The advertised price is not the annual cost
Almost every price you see quoted for these medications is the entry price: the first month, at the starting dose, often on an introductory rate. A year does not look like that month repeated twelve times.
The standard weight-management schedule starts at 2.5 mg and reaches 15 mg around week twenty-one, climbing in 2.5 mg steps. If your route prices by dose, your monthly cost climbs with it. If it does not, it may still change when the introductory period ends.
How we have priced it
We use each route's own advertised monthly rate, as listed on our providers page and checked on the date shown there, and assume the labelled escalation schedule. Where a route prices by dose rather than charging a flat subscription, we say so rather than publishing a single figure that would only be true for one dose.
We are not publishing one headline annual number. For the dose-scaled routes there is no honest way to produce one, and a made-up average would be the least useful thing on this page.
What actually moves the number
- Insurance coverage, by a wide margin. A plan that covers weight management after prior authorisation turns a four-figure annual cost into a few hundred. Nothing else on this list has anything like that effect.
- Whether your route charges flat or by dose. A flat subscription that holds at 15 mg is a genuinely different product from one that scales, and the difference over a year is large.
- Whether membership and medication are billed separately. Two moderate numbers can total more than one large one, and they are harder to compare at a glance.
- Gaps. Prior authorisation delays, supply interruptions and pauses all change the real annual figure, usually downward in cost and unhelpfully in results.
The cost people forget to budget for
SURMOUNT-4 withdrew participants to placebo after an open-label lead-in, and they regained substantially. The equivalent finding for semaglutide is the STEP 1 extension, where people regained about two thirds of what they had lost within a year of stopping.
Whatever else this is, it is not a course of treatment with an end date. If the annual figure only works for you as a one-year project, the honest planning question is what happens in year two, not whether you can afford year one.
What to ask before committing
- Does this price change as my dose increases?
- Is this an introductory rate, and what does it become?
- Is medication included, or billed separately from the membership?
- What is the minimum commitment, and what happens if I stop?
- What happens to my price and my supply if the compounded product becomes unavailable?
Sources
- Provider advertised pricing, as listed and dated on this site's providers pages
- Mounjaro and Zepbound prescribing information, Eli Lilly
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564.
- Aronne LJ, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction (SURMOUNT-4). JAMA. 2024;331(1):38-48.