Zepbound® (tirzepatide) : Full Terms and Conditions

Zepbound Self Pay Journey Program Purchase Offer Terms and Conditions

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Pay $449 for each 1-month supply of the 7.5 mg, 10 mg, 12.5 mg, and 15 mg Zepbound® single-dose vial or Zepbound® KwikPen® for single-patient-use. You will automatically receive the $449 purchase offer on your first purchase of the 7.5 mg, 10 mg, 12.5 mg, or 15 mg Zepbound single-dose vial or KwikPen beginning February 23, 2026.

To continue to be eligible for this Zepbound Self Pay Journey Program purchase offer you must complete your refill purchase of the Zepbound single-dose vial or KwikPen within 45 days of the delivery/received date of your previous Zepbound single-dose vial or KwikPen prescription. Offer valid for 7.5 mg, 10 mg, 12.5 mg, and 15 mg doses of Zepbound single-dose vial or KwikPen only. New and existing patients are eligible. 1-month supply is defined as 28 days and 4 single-dose vials or 1 KwikPen. If refill purchase is completed more than 45 days after the delivery/receipt of your previous Zepbound single-dose vial or KwikPen prescription, purchase offer will not apply.

Regular price for a 1-month supply of Zepbound single-dose vial or KwikPen is $299 for 2.5 mg, $399 for 5 mg, $499 for 7.5 mg, $699 for 10 mg, $699 for 12.5 mg, and $699 for 15 mg. Additional taxes and fees may apply. This Zepbound Self Pay Journey Program purchase offer may be terminated, rescinded, revoked, or amended by Lilly at any time, with or without notice, for any reason. Eligibility required and restrictions apply.

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Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Program Full Terms and Conditions

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By enrolling in and using the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program (“Program”) and using the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card (“Card”), you attest that you meet the eligibility criteria, and you agree to comply with the terms and conditions described below:

Card Eligibility:

1. You have been prescribed Zepbound® (tirzepatide) single-dose pen or Zepbound single-patient-use KwikPen® for an approved use consistent with FDA approved product labeling;
2. If you have been prescribed Zepbound single-dose pen, you must be enrolled in a commercial drug insurance plan;
3. If you have been prescribed Zepbound single-patient-use KwikPen, you must be enrolled in a commercial drug insurance plan that does not provide coverage for Zepbound single-patient-use KwikPen;
4. You are not enrolled in any state, federal, or government funded healthcare program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medicare Advantage, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any state prescription drug assistance program;
5. You are a resident of the United States or Puerto Rico; and
6. You are 18 years of age or older.

Card Terms and Conditions

For patients who have been prescribed Zepbound single-dose pen and have commercial drug insurance coverage for Zepbound single-dose pen: You must have commercial drug insurance that covers Zepbound single-dose pen and a prescription for an approved use consistent with FDA-approved product labeling to pay as little as $25 for a 1-month, 2-month, or 3-month prescription fill of Zepbound single-dose pen. Month is defined as 28-days and up to 4 single-dose pens; 2 months is defined as 56 days and up to 8 single-dose pens; 3 months is defined as 84 days and up to 12 single-dose pens. Card savings are subject to a maximum monthly savings of up to $100 per 1-month prescription, $200 per 2-month prescription, or $300 per 3-month prescription fill and a separate maximum annual savings of up to $1,300 per calendar year. Card may be used for a maximum of up to 13 prescription fills per calendar year. Subject to Lilly USA, LLC’s (“Lilly”) right to terminate, rescind, revoke, or amend Card eligibility criteria and/or Card terms and conditions which may occur at Lilly’s sole discretion, without notice, and for any reason. Card expires and savings end on 12/31/2026.

For patients who have been prescribed Zepbound single-dose pen and have commercial drug insurance that does not provide coverage for Zepbound single-dose pen: You must have commercial drug insurance that does not cover Zepbound single-patient-use KwikPen and a prescription for an approved use consistent with FDA-approved product labeling to: (1) Pay as low as $299 for your 1-month prescription fill of Zepbound 2.5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $215; (2) Pay as low as $399 for your 1-month prescription fill of Zepbound 5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $115; (3) Pay as low as $449 for your 1-month prescription fill of Zepbound 7.5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $65; or (4) Pay as low as $449 for your 1-month prescription fill of Zepbound 10 mg, 12.5 mg, or 15 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $271. Savings on Zepbound 7.5 mg, 10 mg, 12.5 mg, and 15 mg single-patient-use KwikPens are subject to Purchase Offer Terms and Conditions. For all Zepbound single-patient-use KwikPen dosages, month is defined as 28-days and up to 1 single-patient-use KwikPen. Card may be used for a maximum of up to 11 prescription fills per calendar year. Subject to “Lilly’s” right to terminate, rescind, revoke, or amend Card eligibility criteria and/or Card terms and conditions which may occur at Lilly’s sole  discretion, without notice, and for any reason. Card expires and savings end on 12/31/2026.

Purchase Offer Terms and Conditions for Single-Patient-Use KwikPen

You will automatically receive the $449 purchase offer on your first purchase of the 7.5 mg, 10 mg, 12.5 mg, or 15 mg Zepbound single-patient-use KwikPen. To continue to be eligible for this purchase offer, you must complete your refill purchase of the Zepbound single-patient-use KwikPen within 45 days of the delivery/received date of your previous Zepbound single-patient-use KwikPen prescription fill. Offer valid for 7.5 mg, 10 mg, 12.5 mg, and 15 mg doses of Zepbound single-patient-use KwikPen only. New and existing patients are eligible. 1-month supply is defined as 28 days and 1 single-patient-use KwikPen. If refill purchase is completed more than 45 days after the delivery/receipt of your previous Zepbound single-patient-use KwikPen prescription, purchase offer will not apply. Regular price for a 1-month supply of Zepbound single-patient-use KwikPen is $299 for 2.5 mg, $399 for 5 mg, $499 for 7.5 mg, $699 for 10 mg, $699 for 12.5 mg, and $699 for 15 mg. Additional taxes and fees may apply. This purchase offer may be terminated, rescinded, revoked, or amended by Lilly at any time, with or without notice, for any reason. Eligibility required and restrictions apply.

Additional Terms and Conditions

If you have an insurance plan that is participating in an alternate funding program or similar program (“AFP”) that requires you to apply to the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program or otherwise pursue specialty drug prescription coverage through an alternate funding vendor as a condition of, requirement for, or prerequisite to coverage of Zepbound, you are not eligible for and are prohibited from using the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program. AFPs include programs where coverage, reimbursement, or patient out of pocket costs for a product in some way vary based on the availability of a manufacturer co-pay program. AFPs may modify, delay, deny, restrict, or withhold insurance benefits or coverage from patients, or exclude Lilly products from coverage contingent upon a member’s use of Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program. You agree to inform the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program if you are or become a member of such an alternative funding program. You are responsible for any applicable taxes, fees, and any amount that exceeds the applicable monthly or annual maximum Card savings. Monthly and annual maximum savings are set at Lilly’s sole and absolute discretion and may be changed with or without notice at any time for any reason. At its sole discretion and with or without notice, Lilly may reduce, eliminate, or otherwise modify the Card savings for any reason, including but not limited to if your commercial drug insurance plan imposes additional requirements which limits or prevents you from receiving coverage for Zepbound, only allows partial coverage for Zepbound, removes coverage for Zepbound and requires you to utilize the Card, does not provide a material level of financial assistance for the cost of Zepbound, or does not apply Card payments to satisfy your co-payment, deductible, or coinsurance for Zepbound. Card savings are available only for Zepbound prescriptions for the Zepbound single-dose pen (NDC 00002-2506-80, NDC 00002-2495-80, NDC 00002-2484-80, NDC 00002-2471-80, NDC 00002-2460-80, NDC 00002-2457-80) and Zepbound single-patient-use KwikPen (NDC 00002-3566-11, NDC 00002-3555-11, NDC 00002-3544-11, NDC 00002-3533-11, NDC 00002-3522-11, NDC 00002-3511-11). Other methods of administration are not eligible for Program savings. Card savings are not valid for: Massachusetts residents if an AB-rated generic equivalent is available; California residents if an FDA-approved therapeutic equivalent is available. You must meet the Card eligibility criteria, terms and conditions every time you use the Card. If at any time you begin receiving drug coverage under any state, federal, or government funded healthcare program, you understand you will no longer be eligible for the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card and agree to call the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program at 1-866-923-1953. Card activation is required. You may not seek reimbursement from your health insurance, any third party, or any health savings, flexible spending, or other healthcare reimbursement accounts, for any amount of the savings received through the Card. By utilizing the Card, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you will notify your Insurance Carrier of your redemption of the Card. Card savings cannot be combined or utilized with any other program, discount, discount card, cash discount card, coupon, incentive, or similar offer involving Zepbound. You agree that this Card savings is intended solely for the benefit of you, the patient, and that the Card benefits are non-transferable. It is prohibited for any person to sell, purchase, or trade; or to offer to sell, purchase, or trade, or to counterfeit the Card. THIS CARD IS NOT INSURANCE. Lilly has the sole right to interpret and apply Card eligibility criteria, and terms and conditions. Card eligibility, and terms and conditions may be terminated, rescinded, revoked, or amended by Lilly at any time without notice and for any reason. Lilly’s sole discretion to terminate, rescind, revoke, or amend Card eligibility criteria and/or Card terms and conditions includes the right to terminate any individual Card if Lilly determines, in its sole discretion, that a patient does not satisfy the Card’s eligibility criteria or is using or has attempted to use the Card inconsistently with these Terms and Conditions. Eligibility criteria, and terms and conditions for the Zepbound Single-Dose Pen and Single-Patient-Use KwikPen Savings Card Program may change from time to time; the most current version can be found at https://www.lilly.com/lillydirect/medicines/zepbound/zepbound-tirzepatide-full-terms-conditions#commercial. You may be required to obtain a new Card, including if any Card terms and conditions have been terminated, rescinded, revoked, or amended by Lilly. Card void where prohibited by law. Subject to Lilly’s right to terminate, rescind, revoke or amend Card eligibility criteria and/or Card terms and conditions which may occur at Lilly’s sole discretion, without notice, and for any reason. Card expires and savings end on 12/31/2026.

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Zepbound KwikPen Self-Pay Savings Program Full Terms and Conditions

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By enrolling in and using the Zepbound KwikPen Self-Pay Savings Card Program (“Program”) and using the Zepbound KwikPen Self-Pay Savings Card (“Card”), you attest that you meet the eligibility criteria, and you agree to comply with the terms and conditions described below:

Card Eligibility:

1. You have been prescribed Zepbound® (tirzepatide) single-patient-use KwikPen® for an approved use consistent with FDA approved product labeling;
2. You agree that the Card is for self‑paying (cash) patients only and that you will not seek or accept reimbursement for any out‑of‑pocket costs for Zepbound® single‑patient‑use KwikPen purchased with the Card from any third‑party payer, including private insurance or state or federal healthcare programs, nor apply those costs toward any deductible or true out‑of‑pocket requirements;
3. You are a resident of the UnitedStates or Puerto Rico; and
4. You are 18 years of age or older.

Card Terms and Conditions

You must have a prescription for an approved use consistent with FDA-approved product labeling to: (1) Pay as low as $299 for your 1-month prescription fill of Zepbound 2.5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $215; (2) Pay as low as $399 for your 1-month prescription fill of Zepbound 5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $115; (3) Pay as low as $449 for your 1-month prescription fill of Zepbound 7.5 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $65; or (4) Pay as low as $449 for your 1-month prescription fill of Zepbound 10 mg, 12.5 mg, or 15 mg single-patient-use KwikPen, subject to a maximum monthly savings of up to $271. Savings on Zepbound 7.5 mg, 10 mg, 12.5 mg, and 15 mg single-patient-use KwikPens are subject to Purchase Offer Terms and Conditions. For all Zepbound single-patient-use KwikPen dosages, month is defined as 28-days and up to 1 single-patient-use KwikPen. Card may be used for a maximum of up to 11 prescription fills per calendar year. Subject to Lilly USA, LLC’s (“Lilly”) right to terminate, rescind, revoke, or amend Card eligibility criteria and/or Card terms and conditions which may occur at Lilly’s sole discretion, without notice, and for any reason. Card expires and savings end on 12/31/2026.

Purchase Offer Terms and Conditions

You will automatically receive the $449 purchase offer on your first purchase of the 7.5 mg, 10 mg, 12.5 mg, or 15 mg Zepbound single-patient-use KwikPen. To continue to be eligible for this purchase offer, you must complete your refill purchase of the Zepbound single-patient-use KwikPen within 45 days of the delivery/received date of your previous Zepbound single-patient-use KwikPen prescription fill. Offer valid for 7.5 mg, 10 mg, 12.5 mg, and 15 mg doses of Zepbound single-patient-use KwikPen only. New and existing patients are eligible. 1-month supply is defined as 28 days and 1 single-patient-use KwikPen. If refill purchase is completed more than 45 days after the delivery/receipt of your previous Zepbound single-patient-use KwikPen prescription, purchase offer will not apply.

Regular price for a 1-month supply of Zepbound single-patient-use KwikPen is $299 for 2.5 mg, $399 for 5 mg, $499 for 7.5 mg, $699 for 10 mg, $699 for 12.5 mg, and $699 for 15 mg. Additional taxes and fees may apply. This purchase offer may be terminated, rescinded, revoked, or amended by Lilly at any time, with or without notice, for any reason. Eligibility required and restrictions apply.

Post-Transaction Reimbursement

Savings may not be applied at the point of sale and may require further action from you to obtain the applicable savings. If you filled your Zepbound single-patient-use KwikPen prescription within the required 45-days as set forth in the Purchase Offer Terms and Conditions and otherwise meet the Card Eligibility requirements outlined above, but Lilly was not able to verify such at the point of sale, you may submit a claim for post-transaction reimbursement. A post-transaction reimbursement claim may result in Lilly issuing you a reimbursement for the difference between what you paid and what you would have paid had Lilly been able to verify at the point of sale that your Zepbound single-patient-use KwikPen prescription had been filled within the required 45-day timeframe. Claims for post-transaction reimbursement must be submitted through the Program’s online patient reimbursement portal https://eversana-ptr.virtualrx.com or by mailing a completed claim form to Savings Card Post-Transaction Reimbursement, PO BOX 42638 Cincinnati, OH 45242 Attn: PTR Processing. For a copy of the claim form, please call 1-866-923-1953. A valid post-transaction reimbursement claim must include: your name; date of birth; address; a copy of your original activated Zepbound KwikPen Self-Pay Savings Card information; and original pharmacy receipt for your Zepbound single-patient-use KwikPen prescription. At its sole discretion, Lilly may request additional information to validate your claim for reimbursement and is not obligated or required to reimburse any amounts if the requested additional information is not provided. Claims for reimbursement must be submitted in the patient portal or postmarked no later than March 31, 2027. Reimbursement claims are subject to program eligibility and terms and conditions, including Lilly's right to terminate, rescind, revoke, or amend the Post-Transaction Reimbursement program at any time in Lilly's sole discretion, without notice, and for any reason.

Additional Terms and Conditions

You understand and agree this Program and Card is for self paying (cash) patients and operates outside of any health insurance program. You agree not to seek payment or accept reimbursement for any out-of-pocket costs for Zepbound single-patient-use KwikPen purchased with this Card, whether directly or indirectly, from any insurance plan, healthcare reimbursement account, or other third-party payer—including any state or federal healthcare program or private insurance—and you also agree not to apply those out-of-pocket costs toward your deductible or true out-of-pocket obligations. Program self-pay price is not conditioned on any future purchases of Zepbound single-patient-use KwikPen or any other items or services. If you have an insurance plan that is participating in an alternate funding program or similar program (“AFP”) that requires you to apply to the Zepbound  KwikPen Self-Pay Savings Card Program or otherwise pursue specialty drug prescription coverage through an alternate funding vendor as a condition of, requirement for, or prerequisite to coverage of your Zepbound single-patient-use KwikPen, you are not eligible for and are prohibited from using the Zepbound  KwikPen Self-Pay Savings Card Program. AFPs include programs where coverage, reimbursement, or patient out of pocket costs for a product in some way vary based on the availability of a manufacturer co-pay program or other financial assistance program. AFPs may modify delay, deny, restrict, or withhold insurance benefits or coverage from patients, or exclude Lilly products from coverage contingent upon a member’s use of Zepbound KwikPen Self-Pay Savings Card Program. You agree to inform the Zepbound  KwikPen Self-Pay Savings Card Program if you are or become a member of such an alternative funding program. At its sole discretion and with or without notice, Lilly may reduce, eliminate, or otherwise modify the Card savings for any reason, including but not limited to if your commercial drug insurance plan removes coverage for your Zepbound single-patient-use KwikPen and/or requires you to utilize the Card. You are responsible for any applicable taxes, fees, and any amount that exceeds the applicable monthly or annual maximum Card savings. Monthly and annual maximum savings are set at Lilly’s sole and absolute discretion and may be changed with or without notice at any time for any reason. Card savings are available only for Zepbound prescriptions for the single-patient-use KwikPen (NDC 00002-3566-11, NDC 00002-3555-11, NDC 00002-3544-11, NDC 00002-3533-11, NDC 00002-3522-11, NDC 00002-3511-11). Other methods of administration are not eligible for Program savings. You must meet the Card eligibility criteria, terms and conditions every time you use the Card. Card activation is required. Card savings cannot be combined or utilized with any other program, discount, discount card, self-pay discount card, coupon, incentive, or similar offer involving Zepbound. You agree that this Card savings is intended solely for the benefit of you, the patient, and that the Card benefits are non-transferable. It is prohibited for any person to sell, purchase, or trade; or to offer to sell, purchase, or trade, or to counterfeit the Card. THIS CARD IS NOT INSURANCE. Lilly has the sole right to interpret and apply Card eligibility criteria, and terms and conditions. Card eligibility, and terms and conditions may be terminated, rescinded, revoked, or amended by Lilly at any time without notice and for any reason.Lilly’s sole discretion to terminate, rescind, revoke, or amend Card eligibility criteria and/or Card terms and conditions includes the right to terminate any individual Card if Lilly determines, in its sole discretion, that a patient does not satisfy the Card’s eligibility criteria or is using or has attempted to use the Card inconsistently with these Terms and Conditions. Eligibility criteria, and terms and conditions for the Zepbound KwikPen Self-Pay Savings Card Program may change from time to time; the most current version can be found at https://zepbound.lilly.com/savings#terms-and-conditions-2. You may be required to obtain a new Card, including if any Card terms and conditions have been terminated, rescinded, revoked, or amended by Lilly. Card void where prohibited by law. Subject to Lilly’s right to terminate, rescind, revoke or amend Card eligibility criteria and/or Card terms and conditions which may occur at Lilly’s sole discretion, without notice, and for any reason. Card expires and savings end on 12/31/2026.

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