MEDVi: Tirzepatide vs Semaglutide Cost

The two prices at this programme

MEDVi charges $134 a month for semaglutide and $399 a month for tirzepatide. The difference is $265 a month, or $3,180 across a year, for the same clinical wrap, the same platform and the same fulfilment route. Captured 2026-08-05.

Because both figures come from one programme, the gap is the molecule rather than the business model. That is the cleanest version of this comparison available, and it is why pricing the two molecules across different platforms tends to mislead.

What you get for the difference

SURMOUNT-5 randomised adults with obesity to tirzepatide or semaglutide and reported a larger mean weight reduction on tirzepatide over 72 weeks. That is the evidence the price premium rests on, and it is real evidence rather than marketing.

What it does not tell you is what will happen to you. The distribution around a trial mean is wide, tolerability differs between molecules, and the comparison was made at maximum tolerated doses rather than at whatever dose you settle on. Some people do better on the cheaper molecule.

Framed as a budget question: the tirzepatide premium at MEDVi costs $3,180 a year. Whether that is worth paying is a judgement about your own response, and the honest answer is that nobody can make it for you in advance.

Switching between them at this programme

Switching molecules restarts titration. Tolerance does not carry across because the dose ladders are not equivalent and the receptor targets differ, so budget for the titration months again.

Before switching at MEDVi, settle three things in writing: whether the programme charges anything to change molecule, whether any prepaid term you have already paid transfers, and what starting dose your prescriber intends. Programmes rarely volunteer any of the three.

MEDVi discloses its fulfilment as not named, so you can confirm the same pharmacy handles both molecules.

What the spread actually represents

All-in cost runs $215 to $597 a month for the same molecule from the same category of licensed pharmacy. That gap is not the medicine. It is overhead, clinical wrap, sourcing and margin, plus how aggressively a programme is willing to structure its fees.

5 of 16 charge a mandatory recurring fee and 12 hold one price at every strength. Those two facts explain most of the spread, and neither appears in a headline figure.

Where our numbers could be wrong

A programme changed its price after our capture date. A third-party figure we recorded does not survive checking. A promotional rate was published as a standing one. Or a programme publishes something we could not find.

All four are live risks and the first is near-certain over time. Every figure carries its capture date and a link to the source we read, so the check takes about two minutes and does not require trusting us.

Why the cheapest entries are the least reliable

Four distortions push in the same direction: a promotional first month quoted as a standing rate, a prepaid bundle rate quoted as monthly, a medication figure that excludes a mandatory membership, and occasionally a different molecule's price in the wrong column.

Every one of those makes a programme look cheaper than it is, which is why the bottom of any published table is where errors concentrate. It is also why we mark which figures we read at the provider and which we did not, rather than presenting one confident list.

Where we have been able to check an unconfirmed figure against a provider's own page, the number usually moved upward.

How to sanity-check any figure you find elsewhere

Three questions. What dose does it describe? Does it include every recurring fee? And when was it captured? A price failing any of the three is not comparable to the numbers here, and most published figures fail at least one.

Tirzepatide makes this worse than most categories because the same molecule sells under several brands at prices spanning more than fifteenfold. 'Tirzepatide costs X' is not a sentence that can be true without naming the product and the channel.

How semaglutide is priced at these programmes

Semaglutide runs $99 to $299 a month across the 14 programmes in our dataset that carry both molecules. The cheapest we verify is Mochi Health at $99 a month. Tirzepatide at the same programmes runs consistently higher, and the gap is structural rather than promotional.

Semaglutide is a shorter peptide with a longer manufacturing history and more compounding pharmacies equipped to produce it. Tirzepatide is longer, harder to synthesise, and its active ingredient sells at a premium. That difference in input cost is most of the price gap you see between the two columns.

Semaglutide titrates 0.25, 0.5, 1, 1.7 and 2.4 mg weekly, with four weeks at each step, so reaching a semaglutide maintenance dose takes roughly sixteen weeks against eight to twelve for tirzepatide. On a dose-scaled programme that longer ladder means more months at intermediate pricing, which partly offsets the lower headline figure.

What the head-to-head evidence supports

SURMOUNT-5 randomised adults with obesity to tirzepatide or semaglutide and reported a larger mean reduction in body weight on tirzepatide over 72 weeks. It is the strongest direct comparison between the two molecules and it is the reason tirzepatide sustains a premium in a market that otherwise competes hard on price.

The caveats matter. A mean is not a prediction for an individual and the distribution around it is wide; a substantial number of semaglutide participants did better than a substantial number of tirzepatide participants. Trial participants received structured support most telehealth programmes do not replicate. And the comparison was at maximum tolerated doses, which is a different question from what any given person will tolerate.

Semaglutide also carries the larger cardiovascular outcomes evidence base, which is a genuine advantage for some patients and is not captured by a weight-loss endpoint. Neither molecule is simply better than the other; they are differently evidenced.

Where semaglutide is the better buy

Semaglutide wins on three counts and it is worth stating them plainly on a site that leads with the other molecule. It is cheaper at every dual-molecule programme in our dataset. It has the larger cardiovascular outcomes evidence base, which matters for patients whose risk profile makes that endpoint relevant. And more compounding pharmacies produce it, which means supply disruption is less likely to interrupt a titration.

For someone paying cash whose goal is a sustainable course rather than a maximum result, the cheaper molecule they can afford for three years is frequently the better clinical bet than the more effective one they can afford for eight months. Discontinuation is the expensive outcome in this drug class, because the withdrawal evidence is consistent: weight returns when the drug stops, since it suppresses appetite while taken rather than resetting a set point.

Semaglutide is also the more forgiving starting point for people who are uncertain about tolerating an incretin at all. Starting cheaper, establishing tolerability and moving up later costs a second titration, but it risks less money against the possibility that neither molecule suits you.

Where tirzepatide justifies the premium

The head-to-head result is the whole case, and it is a strong one. On average, tirzepatide produced more weight reduction than semaglutide in a randomised comparison at maximum tolerated doses. For someone who has already completed a semaglutide titration and found the result insufficient, that evidence is directly relevant and the premium is defensible.

Tirzepatide also reaches maintenance faster. Its ladder runs 2.5 to 15 mg in 2.5 mg steps against semaglutide's 0.25 to 2.4 mg across five steps, which in practice means eight to twelve weeks to a maintenance dose against roughly sixteen. On a dose-scaled programme, the shorter ladder recovers part of the price difference.

What does not justify the premium is switching from an incomplete semaglutide course. If the dose was never optimised, the comparison being made is not between two molecules but between a finished course and an unfinished one.

Switching between the molecules

Moving from semaglutide to tirzepatide is not a dose conversion. There is no equivalence table between the two, and the standard approach is to restart tirzepatide at 2.5 mg and titrate from the bottom regardless of the semaglutide dose reached. That means paying for another titration period and tolerating another round of the gastrointestinal effects that cluster after each increase.

Priced honestly, a switch costs the titration months again. On a flat programme that is invisible because the price does not move by dose. On a dose-scaled one it can mean several months at intermediate pricing before reaching the dose you actually want.

The practical question is whether your current molecule has genuinely underperformed or whether the dose was never optimised. Switching from an under-titrated semaglutide course to a fresh tirzepatide titration frequently buys a result that a completed semaglutide titration would have produced more cheaply.