"What are the specific circumstances under which insurance will cover the use of Zepbound?"

Zepbound is a prescription medication used for weight management in adults with obesity or overweight and at least one weight-related condition.

Insurance coverage for Zepbound is primarily available through commercial drug insurance plans that cover the medication.

Patients with commercial insurance and a prescription consistent with FDA-approved labeling can pay as little as $25 for a 1-month, 2-month, or 3-month prescription fill of Zepbound.

Those without insurance coverage may be eligible for a discounted price starting at $550 per month through Eli Lilly.

Medicare and Medicaid currently do not cover weight loss medications like Zepbound, but coverage may vary by state.

If a commercial insurance plan does not cover Zepbound, patients may be eligible for a discounted price through Eli Lilly's patient assistance program.

Zepbound is a glucagon-like peptide-1 (GLP-1) receptor agonist, which works by mimicking the functions of natural hormones to regulate appetite and promote weight loss.

The average list price of Zepbound is around $1,060 for a 28-day supply without insurance or manufacturer discounts.

Zepbound's effectiveness for weight loss has been shown in clinical trials, with patients losing up to 22.5% of their body weight over a 72-week period.

Patients may require prior authorization from their insurance company before insurance covers Zepbound, meaning the company and their doctor will discuss Zepbound in the context of their treatment.

Zepbound is available in pre-filled pens that are designed for easy injection, with one pen providing a 1-month supply when used according to the recommended dosing schedule.

Zepbound's long-term safety and efficacy are still being studied, and patients should work closely with their healthcare provider to determine if Zepbound is right for them.