Eli Lilly announced that all six dose strengths of Zepbound (tirzepatide) are now available at U.S. pharmacies on a consistent basis, ending more than a year of intermittent shortages that frustrated patients and prescribers. The company credits its $9 billion manufacturing investment, which included a new facility in Lebanon, Indiana, and expanded capacity at its Research Triangle Park site in North Carolina.
Chief Financial Officer Anat Ashkenazi told analysts during a March 1 investor update that Lilly's production output for tirzepatide has increased by roughly 150% since Q3 2025. "We are now producing ahead of demand for the first time since Zepbound's launch," she said.
The Scope of the Shortage
Zepbound launched in November 2023 with a prescription volume that outpaced every demand forecast Lilly had prepared. Within three months, the FDA placed multiple dose strengths on its official drug shortage list, where some remained through most of 2025 [1].
The shortage meant that patients who had started treatment often could not fill their prescriptions at higher doses, disrupting the titration schedule that is central to safe and effective GLP-1 therapy. Some patients switched to compounded versions, others moved to Novo Nordisk's Wegovy, and some paused treatment entirely.
Dr. Fatima Cody Stanford, an obesity medicine physician at Massachusetts General Hospital and associate professor at Harvard Medical School, described the period as "deeply disruptive to patient care." She estimated that roughly 30% of her patients on tirzepatide experienced at least one missed dose due to supply issues during 2025.
"When patients can't get their medication consistently, they lose trust in the treatment," Dr. Stanford said. "Some regained weight, and convincing them to restart was not always easy."
What Lilly Built
The $9 billion manufacturing expansion is one of the largest pharmaceutical capital investments in U.S. history. It includes:
The Lebanon, Indiana facility, known as LEAP (Lilly Engineering and Advanced Processing), is a 900,000-square-foot manufacturing site that began producing tirzepatide in late 2025 [2]. At full capacity, the facility can produce enough injectable pens to supply millions of patients per year.
The Research Triangle Park expansion in North Carolina added 600,000 square feet of manufacturing and fill-finish space. This site handles the sterile filling of auto-injector pens, which had been a bottleneck during the shortage.
Lilly also invested $1.2 billion in its manufacturing site in Limerick, Ireland, which serves international markets and provides backup capacity for the U.S. supply chain.
Dose Availability Details
The six Zepbound dose strengths (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg) are now all listed as available on the FDA's drug shortage database [1]. This is the first time all doses have been simultaneously available since spring 2024.
Lilly's head of U.S. commercial operations, Patrik Jonsson, said the company has built a three-month buffer inventory across all dose strengths, which should prevent a return to shortage conditions even if demand spikes.
"We overbuilt deliberately," Jonsson explained during the investor call. "We would rather carry excess inventory than put patients through another disruption."
The Compounding Question
The improved supply has implications for the compounding pharmacy market, which grew rapidly during the tirzepatide shortage. While tirzepatide was on the FDA shortage list, compounding pharmacies were legally permitted to produce copies under Section 503A and 503B of the Federal Food, Drug, and Cosmetic Act.
With the shortage resolved, the FDA's position is that compounding pharmacies should stop producing tirzepatide copies. However, enforcement has been inconsistent, and several compounding pharmacy associations have filed legal challenges arguing that patient access concerns justify continued production [3].
Lilly's general counsel has signaled the company intends to pursue legal action against compounders who continue producing tirzepatide now that supply is adequate. "The shortage was the legal basis for compounding," a Lilly spokesperson stated. "That basis no longer exists."
Pricing and Access
Supply resolution does not solve the affordability problem. Zepbound's list price remains approximately $1,059 per month [4]. While Lilly offers a savings card that reduces the cost to $550 per month for eligible commercially insured patients, those without insurance or with exclusions face the full price.
Lilly has resisted calls to lower the list price, arguing that the savings card program and patient assistance program make the drug accessible. The company's patient assistance program provides Zepbound at no cost to qualifying patients who earn less than 400% of the federal poverty level and lack insurance coverage.
Dr. Stanford noted that the supply improvement is meaningful but insufficient. "Having the drug on the shelf is only half the battle," she said. "If patients can't afford it, availability is academic."
What Patients Should Do Now
Patients who paused tirzepatide treatment due to supply issues should contact their prescribers to discuss restarting. Most clinicians recommend restarting at the lowest dose (2.5 mg) and re-titrating upward, even if the patient was previously on a higher dose. This approach minimizes gastrointestinal side effects that can occur when resuming treatment.
Pharmacies that previously could not stock certain dose strengths should now be able to order all six. Patients experiencing difficulty finding their dose should contact Lilly's customer support line or use the company's pharmacy locator tool.
Sources
- FDA Drug Shortage Database. "Tirzepatide Injection." Updated March 2026.
- Eli Lilly. "LEAP Manufacturing Facility Fact Sheet." 2025.
- Alliance for Pharmacy Compounding. "Legal Challenges to FDA Compounding Restrictions." February 2026.
- Eli Lilly. "Zepbound Pricing and Savings Information." March 2026.