Original Reports
Analysis of the tracked dataset, published in full with the method stated.
Reports are our own analysis of the dataset rather than coverage of somebody else's announcement.
Each states its method, links the underlying file, and says what it could not establish.
First-year all-in cost
The reports
The Tirzepatide Telehealth Market
Who is selling, at what price, on what terms, and how much of it we could verify.
Telehealth Price Transparency
What programmes publish before you pay, scored and ranked.
Putting this report in proportion
It is one input into a decision with three parts: what you pay at the dose you hold, who makes what you inject, and what happens if you stop. Weighting one to the exclusion of the others is how people end up on a cheap programme they abandon in month nine.
The frame: 16 programmes publish a capturable price, spanning $215 to $597 a month all-in at a 10 mg maintenance dose. 5 charge a mandatory recurring fee. 4 name the dispensing pharmacy before purchase.
What good looks like
A figure at a named dose, the pharmacy named, cancellation terms published before payment, and a plain statement that a compounded preparation is not FDA-approved. Four things, all cheap to publish, and a minority does all four.
The cheapest verified route sits at $215 a month, which establishes that disclosure and low price are not in tension.
What to ask before you pay
Five questions, all answerable in a short email, all before a medical history changes hands: the total at a maintenance dose including every fee; which pharmacy fills it; whether the prescriber is licensed in your state; the notice period to cancel and what is refundable; and which form of the active ingredient the pharmacy compounds from.
None requires clinical training to evaluate. The speed and specificity of the reply tells you how the operation is run, and it arrives before your money does.
The failure mode this section guards against
Choosing a programme on a number that describes a different situation than yours. An entry price when you will hold maintenance. A medication figure when a membership applies. A promotional rate when you will renew.
Each error is small alone and they compound in one direction, which is why the cheapest-looking option in most published comparisons is the one most likely to be mis-stated. Priced correctly the cheapest verified route sits at $215 a month all-in at a 10 mg maintenance dose.
Why we publish the working rather than a verdict
A single recommendation reads better and acts worse, because it hides the weighting. Two readers with different maintenance doses, different coverage and different tolerance for commitment should not receive the same answer.
So the tables carry the inputs and every ranking states its sort key. Disagree with our weighting and you can take the file and weight it yourself — which is what publishing it is for.
The number most people get wrong
The month-six figure. Almost everyone budgets from the first month, which on tirzepatide describes four weeks at 2.5 mg — roughly 10 mg of active drug against the 40 mg a maintenance month delivers.
Ten of your first twelve months are spent at or near maintenance. A ranking sorted on the advertised month is sorting on about eight per cent of your year, and on a dose-scaled programme those are different numbers entirely.
Run the first-year calculator at the dose you expect to hold. It takes under a minute and it reorders the market for most people.
What a year of this actually looks like
Four weeks at 2.5 mg, four at 0.5 mg, four at 1 mg, four at 1.7 mg, then 10 mg for the remainder. Eight to twelve weeks of titration if nothing is repeated, and repeats are common rather than exceptional.
Budget two extra months at a lower tier and treat anything better as upside. Fix a weekly injection day, record dose and date, and diary the renewal date if an introductory rate applies — the reversion is where most complaints in this category begin.
The molecule, and why it costs more than semaglutide
Tirzepatide is a single peptide that activates two incretin receptors: GLP-1, which semaglutide also targets, and GIP, which it does not. Both receptors influence insulin secretion, gastric emptying and central appetite signalling, and the working hypothesis for the larger effect size is that engaging both produces effects the GLP-1 arm alone does not.
That dual action is also part of why it costs more to make. The peptide is longer and more structurally complex than semaglutide, the synthesis is harder, and the active pharmaceutical ingredient sells at a premium to compounding pharmacies. Across programmes carrying both molecules, tirzepatide typically runs forty to a hundred per cent above the same programme's semaglutide price.
The commercial consequence is that a compounded tirzepatide programme has less room to discount than a compounded semaglutide one. When a tirzepatide price looks dramatically below the market, the explanation is usually a promotional rate, a prepaid term or a starting dose rather than a cheaper supply chain.
What the head-to-head trial actually showed
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 available and it is the reason many people arrive at this molecule specifically rather than at GLP-1 therapy in general.
Three caveats are worth carrying. A mean is not a prediction for an individual, and the distribution around it is wide. Trial participants received structured support most telehealth programmes do not replicate. And the trial compared maximum tolerated doses, which is a different question from what a given person will tolerate.
Read as a purchasing decision, it says the more expensive molecule does more on average. It does not say it will do more for you, and it says nothing about which programme should supply it.
Why titration is a pricing question
Tirzepatide is started at 2.5 mg weekly and increased in 2.5 mg steps at intervals of at least four weeks. The starter dose is a tolerance-building dose rather than a therapeutic one, and the gastrointestinal effects that cause most discontinuation cluster in the days after each increase.
Reaching a maintenance dose therefore takes at least eight to twelve weeks when nothing is repeated, and repeats are common rather than exceptional. Most of a first year is spent at or near maintenance, which is why every figure on this site is stated at 10 mg and why 12 of the 16 priced programmes holding one price across the ladder is a materially different offer from the rest.
Open these rather than taking our word for it. Every one is a regulator, a trial registry, a label, an accreditor or the manufacturer.
Why publish analysis at all
Because the most useful findings in this category are about the information rather than the medicine. How often published prices are wrong, in which direction, and what structural incentive produces the error are questions no individual programme will answer about itself, and they change how a reader should treat every other comparison they encounter.
The method, in one paragraph
We hold one dataset covering 32 programmes: all-in monthly cost at six dose tiers, first-year totals, fee structure, commitment terms, care model, pharmacy disclosure, evidence status and source, each with a capture date. Reports compute over that file and nothing else. Where a finding depends on a figure we could not verify, the report says so rather than rounding the uncertainty away.
What a report will never contain
An estimated price, an invented rating, or a conclusion that cannot be reproduced from the published file. If a chart here cannot be rebuilt from the dataset, that is a defect and we want to hear about it.
Reuse
Cite freely with attribution and carry the capture date shown on the figure. Journalists and analysts can take the underlying file directly from the data page rather than transcribing from a table.