State Availability Dataset

What is in this dataset

Availability and exclusion flags by state. 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.

The question worth asking before the price question

Whether you have a covered indication. Tirzepatide is approved for chronic weight management and, as Mounjaro, for type 2 diabetes; obstructive sleep apnoea in adults with obesity is an additional route. A covered prescription under a documented indication beats every cash route on this site, frequently by an order of magnitude.

Most people do this backwards: compare cash prices, enrol, then discover an indication they already qualified for. Establishing coverage first costs a phone call and can save four figures a year, which is more than any comparison table on this site will save you.

Reading a price like a clinician would

A clinician deciding whether a programme is workable asks three questions a price comparison usually skips. Can this patient stay on it long enough to reach a maintenance dose? Is the supply reliable enough that titration will not be interrupted? And is the prescriber reachable when the fourth-week nausea arrives?

Each maps to something checkable before enrolling. Long prepaid terms answer the first badly if money is tight. A single owned dispensing facility answers the second worse than several named partner pharmacies, because a programme with one supply route cannot reroute your prescription. And the care model answers the third: asynchronous messaging is adequate for most titration questions and inadequate for a few.

None of that appears in an advertised price, and all of it decides whether the price you chose is the price you end up paying.

What the GIP arm may be doing

GIP receptor agonism is the pharmacological difference between tirzepatide and the GLP-1-only agents, and its contribution is still being characterised. Proposed mechanisms include effects on adipose tissue insulin sensitivity, on central appetite pathways distinct from the GLP-1 route, and on the tolerability of GLP-1 agonism itself, which would allow effective exposure at doses that would otherwise be poorly tolerated.

This is an area of active research rather than settled science, and anyone stating the mechanism confidently is ahead of the literature. What is established is the outcome difference in the head-to-head trial; the explanation for it is not fully resolved.