it is included in your plan. Remember to ask about upfront costs and the requirement for prior authorization. You can review the drug list—also referred to as a drug formulary—that is part of your insurance plan's information to get started.

Do Medicare and Medicaid cover Mounjaro?

Mounjaro’s eligibility for Medicare and Medicaid depends on your particular plan. You must speak with your plan provider directly to determine if Mounjaro is covered by your Medicare or Medicaid scenario. These insurance programs provide a range of plans, each with unique coverage details and perks, so it’s essential to determine what your specific plan covers and how much it will cost.

Also, your plan may need prior authorization before Mounjaro is covered. This implies you need your healthcare provider’s consent before the prescription is covered.

Seeking advice from your physician might be helpful if you have concerns regarding Mounjaro’s cost of your Medicare or Medicaid benefits. They can provide information about possible expenses so you know exactly what your financial obligations are about this prescription.

Be Consistent

Keep going if your insurance company initially declines to cover you. In some cases of delay, your doctor may be able to help with the process. Eli Lilly even offers a valuable tool as a template letter of medical necessity. This is an opportunity for your healthcare practitioner to speak out for you and swing the odds in your favor.

Following these guidelines and advocating for your needs will help you navigate insurance successfully and make Mounjaro an affordable part of your healthcare journey.

What are the Alternatives to
Mounjaro: Finding Your Fit

Many GLP-1 medicines can replace Mounjaro in diabetes and weight management. These diabetic treatments manage blood sugar and help you lose weight, making them strong competitors.

Let’s look over some standard options and their pros and cons to help you choose the right medication based on your health needs and insurance coverage.

Ozempic (Semaglutide)

Like Mounjaro, Ozempic is an injectable GLP-1 agonist for type 2 diabetes. It's prescribed off-label for weight loss. Studies suggest that 1 mg of Ozempic reduces body weight by up to 7%, proving its diabetes and weight loss benefits.

wegovy

Wegovy (Semaglutide)

It is FDA-approved for weight management, sharing its active ingredient, Semaglutide, with Ozempic. Weekly maximum dose of Wegovy (2.4 mg) has shown outstanding benefits, resulting in 15% weight loss. It's advised for people with BMIs of 30 or 27 and weight-related medical issues.

saxenda

Saxenda (Liraglutide)

Another GLP-1 candidate is Saxenda (Liraglutide), authorized for chronic weight management. Clinical trials found that Saxenda users lost 5–10% of their body weight annually. This drug is for long-term weight management with diet and exercise.

Trulicity (Dulaglutide)

Developed for type 2 diabetes, Trulicity also aids in weight loss. As appetite decreases, weight loss averages 1% to 2% within six months, depending on the dose. When combined with metformin, another diabetes drug, it can reduce body weight by 4.6%, making it versatile.

Bydureon (Exenatide)

Treats type 2 diabetes and aids weight loss. Studies show it's especially beneficial for overweight or obese people without diabetes. It may not lose weight as quickly as other methods, but it does so gradually, like reduced-calorie diets. Knowing what fits your physique and health goals is crucial. Check out Ro Body for personalized weight loss support and plans. This personalized care can help you make the appropriate health decision.

Conclusion

Even though Mounjaro is expensive, there are ways to get relief, such as through the Mounjaro Savings Card and local coupons. It is also important to understand insurance coverage details, cost, and other options regarding Mounjaro if you wish to be covered by insurance.

People can bridge the gap between medical requirements and financial limitations by being informed and proactive. Together, patients and healthcare professionals can ensure that critical treatments like Mounjaro are not merely a possibility but a reality, providing universal access to healthcare.

Written & Reviewed By
The Diet Pens Team

The Diet Pens Team is a dedicated group of healthcare enthusiasts, nutritionists, and local pharmacists committed to providing the latest and most accurate information about diet pens and weight management. Our team combines years of expertise in healthcare and nutrition with a passion for helping individuals achieve their health goals.

My Cart
Close Recently Viewed
Categories