How Much Does Qsymia Cost With and Without Insurance?
Key takeaways:
Qsymia (phentermine / topiramate ER) is an oral weight-loss medication for adults and children ages 12 and older. It works by suppressing your appetite and making you feel full.
Qsymia is not as costly as injectable weight-loss medications. Without insurance, a 30-day supply of 7.5 mg / 46 mg capsules can cost $260.91 on average. You could pay as little as $176.31 with a GoodRx coupon at select pharmacies. GoodRx has an exclusive discount on Qsymia that can make the brand-name medication less costly than its generic version.
A manufacturer’s savings card for Qsymia can lower costs for consumers who self-pay and whose commercial insurance doesn’t cover the medication. People whose commercial insurance covers Qsymia can also use the savings card for a discount on fills after covering $70 of their copay.
Table of contents
Weight-loss medications are increasing in popularity as people share information about new treatments and their success stories on social media. But the newer, injectable medications are outside many people’s budgets or not covered by their insurance plans. And they’re not guaranteed to work for everyone.
Qsymia (phentermine / topiramate ER) is a more affordable, oral weight-loss medication that has been around for more than a decade. Unlike many other options, it’s approved to treat both adults and adolescents. And in May 2025, the first generic version of Qsymia (phentermine / topiramate ER) was released.
How much does Qsymia cost without insurance?
Without insurance, what you pay for Qsymia depends on several factors, including your:
Pharmacy
Location
Fill quantity
Medication dose
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.
The chart below contains GoodRx exclusive prices for 30-day supplies of different doses of Qsymia and its generic equivalent.
Qsymia doses | Average cash price* |
|---|---|
Qsymia, 30 capsules (3.75 mg / 23 mg) | |
Qsymia, 30 capsules (7.5 mg / 46 mg) | |
Qsymia, 30 capsules (11.25 mg / 69 mg) | |
Qsymia, 30 capsules (15 mg / 92 mg) | |
Phentermine / topiramate ER, 30 capsules (3.75 mg / 23 mg) | |
Phentermine / topiramate ER, 30 capsules (7.5 mg / 46 mg) | |
Phentermine / topiramate ER, 30 capsules (11.25 mg / 69 mg) | |
phentermine / topiramate ER, 30 capsules (15 mg / 92 mg) |
*Note: Qsymia and its generic are controlled substances, so some states do not allow coupons to be used for these medications. You may not be able to get a GoodRx discount in those places.
Is Qsymia covered by insurance?
Some health insurance plans cover Qsymia. Nearly all commercial plans not purchased through an Affordable Care Act (ACA) marketplace and about one-third of Medicaid and ACA plans cover this medication.
If you have insurance, review your plan’s summary of benefits and coverage and formulary (list of covered medications) to determine whether Qsymia is covered. If not, contact your prescription plan provider and ask about your coverage options. You can also discuss alternatives with your prescriber or a pharmacist.
How insurance covers Qsymia
The following charts show the likelihood of coverage for Qsymia 7.5 mg / 46mg capsules, based on the type of insurance plan.
Many health insurance plans require enrollees to get prior authorization, and a few require enrollees to do step therapy. In fact, prior authorization is required for about 1 in 3 people covered by a Medicaid plan — and most people covered by commercial plans not purchased through an ACA marketplace.
Insurance coverage for Qsymia (7.5 mg / 46 mg capsule)
Insurance type | Enrollees covered for Qsymia, 7.5 mg / 46 mg capsule | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial plans (not including plans purchased through an ACA marketplace) | 89.6% | 70.5% | 1.4% |
33.2% | 26.5% | 0.4% | |
Medicare, including original Medicare and Medicare Advantage plans | 1.9% | 1.7% | 0% |
Medicaid, including state-run and managed care plans | 38.3% | 35.1% | 1.3% |
Source: Managed Markets Insight & Technology, LLC™, as of May 12, 2025. (See methodology below.)
Tips if your medication isn’t covered by insurance
If your insurance doesn’t cover Qsymia, you still have options:
Use a GoodRx coupon to save on your prescription.
Ask your prescriber about less costly options that meet your needs, such as switching to a lower-cost generic medication.
Request a formulary exception from your insurance company. If your request is denied, you have the right to file an appeal with your plan.
When it’s time for open enrollment, compare different health insurance plans to find one that provides the coverage you need.
How can I save on Qsymia?
GoodRx has an exclusive manufacturer discount for Qsymia that can help you pay less for this medication.
Weight loss in a pill: With all the news about injectables, some people may have missed long-standing oral weight-loss medications. Several pills, including Qsymia, have been effective for decades at helping people manage their weight.
First Qsymia generic: The first generic version of Qsymia was released in May 2025, but there are ways to pay less if you stick with the brand-name medication.
Qsymia vs. Wegovy: Qsymia is a daily pill, and Wegovy is a far pricier weekly injection. Qsymia may take longer to work than Wegovy, and you may lose more weight on Wegovy — which can also improve your heart health.
The manufacturer savings card for Qsymia offers discounts for cash-paying consumers who 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 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.
For a consumer with commercial insurance, the manufacturer savings card offers a discount after you cover $70 of your copay. Then you are eligible to receive $65 off each supply of 28 to 30 days for up to 100 fills. If you have the 3.75 / 23 mg dose in quantities of 14 or 15 days, you are eligible to receive $65 off for up to 10 fills. Manufacturer discounts are not available for people with government health insurance such as Medicare, Medicaid, and Tricare.
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.
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 threshold for having obesity.
How do you take Qsymia for the best results?
Qsymia is taken by mouth once a day. It’s recommended that you have your dose 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 — there are 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 to have your prescriber regularly check 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 you may 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 this medication. The REMS program also requires participants to use effective birth control methods.
Frequently asked questions
In Qsymia studies, the average weight loss for people taking this medication was about 8% to 10% after 56 weeks (about 13 months). About 70% of participants lost at least 5% of their initial body weight after taking the highest Qsymia dose for a year. And almost 50% of participants lost at least 10% of their starting weight.
The “better” medication depends on your goals, preferences, and budget. Wegovy is a weekly injection, while Qsymia is a daily pill. Qsymia may take longer to work than Wegovy (2 months versus 1 month), on average. You may lose more weight on Wegovy, which can also improve your heart health. Each has a distinct list of side effects that you should consider. Wegovy is far more costly than Qsymia, but your out-of-pocket costs could be similar if both medications are covered by your insurance plan.
There isn’t one weight-loss pill that’s widely considered to be the most effective. Some studies suggest that Qsymia delivers the best results. But it’s a controlled substance, so this pill may not be the best option for you.
The bottom line
Qsymia is an oral, prescription-only weight-loss medication that combines phentermine and topiramate ER. The capsules were approved for use by adults in 2012 and for children 12 and older in 2022. Qsymia works by suppressing your appetite, reducing cravings, and helping you feel full faster.
Without insurance, a 30-day supply of 7.5 mg / 46 mg capsules can cost $260.91 on average. You could pay as little as $176.31 with a GoodRx coupon at select pharmacies. GoodRx has an exclusive discount on Qsymia that can make the brand medication less costly than its generic version, which was released in May 2025. Keep in mind that since Qsymia is a controlled substance, your state may not allow the use of discount cards on your prescription. A Qsymia savings card offered by the manufacturer can help self-pay consumers and people with commercial insurance get the medication for less than $100 per fill.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of May 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including the ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Business Wire. (2024). GoodRx announces exclusive low cash price for Qsymia, the leading branded once-daily oral weight management medication for adults.
Gadde, K. M., et al. (2011). Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): A randomised, placebo-controlled, phase 3 trial. The Lancet.
Lonneman, D. J., Jr., et al. (2013). Phentermine/topiramate extended-release capsules (Qsymia) for weight loss. Pharmacy and Therapeutics.
Medicaid.gov (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Qsymia. (2024). Risk evaluation and mitigation strategy (REMS).
Qsymia. (2025). The Qsymia savings card.
Qsymia Engage. (2024). Frequently asked questions.
U.S. Food and Drug Administration. (2022). FDA approves treatment for chronic weight management in pediatric patients aged 12 years and older.
Vivus. (2024). Qsymia- phentermine and topiramate capsule, extended release [medication guide]. DailyMed.
Vivus. (2024). Qsymia- phentermine and topiramate capsule, extended release [package insert]. DailyMed.
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