Drugmaker Eli Lilly said Tuesday it was slashing prices for two of the lowest doses of its blockbuster weight-loss drug Zepbound, a move that aims to expand access and ease supply constraints. But two key changes to how the cheaper drugs are obtained and used may not be appealing to some patients.
Under the new pricing plan, the lowest dose of 2.5 milligrams will cost $399 for a month’s supply, and the lowest dose of 5 milligrams will cost $549 for a month’s supply — down from the $1,059 monthly list price for any dose.
But the lower-priced doses are only available through Lilly’s telehealth platform, LillyDirect, and are not covered by insurance, so patients must pay cash. Patients who select the lower-priced dose are also not eligible for Lilly’s discount savings program.
Lilly said it’s able to sell the drug at the lower price because it will be sold in vials rather than in a single-dose auto-injector pen, meaning patients will have to draw the drug from the vial with a syringe. (The 2.5 mg and 5 mg doses will still be sold in the auto-injector pen, though they won’t be sold at the new discounted price.)
Frustrated Zepbound users have been pushing for a vial option for some time, attributing Lilly’s ongoing supply issues to the complex manufacturing process required for the autoinjector pen. Some patients are instead turning to compounded versions of the weight-loss drug, which typically come in vials and are less expensive.
“These new vials will not only help meet the high demand for our obesity medications, but also expand access for patients seeking safe and effective treatment options,” Patrick Johnson, president of Lilly USA, said in a press release.
Dr. Maria Daniela Hurtado Andrade, an endocrinologist at the Mayo Clinic in Jacksonville, Fla., questioned who would benefit from a lower-cost version. The $399 price tag for the lowest dose still amounts to about $5,000 a year, an insurmountable cost for many racial and ethnic minorities, she said.
“The majority of patients will still not be able to afford the medicine,” Furtado Andrade said.
She added that the move to lower prices only for the lowest-dose vaccines could backfire: People may feel negatively about being limited to a low-dose vaccine while more effective options are reserved for the wealthy and those who can afford it.
“We’re just giving people hope,” she said.
Dr. Shauna Levy, an obesity medicine expert and medical director of the Tulane Obesity Center in New Orleans, called it an “overall win” for the obesity community.
“I’m excited to see how Novo Nordisk responds to this, because I think they too will have no choice but to lower the price of their medicines,” she said.
Lilly and Novo Nordisk, which make Ozempic and Vigovi, have been under pressure to lower prices for the hugely popular but expensive weight-loss drugs.
In July, President Joe Biden and Sen. Bernie Sanders (I-Vt.), chairman of the Health, Education, Labor and Pensions Committee, wrote an op-ed in USA Today saying the drug companies “must stop ripping off the American people with high drug prices.”
In a June interview, Sanders called Novo Nordisk’s high drug prices “absurd” and said he was spearheading a campaign to pressure the company to lower them. Novo Nordisk CEO Lars Fluagaard Jorgensen has agreed to testify before Sanders’ committee next month.
Novo Nordisk and Sanders’ office did not immediately respond to requests for comment.
Who can get the low-cost vials?
Lilly said Zepbound’s lower-priced vials offer a new option for patients, especially those who are uninsured, whose insurance doesn’t cover the cost of the drug or who aren’t eligible for the company’s discount savings program, which doesn’t apply to people who are covered by government-run insurance programs such as Medicare or Medicaid.
According to the company, doctors can send prescriptions for vials to LillyDirect, which will ship them directly to patients. The vials will be available for purchase through LillyDirect in all 50 states. Lilly will provide instructions on how to use the vials and will also sell syringes to those who want them.
Dr. Christopher McGowan, a gastroenterologist who runs a weight-loss clinic in North Carolina, said one problem he has with using LillyDirect is supply.
“We tried to take advantage of it when it was first announced, but there was no supply,” McGowan told NBC News on Monday, saying he had not been informed of Lilly’s new price announcement. “It was comparable to other pharmacies.”
Lilly says the move to vials should help liberalize supply. The company has opted to offer just two of the six doses at the lower price. The 2.5mg dose is considered a “starter” dose, the first dose patients take, then increase doses until they reach a so-called maintenance dose.
McGowan said most of his patients will continue to be treated with the 10mg or 15mg dose of Zepbound, but that often depends on supply. He said he doesn’t have any patients taking the 2.5mg or 5mg doses long-term, but he’s sure some would if the price came down.
That said, “if a patient is responding well to the high dose, we want to continue them on that high dose,” he says. “We don’t want to take the risk of weight loss by not reducing the dose.”
Hurtado Andrade also expressed concern about the transition from pens to vials, saying some patients, including elderly people, may have difficulty using the syringes.
“That could be an obstacle,” she said. “The pen is very simple. You just have to press one button to administer the dose you need each week.”
Four D. Scott, 46, of Las Vegas, said he doesn’t like the idea of sucking up drugs with a syringe.
Scott, who asked to use only the initial of her first name, said she had been overweight her whole life and, after years of dieting and exercise, was prescribed Zepbound about a month ago.
Her insurance doesn’t cover the drug, but she can get it through Eli Lilly’s discount savings program for a monthly copay of $550. But the program runs only through the end of December, so she’ll have to reapply for the savings program, if Lilly allows it, or pay the full price out of pocket after that.
Once my Zepbound discount card expires at the end of the year, the vials will be a new, lower-cost option — provided I can stop using syringes.
“I’m also on medication that makes me a bit shaky, so skipping it wouldn’t be ideal,” she says.
