Eli Lilly lowers cost of weight loss drug

Drugmaker Eli Lilly is significantly lowering the prices of the two lowest doses of its blockbuster weight loss drug Zepbound, it said Tuesday, in a move to expand access and ease supply constraints. Two key changes to how people get and use the cheaper medicine, however, might not be appealing to some patients.

Under the new pricing plan, a month’s supply of the lowest dose, 2.5 milligrams, will cost $399, while a month’s supply of the 5 mg dose will cost $549. That’s down from a monthly list price of $1,059, regardless of the dosage.

The lower-cost doses will be offered only through Lilly’s telehealth platform, LillyDirect, however, and they won’t be covered by insurance, meaning patients will need to pay for them in cash. Patients who opt for the lower-cost doses also won’t qualify for Lilly’s discount savings program. 

Lilly said it’s able to charge the lower price because the drug will be sold in vials rather than single-dose auto-injector pens, which means patients will need to draw the medicine out of the vial with a syringe. (The 2.5 and 5 mg doses will still be available in the auto-injector pens as well, just not at the new discounted price.)

Frustrated Zepbound users have been advocating for vial options for some time, as they believe Lilly’s ongoing supply problems stem from the complicated manufacturing process required for the auto-injector pens. Some patients have instead looked to compounded versions of the weight loss drug, which typically come in vials and are less expensive. 

“These new vials not only help us meet the high demand for our obesity medicine, but also broaden access for patients seeking a safe and effective treatment option,” Patrik Jonsson, president of Lilly USA, said in a press release.

Dr. Maria Daniela Hurtado Andrade, an endocrinologist at the Mayo Clinic in Jacksonville, Florida, questioned who would benefit from the lower-cost versions. The $399 price for the lowest dose is still almost $5,000 a year — an insurmountable cost for many racial and ethnic minorities, she said. 

“The majority of patients will not be able to afford the medication, still,” Hurtado Andrade said.

The move to only cut the prices of the lowest doses, she added, may also backfire. People may feel negatively about being limited to the lower doses, while the more effective options are reserved for the wealthy and those who can afford them.

“We’re only giving people a taste of hope,” she said.

Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, called it an “overall win” for the obesity community. 

“I am excited to see how Novo Nordisk responds to this because I think they have no choice but to also lower the price of their medications,” she said.

Lilly and Novo Nordisk, the maker of Ozempic and Wegovy, have been under pressure to lower the cost of their hugely popular — but pricey — weight loss drugs.

In July, President Joe Biden and Sen. Bernie Sanders, I-Vt., the chair of the Health, Education, Labor, and Pensions Committee, wrote in an op-ed in USA Today that both drugmakers “must stop ripping off Americans with high drug prices.” 

In an interview in June, Sanders called the higher prices of Novo Nordisk’s medications “absurd” and said he was spearheading a public pressure campaign to get it to lower its prices. Novo Nordisk CEO Lars Fruergaard Jørgensen has agreed to testify before Sanders’ committee next month. 

Sanders said in a statement that he was “pleased that Eli Lilly took a modest step forward.”

The senator criticized other moves by the drugmaker, however, including raising the cost of Zepbound for patients on its assistance program and not lowering the price its diabetes drug Mounjaro.

“There is no rational reason, other than greed, why Mounjaro should cost $1,069 a month in the United States but just $485 in the United Kingdom and $94 in Japan,” Sanders said.

A Novo Nordisk spokesperson declined to say whether the company plans to lower the cost of its weight loss drug Wegovy.

In a statement, the spokesperson said, “the most effective way for the millions of Americans living with obesity to access affordable medication is by ensuring coverage through government and commercial insurance plans.”

Who can get the lower-cost vials?

Lilly said the lower-cost vials of Zepbound will provide patients with another option, particularly people without insurance, those whose insurance won’t cover the cost of the drug or those who don’t qualify for the company’s discount savings program. Zepbound’s savings program excludes people on government-run insurance programs such as Medicare and Medicaid.

Doctors can send prescriptions for the vials to LillyDirect, which will ship them directly to patients, the company said. The vials will be available on LillyDirect in all 50 states, it said. Lilly will provide instructions on how to use the vials and will also make syringes available for purchase if people want them. 

Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in North Carolina, said one issue he has had with using LillyDirect is supply. 

“We tried to utilize that when they first announced it, and they didn’t have any supply,” said McGowan, who spoke to NBC News on Monday and wasn’t told about Lilly’s new pricing announcement. “It was no better than any other pharmacies.”

Lilly says the move to vials should help free up supply. It has chosen to make only two of its six doses available for lower prices. The 2.5 mg dose is considered the “starter” dose — the one patients take first before they move up to higher doses until they reach their so-called maintenance doses. 

McGowan said most patients in his practice stay on the 10 mg or 15 mg doses of Zepbound, although that often depends on supply. He said that none of his patients use the 2.5 mg or 5 mg doses long-term but that he believes they would if the prices were lower. 

That having been said, “patients who are responding well to the high doses want to stay on the high doses,” he said. “We don’t want to step down and risk weight recurrence.”

Hurtado Andrade said she also worries about the transition from pens to vials, saying some patients, including older adults, may find it difficult to use a syringe.

“It may be a roadblock,” she said. “The pens are very straightforward. You have to press one button to get the dose you need every week.”

For D Scott, 46, of Las Vegas, said she doesn’t like the idea of drawing up medication with a syringe. 

Scott, who asked that only the initial of her first name be used, said she had been overweight her entire life. After years of diet and exercising, she was prescribed Zepbound about a month ago. 

Her insurance doesn’t cover the medication, but she can get it for $550 a month out of pocket through Eli Lilly’s discount savings program. However, the program runs until only the end of December, so she will need to either reapply for the savings program — if Lilly lets her — or pay the full cost herself afterward.

The vials would provide a new, lower-cost option once her Zepbound discount card runs out at the end of the year — if she can get over using a syringe.

“I also take medicines that make me a little shaky, so drawing out medicines is not ideal,” she said.