Update on Zepbound availability and policy:

Zepbound, tirzepatide, was approved for weight loss by the US FDA at the end of 2023.

It is your responsibility to determine whether Zepbound is on formulary (available) for your insurance plan. If it is a plan exclusion we are limited in what we are able to do. We can provide a letter requesting coverage for you to submit to your employer/insurance carrier requesting coverage, however we are unable to submit individual appeals.

Zepbound is a very effective medication and high demand has led to significant supply and supply chain issues.

There are 6 doses of Zepbound – 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg weekly. The 2.5, 7.5 and 12.5 mg doses are only indicated for dose titration and are not covered for more than 4 doses/1 month.

Zepbound is on the FDA drug shortages list with all doses except for 2.5 mg showing “limited availability through Q2 2024” – this means the end of June; some reports indicate shortages until 2025. Patients are reporting that it is extremely difficult, if possible at all to get prescriptions filled, particularly for the 5 and 7.5 mg doses.

We follow titration guidelines approved by the FDA, and do not recommend skipping of doses to the next available. Skipping could result in intolerable side effects and further setbacks.

The Lilly Direct program for getting Zepbound Rx has most recently reported a 10-day turnaround time for processing applications (before the Rx is sent to a pharmacy to be filled) and has a significant backlog of orders waiting for improved supplies.

For patients not currently taking Zepbound we do not recommend attempting to start at this time. Options include waiting for supplies to improve or starting the related medication Wegovy. (There have been shortages of the lower doses of Wegovy but over the past month we have seen definite evidence of improved supply.)

Patients already taking Zepbound and attempting to fill prescriptions should anticipate significant difficulty and delays including the need to call around to multiple pharmacies to identify ones with availability. We do not get accurate, up to date information about availability at different pharmacies and are unable to assist in this process beyond sending an initial prescription. Locating a pharmacy with available stock and having the Rx transferred to that pharmacy if needed are the responsibility of the patient.

We are not able to send refill doses for the 2.5 mg; 7.5 mg; and 12.5 mg titration doses. Each request for an additional month requires an additional prior approval and we are now seeing these requests be denied. In particular, when it comes to the question of repeating the 2.5 mg dose we are perpetuating the supply chain disruptions.

Options for patients currently taking Zepbound include temporarily stopping medication or switching to Wegovy. These options, while not ideal, seem to make the most sense until we see concrete evidence of improvement in the supply situation. Doses of Zepbound may be spread out to every 10 days instead of every 7 to extend supply.

For patients who do not have diabetes it is not harmful to stop Zepbound abruptly. Depending on the length of time off of medication, restarting may require a temporary reduction in dose and repeating titration.

Mounjaro contains the same drug, tirzepatide, as Zepbound but is indicated for diabetes. There are also significant supply issues with Mounjaro and we are not able to switch prescriptions back and forth.

Please know that we understand and share in your frustration with this situation and that we will continue to work with you to get the best, most appropriate treatments.

Additional information:

1-800-LillyRx (1-800-545-5979)