Lilly says Zepbound led 2025 weight management prescriptions as four-dose KwikPen is cleared

Eli Lilly said Feb. 23, 2026, that the FDA cleared a label expansion for its obesity drug Zepbound (tirzepatide), adding a four-dose KwikPen built to hold a month's worth of treatment in one device ^[1][2]. The company paired that news with a claim that no other weight management medicine was prescribed more often in 2025 ^[1][2].

In the release, Lilly calls Zepbound the "#1 prescribed injectable obesity-management medication," citing national prescription audit data, and puts the medicine at the center of its weight-loss business ^[1][2]. The release does not give a total prescription count or say how far ahead of the next product Zepbound finished ^[1][2].

"Zepbound is the #1 prescribed injectable obesity-management medication, helping adults achieve meaningful and clinically proven weight loss, on average, up to 50 pounds as seen in SURMOUNT-5," said Ilya Yuffa, executive vice president and president of Lilly USA and Global Customer Capabilities ^[1][2].

Lilly also reported that one of every three patients new to a branded weight management drug in 2025 received Zepbound self-pay vials ^[1][2]. More than 1 million patients obtained Lilly treatments through LillyDirect during the year, according to the company, which says its self-pay prices run at least 50% below the list price of other incretin (GLP-1) obesity medicines ^[1][2].

How the two payment formats compare

People paying out of pocket through LillyDirect can get any Zepbound strength in either the KwikPen or a single-dose vial at the same price, beginning at $299 a month for the 2.5 mg strength ^[1][2]. Lilly has not said what the 5 mg through 15 mg strengths cost under that arrangement, and it has not said whether insurers will cover the pen ^[1][2].

The KwikPen is meant for a single patient. Lilly warns that sharing it can pass a serious infection from one person to another even when the needle has been changed ^[1][2].

Zepbound is sold in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg strengths. The 2.5 mg strength is a starting dose and is not approved for maintenance; the maintenance doses are 5 mg, 10 mg or 15 mg injected once a week for weight reduction and long-term upkeep, and 10 mg or 15 mg for obstructive sleep apnea ^[1][2].

The trial numbers behind the claim

In SURMOUNT-1, a 72-week study of adults without diabetes, average weight loss was 15.0% (34 lbs) at 5 mg, 19.5% (44 lbs) at 10 mg and 20.9% (48 lbs) at 15 mg, compared with 3.1% (7 lbs) on placebo. Starting weights averaged about 227 to 233 lbs ^[1].

In SURMOUNT-5, also 72 weeks, participants on the highest Zepbound dose they could tolerate lost an average of 20.2% of body weight (50 lbs), while those on injectable Wegovy (semaglutide) at their top tolerated dose lost an average of 13.7% (33 lbs). Starting weights averaged 248.4 lbs and 250 lbs ^[1][2]. Lilly notes that SURMOUNT-5 was open-label, making it less rigorous and its findings less certain, and that factors other than the medicines may have contributed to weight loss ^[1][2].

Why it matters for patients

This is a change in how the drug is delivered, not a change in the drug itself. For someone already buying Zepbound without insurance, the announcement means the starting self-pay price of $299 a month for the 2.5 mg strength applies to either format, so the choice between them comes down to handling rather than cost at that strength ^[1][2].

Several practical questions remain open. Lilly has not reported how the two formats compare on price at the higher, maintenance strengths, whether insurance plans will pay for the pen, or when it might reach pharmacies outside LillyDirect ^[1][2].

Zepbound carries warnings about thyroid tumors including thyroid cancer, severe stomach problems, dehydration that can lead to kidney problems, gallbladder disease, pancreatitis, serious allergic reactions, low blood sugar, vision changes in people with type 2 diabetes, and depression or thoughts of suicide ^[1][2]. The label states the drug is not for cosmetic weight loss, and that it is not known whether it is safe or effective in children ^[1][2].

What happens next

Lilly says the KwikPen is available by prescription through LillyDirect now ^[1][2]. No other dated milestones, such as wider pharmacy distribution or pricing for the remaining strengths, have been disclosed ^[1][2].