What specific doses and indications of Zepbound are included in the TrumpRx and Medicare pricing agreements?
Executive summary
Zepbound (tirzepatide) is included in the TrumpRx agreements with specific starter- and pen-dose price points and in the administration’s Medicare deals tied to limited coverage criteria; the reporting shows starter/lowest-dose retail pricing between $299–$350 on TrumpRx/LillyDirect and a negotiated Medicare price target of about $245/month with a $50 beneficiary copay for qualifying indications [1] [2] [3] [4] [5]. Coverage scope for Medicare is narrow in the public documents: the administration says Medicare will cover Wegovy and Zepbound for patients with obesity plus specified comorbidities, and separate reporting highlights an FDA-approved non‑weight‑loss indication for Zepbound (obstructive sleep apnea in adults with obesity) that creates an alternate Medicare pathway [5] [4] [6].
1. What doses of Zepbound are listed for TrumpRx and direct sales
The TrumpRx page and related reporting show Zepbound offered via LillyDirect with a lowest/“starter” per‑month price around $299 for the lowest available dose and higher pen doses rising to roughly $449 for larger strengths, while some outlets reported an initial TrumpRx starter-price of $350 that would “trend down” over time [1] [7] [2] [8]. Multiple guides and briefings list TrumpRx starter-dose pricing for Wegovy and Zepbound at $350/month for initial injected doses, with manufacturer direct channels (LillyDirect) already offering multidose pens at $299 (lowest dose) and higher-priced strengths up to $449 [9] [7] [8] [1].
2. What dose ranges are implied by the materials (and how explicit are they?)
Reporting indicates multiple dose tiers for injectable tirzepatide—including references to common therapeutic pen strengths in the 2.5 mg starter neighborhood and larger maintenance doses up through 7.5–15 mg—though the administration’s fact sheets and TrumpRx listings emphasize price tiers by dose rather than a standardized list of milligram strengths in a single table [1] [2]. The TrumpRx product page routes users to LillyDirect for eligibility and ordering rather than selling discrete strengths itself, which means precise dose availability and per‑dose pricing is ultimately determined and published by the manufacturer’s platform [10] [1].
3. Which indications are covered under the Medicare agreements and what are the limits
The White House and agency briefings state Medicare will be enabled to cover Wegovy and Zepbound for adults with obesity and at least one related comorbidity, and beneficiaries would face a $50 monthly copay for anti‑obesity medications under the negotiated framework [4] [5]. However, statutory restrictions and program rules complicate coverage for purely weight‑loss uses: Medicare Part D generally excludes weight‑loss drugs, and reporting notes that the administration’s approach uses policy changes and negotiated demonstrations to create eligibility pathways—while also acknowledging the Biden administration had proposed different regulatory interpretations earlier [6] [5].
4. Alternate coverage pathway: Zepbound’s non‑weight indication and Medicare implications
Separately, clinical/regulatory reporting documents that the FDA approved Zepbound for treatment of moderate‑to‑severe obstructive sleep apnea (OSA) in adults with obesity, which creates an independent coverage pathway under existing Medicare rules for non‑weight‑loss indications and the chance that beneficiaries with OSA could access the drug sooner than through an obesity policy change [6]. Analysts and policy summaries emphasize that the Trump administration’s negotiated prices ($245/month Medicare target) and the OSA approval together broaden possible access, but they also stress variability across plans, state Medicaid participation, and enrollment timelines for demonstration models [6] [4] [5].
5. Uncertainties, caveats and who decides final dosing/pricing in practice
Public documents and reporting show variance and caveats: the White House cites average/“as low as” monthly figures (about $346 average, as low as $299 depending on dose) while other outlets quote $350 starter prices that will decline to $245 over two years, and some discounts are explicitly not available to people covered by existing government insurance until plan participation and regulatory changes occur—meaning manufacturer platforms (LillyDirect) and plan opt‑ins will determine precise patient access by dose and price [2] [7] [9] [11] [10]. In short, the agreements specify lowest‑dose pricing and Medicare eligibility criteria (obesity + comorbidity) and set a Medicare price target/cap, but exact milligram‑by‑milligram availability and patient eligibility will depend on manufacturer implementation, plan participation, FDA approvals for oral formulations, and ongoing regulatory steps [1] [2] [4] [3].