How Much Does Qsymia Cost With and Without Insurance?

Weight-loss medications are experiencing something of a renaissance as people share information about new treatments and their success stories on social media. But the newer, injectable medications are outside of many people’s budgets. And, on top of that, they’re not guaranteed to work for everyone. 

Qsymia (phentermine / topiramate ER) is a more affordable, oral weight-loss medication that’s been around for a decade. And unlike many other options, it’s approved to treat both adults and adolescents.

What is Qsymia?

Qsymia is an oral medication prescribed to people who have a body mass index (BMI) of at least 30 — or 27 with a weight-related condition like high blood pressure, diabetes, or high cholesterol — and have had difficulty losing weight. The extended-release capsules contain two active ingredients: phentermine and topiramate ER.

Promotional Disclosureinfo_outlined

SPECIAL OFFER

Save over 40% on Qsymia with GoodRx

Discover the once daily Qsymia for weight management. Qsymia is for adults and children 12-17 in combination with a healthy diet and regular exercise.

Save now

Phentermine (Adipex P, Lomaira) is an appetite suppressant that reduces feelings of hunger and potentially provides an energy boost. Topiramate ER (Qudexy XR) is used to treat epilepsy (a seizure disorder) and migraines. Researchers are not sure how exactly topiramate helps with weight loss, but one theory is that it signals to the brain that you are full.

One thing that differentiates Qsymia from some other weight-loss medications is that it can be prescribed to both adults and adolescents. The FDA approved Qsymia as a weight-management tool for adults in 2012. In 2022, the agency expanded its approval to include children 12 years and older who have a BMI in the 95th percentile or greater, which is considered the range for obesity.

In the U.S., about 20% of children and adolescents ages 2 to 19 are considered to have obesity, according to the latest CDC statistics. Research has shown that children who are considered to be overweight are more likely to have obesity as adults.

How much does Qsymia cost without insurance?

Your cost for Qsymia without insurance will depend on where you purchase the medication and whether you have a discount.

The manufacturer savings card for Qsymia offers discounts for cash-paying consumers: people who are self-pay and those with insurance plans that don’t cover the medication. The savings card, which can be used at retail locations and mail-order pharmacies, offers the following discounts:

• $75 off a 28- to 30-day supply of Qsymia for up to 100 refills

• $70 off a 14- or 15-day supply of the 3.75 mg/23 mg dose of Qsymia for up to 10 refills

Qsymia Engage, a program that provides home-delivery for cash-paying consumers, offers an exclusive $98 flat rate for all 30-day Qsymia prescriptions, no matter the dose. This deal also applies to the 44-capsule new patient pack and the 44-capsule titration pack, which is used for increasing dosages. There may be additional costs for shipping and handling.

You can also save with GoodRx. Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of Qsymia at an exclusive cash price of $149.10.

Note: Qsymia is a controlled substance, and some states do not allow coupons to be used for these medications.

Does insurance cover Qsymia?

Health insurance coverage for Qsymia varies by provider and plan.

Medicare

Until March 2024, Medicare was barred by law from covering weight-loss medications. Medicare Part D plans are now allowed to cover Wegovy when it’s prescribed to reduce the risk of heart attack and stroke in people who have cardiovascular disease and are considered overweight or obese. So far, that’s the only weight-loss medication covered by Medicare Part D.

Medicaid

Medicaid programs, which are run by states and territories, are required to cover nearly all FDA-approved medications for their medical indications. But Medicaid is not required to cover weight-loss medications, so coverage for Qsymia varies by state and territory. 

Sixteen state Medicaid programs covered at least one weight-loss medication as of July 1, 2023:

• California

• Connecticut

• Delaware

• Hawaii

• Kansas

• Louisiana

• Michigan

• Minnesota

• Mississippi

• New Hampshire

• Pennsylvania

• Rhode Island

• South Carolina

• Texas

• Virginia

• Wisconsin

Not all of these state programs necessarily cover Qsymia. And those that do may have limitations regarding quantities.

Commercial insurance

Commercial health insurance plans may or may not cover Qsymia. According to the Obesity Medicine Association, plans may not cover weight-loss medications in general if they consider losing weight a cosmetic need.

Tricare and veterans benefits

Tricare insurance covers some prescription weight-loss medications, including Qsymia. But your prescriber may need to submit a coverage review, which is like a prior authorization.

Insurance coverage through the U.S. Department of Veterans Affairs (VA) may cover medications for weight loss and weight management. If you have coverage through the VA, you should discuss what’s available with a VA healthcare representative.

Are there ways to save on Qsymia?

In addition to discounts for cash-paying consumers, the Qsymia savings card offers these discounts to people with commercial insurance that covers the medication:

• $65 off a 28- to 30-day supply of Qsymia for up to 100 refills

• $65 off a 14- or 15-day supply of the 3.75 mg/23 mg dose of Qsymia for up to 10 refills

Consumers with government-sponsored health insurance such as Medicare, Medicaid, Tricare, or VA healthcare are not eligible for these manufacturer savings.

How do you take Qsymia for the best results?

Qsymia is taken by mouth once a day. It’s recommended that you take it in the morning to avoid sleep issues. And Qsymia works best when combined with regular exercise and a reduced-calorie diet. Most people experience weight loss with Qsymia after about 8 weeks of taking it.

While many people find success with Qsymia, it's important to acknowledge that — like all medications — it has some side effects. Common side effects of Qsymia include:

• Constipation

• Dizziness

• Dry mouth

• Insomnia

• Numbness and tingling

• Taste changes

Qsymia has also been known to increase heart rate, so it's recommended that your prescriber regularly checks your heart rate while you're taking the medication. Since Qsymia is a controlled substance, it also comes with a risk of dependence and misuse.

Qsymia can increase the risk of birth defects such as cleft lip and cleft palate, so you should avoid taking it if you're pregnant or planning to become pregnant. Because of these risks, the FDA requires that people who may become pregnant participate in a Risk Evaluation and Mitigation Strategy (REMS) program while taking Qsymia. The program requires participants to have a negative pregnancy test before starting Qsymia and monthly while taking it. The REMS program also requires participants to use effective birth control methods.

Why trust our experts?

Written by:

Tamara E. Holmes

Tamara E. Holmes is a Washington, DC-based freelance journalist and content strategist who has been writing about personal finance, health, and health insurance for more than a decade. Her work has appeared in various print and online publications, such as USA Today, AARP, Working Mother, and Diversity Woman.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Our editorial standards

Meet our experts