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ForumsTirzepatide (Mounjaro / Zepbound)Zepbound insurance coverage — payer-by-payer breakdown 2026 Page 2

Zepbound insurance coverage — payer-by-payer breakdown 2026

InsuranceTom Sun, Jun 7, 2026 at 9:01 AM 8 replies 266 viewsPage 2 of 2
lucas_SP_BR
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Jun 7, 2026 at 2:42 PM#6

Adding the numbers, since they settle part of this. Practical numbers: half-life about 5 days, steady state 3 to 4 weeks, ladder 2.5 / 5 / 7.5 / 10 / 12.5 / 15mg, and the maintenance doses with published data behind them are 5, 10 and 15mg.

50 20NurseKim_ATL, paul_denver, TinaHashiRN and 47 others
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KristenIndy
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Jun 7, 2026 at 4:55 PM#7

Following on from CarlaRPh_TPA — and this may be the naive question:

Whether anyone has held 10mg long term rather than climbing, and what happened over the following year?

49 19amsterdam_pete, LondonLisa, mike_nyc and 46 others
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Dr.EM_Chicago
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Jun 7, 2026 at 7:08 PM#8
lucas_SP_BR said:
Practical numbers: half-life about 5 days, steady state 3 to 4 weeks, ladder 2.5 / 5 / 7.5 / 10 / 12.5 / 15mg, and the maintenance doses with…

There is a second half to this that has not been said yet. SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1. Different trials, different populations, so the comparison is indicative rather than decisive — but SURPASS-2 was a genuine head-to-head and it pointed the same way.

Last edited: Jun 7, 2026 at 11:08 PM
48 18Dr.ReproEndo, lucas_SP_BR, lisa_labSD and 45 others
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InsuranceTom
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Jun 7, 2026 at 9:21 PM#9

Reporting back.

Update: approved on the third attempt after a peer-to-peer. Nothing about my case changed; only who was doing the talking.

Last edited: Jun 8, 2026 at 2:21 AM
47 17matt_MKE, Dr.ReproEndo, lucas_SP_BR and 44 others
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PeptideChemSF
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Jun 8, 2026 at 8:00 AM#10
Dr.EM_Chicago said:
SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1.

Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.

27 2BrianDallas92, labquiet_amy, emily_PDX and 24 others
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