Pens vs. Vials: What's the Difference?
Zepbound is available in two forms, with dramatically different pricing:
| Feature | Pens (Standard) | Vials (LillyDirect) |
|---|---|---|
| Monthly Cost | $1,086 | $299-449 |
| Convenience | Pre-filled, click to inject | Draw your own doses |
| What's Included | 4 pens per box | Vials + syringes provided |
| Availability | Any pharmacy | LillyDirect only |
| Insurance | May be covered | Self-pay only |
💡 Why Vials Are Cheaper: Eli Lilly created the vial program specifically for cash-pay patients. By removing the convenience of pre-filled pens, they can offer the medication at a significant discount while still making the drug accessible.
LillyDirect Vial Pricing by Dose
| Dose | Monthly Price | Typical Phase |
|---|---|---|
| 2.5mg | $299 | Weeks 1-4 |
| 5mg | $399 | Weeks 5-8 |
| 7.5mg | $449 | Weeks 9-12 |
| 10mg | $449 | Weeks 13-16 |
| 12.5mg | $449 | Weeks 17-20 |
| 15mg | $449 | Maintenance |
⚠️ 45-Day Refill Requirement: To maintain the $449 pricing at higher doses, you must refill within 45 days. Missing this window may reset your pricing or access.
First-Year Cost Projection (Vials)
Tirzepatide uses a 20-week titration to reach maximum dose:
| Period | Dose | Cost |
|---|---|---|
| Month 1 | 2.5mg | $299 |
| Month 2 | 5mg | $399 |
| Month 3 | 7.5mg | $449 |
| Month 4 | 10mg | $449 |
| Month 5 | 12.5mg | $449 |
| Months 6-12 | 15mg (×7) | $3,143 |
| 12-Month Total | $5,188 | |
Compare this to retail pricing at $1,086/month = $13,032/year. LillyDirect vials save you nearly $8,000 annually.
With Insurance Coverage
If your insurance covers Zepbound (coverage has been dropping—CVS Caremark removed it in July 2025), you can use the Lilly Savings Card:
| Scenario | Monthly Cost | Annual Cost |
|---|---|---|
| Insurance + savings card | $25 | $300 |
| Insurance only | $100-300 | $1,200-3,600 |
| LillyDirect vials (no insurance) | $299-449 | ~$5,188 |
| Retail (no savings) | $1,086 | $13,032 |
Zepbound vs. Alternatives
| Option | Monthly Cost | Notes |
|---|---|---|
| Zepbound vials | $299-449 | Best brand tirzepatide value |
| Mounjaro (for diabetes) | $1,079 | Same drug, different indication |
| Compounded tirzepatide | $299-449 | Similar price, not FDA-approved |
| Wegovy (NovoCare) | $349 | Different drug class |
💡 Interesting: At $299-449/month, LillyDirect vials are priced competitively with compounded tirzepatide. If price is similar, many patients prefer the FDA-approved brand option.
Compare All Tirzepatide Options
See Zepbound, Mounjaro, and compounded pricing side-by-side.
View Price Comparison →