Key takeaways:
Trulicity (dulaglutide) is an FDA-approved, once-weekly injection for treating Type 2 diabetes in adults and children ages 10 and older. It’s also approved to lower the risk of serious cardiovascular problems in adults with Type 2 diabetes who have or are at risk for heart disease.
The manufacturer's list price for Trulicity is about $980 per month, but the actual cost without insurance or discounts can range from $1,000 to $1,350.
With commercial insurance, you may pay as little as $25 for up to 12 Trulicity injection pens. A GoodRx coupon can reduce your Trulicity cost by about 28% at participating pharmacies, with or without insurance.
For those living with Type 2 diabetes, Trulicity (dulaglutide) is an injectable medication taken once a week to help manage blood glucose (sugar) levels. But Trulicity can also reduce the risk of serious cardiovascular problems for some people. They may even experience weight loss while taking Trulicity, although it’s not FDA-approved for weight loss.
Insurance may cover Trulicity when prescribed for FDA-approved purposes. But, the medication is unlikely to be covered when taken for non-FDA-approved uses. Without insurance, Trulicy can cost over $13,000 per year.
How much does Trulicity cost, and what affects the price?
The manufacturer's list price for a 28-day supply of Trulicity (4 injection pens) is about $980. Each Trulicity pen has one dose, and the available doses range from 0.75 mg to 4.5 mg.
Based on GoodRx data, the retail price of Trulicity ranges between $1,000 and $1,350 due to pharmacy markups. However, your out-of-pocket costs will vary depending on several factors, including: .
Pharmacy location: The cost of a medication can vary from one pharmacy to another, even within the same city. You can use GoodRx to compare prices so you can get the best deal in your area.
Health insurance coverage: If your insurance plan covers Trulicity, you may pay less than the retail price. However, your cost with insurance depends on your copay, coinsurance, and deductibles.
Reason for prescription: If you’re prescribed Trulicity for Type 2 diabetes, your insurance will likely cover some of the expense. But expect to pay the full cost out of pocket if you don’t have diabetes and are prescribed the medication for weight loss.
Dosage: The starting dose of Trulicity is 0.75 mg, which can be increased gradually up to a maximum dose of 4.5 mg per week. Pharmacy prices may vary for each dose.
Discounts: You may pay less for Trulicity if you use a prescription discount platform such as GoodRx or qualify for a savings card from the manufacturer.
Does insurance cover Trulicity?
Insurance may cover Trulicity when it's prescribed for FDA-approved uses. The FDA has approved Trulicity to treat Type 2 diabetes in adults and children ages 10 and older. Trulicity is also approved to prevent serious cardiovascular problems in adults with Type 2 diabetes who have heart disease or risk factors for heart disease.
Trulicity is not FDA-approved for weight loss in people who don’t have diabetes. This means your insurance is unlikely to cover it when it’s prescribed "off-label" for this purpose.
Does employer-sponsored health insurance cover Trulicity?
Employer-sponsored insurance plans may cover Trulicity when it’s used for FDA-approved purposes. However, coverage varies depending on your specific plan's formulary. A formulary is a list of prescription medications covered by your health plan.
Some plans may require step therapy, which means you must first try a different, usually lower-cost medication. If that medication doesn't work well for you, then your insurance may cover Trulicity.
Your healthcare professional may also need to request a prior authorization from the health plan.
Does Medicare cover Trulicity?
Medicare may help pay for Trulicity when it’s prescribed for FDA-approved uses. Similar to commercial plans, prior authorization and step therapy may be required.
However, if you don’t have diabetes and you're prescribed Trulicity for chronic weight management, Medicare may not cover it. Medicare is not allowed to cover medications taken solely for weight loss.
Does Medicaid cover Trulicity?
Medicaid may cover Trulicity. But, the specific services and medications covered by Medicaid can vary from state to state.
Your state’s Medicaid program administrators can tell you if Trulicity is included in your plan and if you need to meet certain criteria before coverage kicks in.
How can you get your insurer to cover Trulicity?
Getting your insurer to cover Trulicity may require some effort, even if the medication is included under your plan’s coverage for Type 2 diabetes. Here are some steps you might have to take:
Make an appointment with your medical team. During this visit, discuss with your healthcare professional whether Trulicity is a suitable option for you. If they believe Trulicity could be beneficial, they’ll write a prescription, which you’ll need to obtain the medication.
Check if your insurance plan covers Trulicity. You can review your insurance plan's formulary or contact your health plan's customer service department to ask about coverage guidelines. A representative can give you details about the requirements to obtain the medication and your expected out-of-pocket costs.
Request prior authorization or step therapy approval. In many cases, your insurance company will require a prior authorization or proof that you've met step therapy criteria. A healthcare professional can send a letter of medical necessity directly to your insurer to show that Trulicity is the right choice for your treatment.
File an appeal if needed: If your prior authorization request is denied but Trulicity is on your plan's formulary, you and your prescriber can appeal the decision. This process typically involves submitting additional medical records and documentation to support your need for the medication. Be sure to follow your plan's specific appeals procedure.
You may find out that Trulicity is not part of your insurance plan’s formulary. In this case, you and your prescriber can request a formulary exception. This is a request to your insurer to cover a medication that's not included in its formulary. Each health plan has specific requirements for submitting a formulary exception.
Ways to save money on Trulicity
Here are six ways to lower your out-of-pocket costs for Trulicity.
1. Get a free GoodRx coupon
GoodRx is partnering with InsideRx and Eli Lilly to lower the price of Trulicity. When you use a GoodRx coupon, you can save up to 28% off the average cash price of $1177.05.
Follow these steps to download a free GoodRx coupon:
Visit www.goodrx.com or download the GoodRx app.
Enter “Trulicity” in the search bar.
Click on “Find the lowest prices.”
Text, print, or email your coupon.
Show the coupon at your pharmacy when you fill your Trulicity prescription.
2. Use the Trulicity Savings Card
Using prescription savings coupons, such as those from Trulicity's manufacturer, Eli Lilly, can lower your cost. If you have commercial prescription insurance and meet certain criteria, you may be eligible for the Trulicity Savings Card. With this card, you can pay as little as $25 for up to 12 Trulicity pens. If you qualify, you can request a card via email or ask a healthcare professional for one.
3. Ask for a 3-month supply
Instead of getting a month’s supply of Trulicity at a time, ask your healthcare professional to prescribe 3 months’ worth. This can potentially lower your costs and reduce the number of trips you make to the pharmacy, saving you time and money.
If your insurance covers Trulicity, check if they offer lower prices for prescriptions filled through their mail-order pharmacy.
4. Ask for samples
When starting Trulicity, ask your prescriber if they have free samples. Trying a sample of Trulicity allows you to gauge how well the medication works for you before committing to a full prescription. These samples can provide short-term cost savings.
5. Take advantage of your HSA or FSA funds
Health savings accounts (HSAs) and flexible spending accounts (FSAs) are great tools for saving money on your Trulicity prescription. These accounts let you set aside pretax dollars specifically for qualified medical expenses, including prescription medications.
6. Check the Lilly Cares Program
The Lilly Cares Program may be an option for those without insurance or who are enrolled in Medicare Part D. Through this program, you may be able to receive Trulicity for free.
However, Lilly Cares is not currently accepting new applications for Trulicity. If you're interested in this program, check their website periodically to see if they begin accepting applications for Trulicity again.
The bottom line
Without insurance, a one-month supply of Trulicity (dulaglutide) can cost between $1,000 and $1,350. The cost can be impacted by the pharmacy you choose, where you live, and the dosage you need. You can reduce your cost by using a GoodRx coupon, applying for a manufacturer's savings card, and looking into other money-saving strategies.
Why trust our experts?
References
Eli Lilly and Company. (2022). Trulicity- dulaglutide injection, solution [package insert].
Lilly Cares Foundation. (n.d.). Check your eligibility.
Trulicity. (n.d.). Savings & resources.
