Zepbound to Zepbound Kwikpen - Pharmacy Cost Savings

Key Points: 

• Zepbound Kwikpen is the same medication and active ingredient (tirzepatide) as the original Zepbound, from the same manufacturer Eli Lilly, available since April 2026 
• Zepbound Kwikpen is a new formulation & injector device, which contains 4 weekly doses in one pen-injector as a multiple-dose device vs. “classic” or “original” Zepbound  single-use devices.  
• All Kwikpen formulation strengths provide meaningful cost-advantages, without any difference in clinical effects of the drug: 
  • Zepbound 2.5mg to 7.5mg strengths: approximately ~60% lower cost  
  • Zepbound 10mg to 15mg strengths: approximately ~40% lower cost 
  • Average cost per claim for 28-day supply of drug: 
    • Zepbound Kwikpen: $566 
    • Zepbound autoinjector original: $1,043 
    • Wegovy injection: $1,292 

Prescribing Nuances:  

• Dispensing pharmacies cannot adjust a Zepbound prescription order to Zepbound Kwikpen on their own due to pharmacy regulations 
• New electronic or written prescriptions need to be sent specifically for Zepbound Kwikpen 
• Remember to send an additional prescription order for pen-needle tips which are required for use with the Kwikpen, needle tip needs to be changed every dose 
• Pen needle tips are covered without authorization, for the preferred Embecta brand 
• Remind patients to never share medication between others, including friends and family 
• Must be stored in refrigerator, just like original Zepbound autoinjector pens 
• Counsel patients on device change: do not throw away after only 1 injection or 1 use! 

Potential Patient Candidates for Zepbound Kwikpen: 

• Existing patients on Zepbound/tirzepatide for weight loss or obstructive sleep apnea 
• New start patients for GLP-1 Weight Loss medication 
• Strong consideration to transition patients already established on Wegovy (semaglutide) to Zepbound Kwikpen 
  • Zepbound has superior weight loss effects due to dual-mechanism of action of tirzepatide (GLP-1 agonist and GIP agonist for tirzepatide), compared to semaglutide (GLP-1 agonist only).  
  • Exceptions for Wegovy patients to avoid transition to Zepbound Kwikpen: Patients under the age of 18 years old (Zepbound not FDA approved for pediatric use), OR if Wegovy is prescribed for one of two unique FDA approved indications: reduction of major cardiovascular events (MACE) or metabolic-associated liver disease (MASH)  

Prior Authorization (PA) Considerations: 

• Patients with existing approval for classic/traditional Zepbound autoinjector will already have a corresponding approval for any strength of Zepbound Kwikpen with the same 6-month approval duration, even if not noted on their PA approval letter 
• Michigan Medicaid Common Formulary Prior Authorization Criteria for Weight Loss agents: 
• https://www.michigan.gov/mdhhs/assistance-programs/medicaid/medicaidhealthplans/pharmacy
• Click link for “Drug PA Criteria” and Search or Ctrl+F for “Weight Loss” to view 
• Patients transitioning to Zepbound Kwikpen from a different GLP-1 weight loss agent other than original Zepbound autoinjector will need a new PA request to be approved.  
• Best practice to provide clear documentation that patient is transitioning to a more cost-effective and superior weight loss agent with the new PA request  
• Provide documentation of baseline weight and BMI prior to current GLP-1 weight loss medication, and current weight and BMI to show evidence of 5% weight loss from baseline, if on GLP-1 for weight loss for 6 or more months    
• For MI Meridian Medicaid pharmacy benefit, the patient’s incoming pharmacy claim for Zepbound Kwikpen, or any other GLP-1 agonist, must be at least 21 days apart from previous claim for a GLP-1 or the pharmacy will get a rejection for Duplicate Therapy. 
• This can be overridden with an approved prior authorization exception, if the prior authorization request includes documentation of a dose change (increase or decrease), formulation change (e.g. classic autoinjector to Kwikpen), or therapy change (e.g. Wegovy changed to Zepbound Kwikpen)  

Clinical Considerations: Changing from Wegovy/semaglutide to Zepbound/tirzepatide) 

• There are no official or universal dose conversion charts or published recommendations 
• Standard safety best practice is to start patients at the lowest Zepbound dose of 2.5mg once weekly, if changing from Wegovy or another weight loss agents, and titrate up as recommended in the Zepbound prescribing information (2.5mg weekly for 4 weeks, then 5mg weekly for 4 weeks, increasing as tolerated by 2.5mg increments at 4-week intervals)  

Zepbound Kwikpen Product & NDC List, Utilization Management Reminders: