NC Medicare Drug Spending: Mounjaro
The Newest Diabetes Drug Costing North Carolina Medicare $86 Million in Its First Full Year
Ranked 165th in prescriptions. But Mounjaro is already NC's 18th most expensive Medicare drug after launching in mid-2022.
$85.6M
Total NC Medicare spend on Mounjaro (tirzepatide), 2023
$1,278
Average cost per prescription
#165 / #18
Rank by prescriptions / rank by total cost
What is Mounjaro and how is it different from Ozempic?
Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist from Eli Lilly, approved for Type 2 diabetes in May 2022. It activates two hormone pathways instead of one, producing larger reductions in blood sugar and body weight than existing GLP-1 drugs in clinical trials. NC Medicare Part D covers it for diabetes. In 2023 it was still relatively new, which is why it's ranked 165th by prescription volume but already 18th by total cost. It's climbing fast.
Why does it cost $1,278 per prescription?
Eli Lilly manufactures Mounjaro under patent. No generic exists. NC Medicare filled 66,989 Mounjaro prescriptions in 2023 for $85.6 million. By 2025, volume has likely grown substantially as prescribers and patients become more familiar with it.
What Part D enrollees should know
Mounjaro's formulary placement varies widely. Prior authorization requirements are common. Compare how different plans cover Mounjaro versus Ozempic during open enrollment. If both are appropriate for your situation, the plan that tiers your specific drug lower can save hundreds of dollars per year.
Where this drug is headed
North Carolina has above-average obesity rates, and tirzepatide has produced some of the most dramatic weight-loss results ever seen in a clinical drug trial. Demand will keep growing. Its cost impact on NC Medicare Part D will be substantial over the next several years.
NC Medicare spent $85.6 million on Mounjaro in 2023, its first full year of availability. Ozempic, which launched earlier in the same class, cost $407 million that year. Mounjaro is on a similar trajectory.
Top 10 North Carolina Drugs by Total Medicare Part D Spending, 2023
Source: CMS Medicare Part D Prescribers by Geography and Drug, 2023. North Carolina state-level data.
A note on this data: All figures come from the Centers for Medicare & Medicaid Services
(CMS) Medicare Part D Prescribers by Geography & Drug dataset, 2023. This data covers Medicare Part D
(prescription drug coverage) only and does not represent commercial insurance, Medicaid, or cash-pay prescriptions.
Suppressed values (fewer than 11 beneficiaries) are excluded from totals.
This article is for educational purposes only. Nothing here is medical advice. Talk to your doctor before
making any decisions about your medications or treatment. This content is not connected with or endorsed
by the U.S. Government or the federal Medicare program.
