How Much Is Xenical (Orlistat) With and Without Insurance?
Key takeaways:
Xenical (orlistat) is an oral weight-loss medication that decreases the amount of fat you absorb from food. The capsules are available by prescription as brand-name Xenical and generic orlistat. There is also a lower-dose version called Alli that is available over the counter (OTC).
Insurance plans do not usually cover weight-loss medications. Medicare Part D plans don’t cover Xenical, but some Medicaid programs do. Some commercial insurance plans and your military prescription benefits may cover Xenical.
With a GoodRx coupon, 90 capsules of Xenical can cost as low as $435.38, and 90 capsules of orlistat can cost as low as $634.42. A 60-capsule Alli starter pack costs about $50 OTC, but with a GoodRx coupon, you can pay as low as $39.52.
You can save by choosing generic orlistat or OTC Alli instead of brand-name Xenical. You can pay less for Xenical and orlistat with a free GoodRx coupon.
Table of contents
Much attention has been paid to new injections approved for weight management, such as Wegovy (semaglutide) and Zepbound (tirzepatide). But several oral weight-loss medications have been available for decades. One of those options is Xenical.
Here’s how much the different versions of Xenical cost, and how you can save on them.
What is Xenical?
Xenical (orlistat) is a weight-loss medication that was FDA approved in 1999. It’s approved for long-term use. It works by limiting the activity of certain gastric and pancreatic enzymes (proteins). This helps block fat that you eat from being absorbed into the body.
The medication can also lower the risk of regaining weight. This is important because most people who lose a substantial amount of weight regain it within a couple of years.
Orlistat, the active ingredient in Xenical, is available as a generic medication. Typically, Xenical and orlistat are prescribed for people with a body mass index (BMI) of 30 or more. For those with a weight-related condition, such as Type 2 diabetes or high blood pressure (hypertension), these medications may be prescribed if you have a BMI of at least 27.
In 2007, the FDA approved an over-the-counter (OTC) version of orlistat called Alli. It’s half the dose of orlistat (60 mg) and generally costs less. Xenical prevents about 30% of fat from food from being absorbed by the body, and Alli prevents about 25% of fat from food from being absorbed.
And while most weight-loss medications are only approved for adults, both Xenical and generic orlistat (but not Alli) are approved for children ages 12 and older. Alli is approved for people 18 and older.
How much does Xenical cost without insurance?
The amount you will pay for Xenical depends on whether you buy the brand-name medication, generic orlistat, or Alli. If your health insurance covers the medication, it can reduce your out-of-pocket costs. You also may be able to save with a GoodRx coupon.
Typically, Xenical, generic orlistat, and Alli are taken 3 times a day with each main meal containing fat. So a monthly supply is 90 capsules.
The cost of brand-name Xenical can be more than $900 for 90 capsules without insurance. With a free GoodRx coupon, you could pay as low as $435.38 for a 1-month supply.
Generic orlistat can be more than $700 for 90 capsules without insurance. With a free GoodRx coupon, you could pay as low as $634.42 for a 1-month supply.
Alli is sold in packs with 60, 120, or 170 capsules. The cost for a 60-count starter pack is typically less than $50 OTC. If your prescriber writes a prescription for OTC Alli, you can also use a GoodRx coupon and pay as low as $39.52.
You also may be able to save on Xenical and orlistat by buying larger quantities, such as a 90-day supply of 270 capsules. And the price per capsule is lower when you buy more Alli pills at one time.
Here are GoodRx prices for Xenical and orlistat.
Orlistat type | Dosage form | GoodRx price |
Xenical | 90 capsules, 120 mg | |
Xenical | 270 capsules, 120 mg | |
Orlistat | 90 capsules, 120mg | |
Orlistat | 180 capsules, 120 mg | |
Orlistat | 270 capsules, 120 mg | |
Alli | 30 capsules, 60 mg | |
Alli | 60 capsules, 60 mg | |
Alli | 90 capsules, 60 mg | |
Alli | 120 capsules, 60 mg | |
Alli | 270 capsules, 60 mg |
Does insurance cover Xenical?
Whether your health insurance will cover Xenical or orlistat depends on your prescription 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 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 are run by states and territories. They are required to cover nearly all FDA-approved drugs for their medical indications except for weight-loss medications. That means Medicaid coverage for Xenical depends on where you live. Sixteen states covered at least one weight-loss drug as of July 1, 2023. Those states are:
California
Connecticut
Delaware
Hawaii
Kansas
Louisiana
Michigan
Minnesota
Mississippi
New Hampshire
Pennsylvania
Rhode Island
South Carolina
Texas
Virginia
Wisconsin
In three of those states — Louisiana, South Carolina, and Texas — the only covered weight-loss medication was Xenical or its prescription generic, orlistat.
Your coverage for weight-loss medications may be limited by quantity and restricted to certain medications — and Xenical and orlistat may not be included.
Commercial insurance
Commercial health insurance may or may not cover Xenical or generic orlistat. According to the Obesity Medicine Association, your plan may not cover weight-loss medications because they are considered cosmetic treatment.
Tricare and veterans benefits
Tricare insurance covers some prescription weight-loss medications, including Xenical or generic orlistat. But your prescriber may need to submit a coverage review, which is like a prior authorization. You can discuss options with your prescriber or military health professional.
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.
Can you save by using coupons or buying online?
Using a GoodRx coupon and buying a 90-day supply of 270 capsules can help save you money on Xenical and orlistat.
You can also save on Alli by buying larger quantities. By registering with the manufacturer to share your health information, Alli offers coupons: $5 off a 60-count starter pack and $10 off a 120-capsule refill package. You may be able to save money and time by buying Alli online, where you also may have access to free shipping.
How do you take Xenical for the best results?
People typically take Xenical, orlistat, and Alli 3 times a day for each main meal that contains fat. For the medication to be effective, you should take a capsule no later than an hour after you eat.
This medication works best when combined with a reduced-calorie, low-fat diet, and regular exercise. A daily multivitamin is recommended because these medications prevent the absorption of certain vitamins while blocking fat. You should take the multivitamin 2 hours before or after the orlistat dose. The price of the multivitamin should be factored in your cost of taking this medication.
The bottom line
Xenical is a prescription weight-loss medication that has been available since 1999. It works by limiting the absorption of fat from your diet. A lower-dose, over-the-counter (OTC) version, Alli, hit store shelves in 2007.
Without insurance, 90 capsules of brand-name Xenical can cost more than $900 and 90 generic orlistat pills can cost more than $700. With a free GoodRx coupon, 90 capsules could cost as low as $435.38 for Xenical and as low as $634.42 for orlistat.
Alli is sold in different quantities, but a 60-capsule starter pack costs less than $50 OTC and as low as $39.52 with a GoodRx coupon. You can save on Alli with manufacturer coupons after you register with the manufacturer.
One additional cost of taking this medication is the recommended multivitamin to replenish nutrients that may be blocked, along with fat, from being absorbed into the body.
Why trust our experts?
References
Aphena Pharma Solutions - Tennessee, LLC. (2024). Alli- orlistat capsule [package insert].
Bansal, A. B., et al. (2022). Orlistat. StatPearls.
H2-Pharma LLC. (2023). Orlistat- orlistat capsule [package insert].
Hinton, E., et al. (2023). Amid unwinding of pandemic-era policies, Medicaid programs continue to focus on delivery systems, benefits, and reimbursement rates: Results from an annual Medicaid budget survey for state fiscal years 2023 and 2024. KFF.
Johns Hopkins Medicine. (n.d.). Maintaining weight loss.
Noguchi, Y., et al. (2024). Medicare plans can now cover Wegovy for patients at risk of heart disease. NPR.
Obesity Medicine Association. (2023). Does insurance cover weight loss medication?
Tricare. (2022). Weight loss products.
U.S. Food and Drug Administration. (2015). Orlistat (marketed as Alli and Xenical) information.
Williams, E., et al. (2023). Medicaid utilization and spending on new drugs used for weight loss. KFF.
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