Phentermine + topiramate (the brand name Qsymia)
| Item | Typical cost (US 2024‑2026) | Notes |
|------|-----------------------------|-------|
| Brand‑name Qsymia (45 mg phentermine + 2.5 mg topiramate) | $120 – $160 per 30‑day supply (≈ $4 – $5 per pill) | Most pharmacies quote this range for a 30‑day pack. Prices can vary by pharmacy, location, and whether you have insurance. |
| Brand‑name Qsymia (90 mg phentermine + 5 mg topiramate) | $170 – $210 per 30‑day supply (≈ $5 – $7 per pill) | The higher‑dose option is generally used once you’re tolerating the 45 mg/2.5 mg dose. |
| Insurance coverage | Many plans cover Qsymia, but it often falls under “weight‑loss” or “specialty” drug tiers. Co‑pay/coinsurance can range from a few dollars to over $50 per month. | Check with your insurer or pharmacy benefits manager (PBM). |
| Generic alternatives | As of 2026, no FDA‑approved generic for the exact combination is available. | The two components (phentermine and topiramate) are available separately in generic form, but they’re not approved for the fixed‑dose, weight‑loss indication. |
| Patient assistance / manufacturer discount | The manufacturer (Eli Lilly) offers a Qsymia Patient Assistance Program (PAP) for patients who meet income eligibility (< 200 % federal poverty level). | Eligibility requirements include proof of income, no other insurance, or being uninsured. |
| Discount cards & pharmacy programs | Many large pharmacy chains (CVS, Walgreens, Walmart, etc.) offer discount cards that can reduce the out‑of‑pocket cost by 20 %–50 %. | Savings vary by card and pharmacy; always compare before picking a pharmacy. |
| Online & mail‑order options | Some specialty pharmacies offer mail‑order with 30‑day or 90‑day refills. Shipping costs may add $5–$10 to the total. | Mail‑order can save on pharmacy visit fees but check drug stability and storage instructions. |
How to get the best price
1. Check your insurance plan
* Use the pharmacy’s online portal or call the pharmacy’s benefits manager to see if Qsymia is covered and what the out‑of‑pocket cost will be.
* If you have a high deductible, consider using a 90‑day supply to reduce pharmacy visit fees.
2. Ask about the patient assistance program
* If you’re uninsured or have limited coverage, you can apply for the Qsymia PAP online. You’ll need income documents and proof of residency.
3. Compare pharmacy discount cards
* Most major chains have cards that you can get at checkout. Compare the savings offered by each chain.
4. Consider generic phentermine + topiramate separately
* Some prescribers might be willing to prescribe the two drugs separately if you’re comfortable taking them at different times of day. The cost of each generic can be $10–$20 for a 30‑day supply, so combined you might pay less than the branded combo—though the exact dosing schedule and insurance coverage will differ.
5. Ask your prescriber about “step‑down” dosing
* Starting at the lowest dose (45 mg/2.5 mg) and gradually stepping up can sometimes reduce the number of pills needed during the first few months, saving money.
6. Use pharmacy benefit management tools
* Many PBMs have apps that let you compare copay, coinsurance, and pharmacy network options in real time.
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Quick summary
- Brand Qsymia: $120–$160 for the 45 mg/2.5 mg dose (≈ $4–$5/pill) and $170–$210 for the 90 mg/5 mg dose (≈ $5–$7/pill).
- No FDA‑approved generic for the fixed‑dose combination yet.
- Insurance can reduce costs but varies widely; check with your plan.
- Manufacturer and pharmacy discount programs can provide significant savings.
If you’re looking at specific pharmacies or have a particular insurance plan, let me know the details and I can walk you through the exact numbers.