Source Ledger

What is in this dataset

Every record with its source and provenance class. Every record carries the date it was captured and an evidence status saying whether we read the figure at the provider or took it from a third party.

How to use it

Download the file, sort it yourself, and check that our published rankings reproduce. If they do not, that is a bug or a lie and either way you can find it without our help.

What it does not contain

Service quality, shipping reliability or clinical depth. We hold no measurements of those we would defend, so they are absent rather than estimated.

Why this distinction changes what you pay

Every structural difference in this market resolves into money at a maintenance dose. Whether a programme charges a membership, whether it reprices with the dose, whether it demands a term, and whether it bundles or splits its charges together account for most of the gap between the cheapest tracked first year at $2,580 and the most expensive.

None of those differences is visible in an advertised headline figure, which is the reason this site exists in the form it does.

How to act on it this week

Price the dose you expect to maintain on rather than the starter dose. Add every recurring fee. Ask whether the quoted rate holds at renewal. Establish who compounds the medicine. And do not enter a prepaid term until you have held a maintenance dose for a cycle.

Those five steps take under an hour and reliably beat any amount of comparison reading, because they surface the information that comparison tables omit.

How this connects to what you will actually pay

Everything in this section resolves to one number: the all-in monthly cost at the dose you end up holding. Across the 16 programmes we price, that runs from $215 at the cheapest tracked route to several times that at the most expensive, for the identical molecule from the same category of licensed pharmacy.

5 of those programmes charge a recurring platform fee on top of medication and 12 hold one price at every strength. Those two facts explain most of the spread between advertised prices and real ones.

What we could verify and what we could not

11 of 32 tracked programmes have a price we read at the provider or manufacturer. The rest carry third-party figures we have not confirmed, or publish nothing we can interpret. Every table on this site marks which is which, and the comparison matrix lets you filter to verified prices only.

Where we have checked a third-party figure against a provider's own page, it has almost always moved — and it has moved upward. Promotional first months, prepaid bundle rates and medication-only figures that exclude memberships are all published as ongoing all-in prices. Assume an unverified figure is optimistic.

The regulatory distinction that sits under all of this

Compounded tirzepatide is not FDA-approved. FDA does not review compounded preparations for safety, effectiveness or quality before they are marketed. The active molecule is the same as the branded product; the pre-market review is not, and the assurance comes instead from the pharmacy, the state board that licenses it and, at good operations, batch sterility and potency testing.

That is a legitimate framework rather than a loophole, and it is also why the price is lower. It puts more of the verification burden on the patient, which is the honest trade being made.

What is in the file

32 programme records. Each carries name, type, pricing model, medication cost, any recurring fee, all-in cost at six dose tiers, a first-year total, cost per milligram, prepaid rate and term, published state count, care-model attributes, evidence status, source text, a resolvable source URL, a Wayback lookup and the capture date.

16 of them carry a price. The remainder carry an explanation of why not, which is a field rather than a silent null.

How to work with it

The JSON is the canonical form and carries claim-level citations; the CSV is flattened for spreadsheets and drops the nested care-model and claims objects. Both are regenerated on every build, so a figure in the file and a figure on a page cannot drift apart.

Sort by first_year to reproduce our cheapest ranking. Filter evidence_status to source-verified for the subset we would defend. Group by pricing_model to see the flat-versus-scaled split.

What it deliberately omits

Ratings, scores out of ten, review counts and sentiment. None of those is measurable from public material in a way we would defend, and publishing them would make the file look more authoritative than it is.

It also omits estimated prices. A programme that does not publish appears with nulls and a reason, because a null is checkable and an estimate is not.

Licence and citation

Reuse permitted with attribution to this site, carrying the capture date shown on the figure. A price without its date is not a fact, and republishing one without it is how the errors we spend our time correcting get created in the first place.

What the dose ladder means for your bill

The approved ladder runs 2.5, 5, 7.5, 10, 12.5 and 15 mg weekly. Clinical trials studied 5, 10 and 15 mg as maintenance arms; the intermediate steps exist for titration rather than as targets. Where a person settles is a clinical decision driven by response and tolerability, not a preference.

That matters commercially because a dose-scaled programme is quoting you a price for a decision your prescriber has not made yet. If you settle at 15 mg on a programme that reprices at every step, you will pay materially more than the figure that attracted you. If you settle at 5 mg, you may pay less than a flat programme would charge.

Flat pricing is therefore worst value at the bottom of the ladder and best at the top. It is less a lower price than insurance against an outcome nobody can predict at signup. The cheapest flat option we verify is NexLife at $215 a month all-in.

Compounded is not a generic, and the difference is technical

A generic medicine has demonstrated bioequivalence to a reference product and been approved on that basis. A compounded preparation has done neither. It contains the same active molecule, but the formulation, concentration, excipients, container and beyond-use dating are decisions made by the compounding pharmacy rather than specifications reviewed by a regulator.

Practically, that means two vials of compounded tirzepatide from different pharmacies are not necessarily interchangeable. Concentration varies between operations, which is why dosing instructions are given in units or millilitres rather than by the pen click a Zepbound user would recognise, and why switching programmes mid-course requires confirming the new concentration rather than assuming it.

None of that makes compounding illegitimate. It does move a layer of quality assurance from a federal review process onto a pharmacy you can, and should, check.

Where the evidence stops

The trial evidence for tirzepatide concerns the approved product at studied doses. It does not extend to compounded preparations, to microdosing schedules marketed as a cheaper entry point, or to combination vials with added vitamins. Those may be reasonable in practice, but the evidence base does not follow them.

Anyone citing trial outcomes to sell a compounded preparation is borrowing credibility from a product they are not dispensing. The honest framing is that the molecule has strong evidence behind it and the specific preparation in the vial has the pharmacy's assurance behind it.