Pricing mechanics · Tirzepatide
Tirzepatide dose ladder economics
Tirzepatide's ladder has six steps and takes at least twenty weeks to climb from 2.5 mg to 15 mg per week. On 16 of the 27 rankable programs that climb costs nothing extra. On the rest it is the largest uncontrolled variable in the whole purchase.
The six steps
The approved labelling starts at 2.5 mg for four weeks — explicitly not a treatment dose — then steps to 5, 7.5, 10, 12.5 and 15 mg, with roughly four weeks at each. That is five months before the top of the ladder is reachable, and this site quotes every tirzepatide figure at 10 mg per week as a common settling point.
What the climb costs where it is priced
Among programs publishing more than one price on the ladder, the distance between the bottom and top rungs runs:
- Ro (Ro Body) — $448 at the bottom, $598 at the top, $150 a month apart ($1,800 a year if you settle high).
- LillyDirect (Zepbound) — $299 at the bottom, $449 at the top, $150 a month apart ($1,800 a year if you settle high).
- Lavender Sky Health — $225 at the bottom, $352 at the top, $127 a month apart ($1,524 a year if you settle high).
- Enhance MD — $169 at the bottom, $280 at the top, $111 a month apart ($1,332 a year if you settle high).
- Direct Meds — $299 at the bottom, $399 at the top, $100 a month apart ($1,200 a year if you settle high).
- ShedRx — $199 at the bottom, $289 at the top, $90 a month apart ($1,080 a year if you settle high).
The incentive problem nobody names
On a dose-tiered program, the company you are paying earns more each time your dose rises, and your dose rises on the recommendation of a clinician that company pays. That is not an accusation about anyone's conduct — it is a structural conflict that flat pricing simply does not have, and it is worth knowing which side of it you are on.
Flat pricing removes it entirely. The program earns the same whether you settle at 5 mg or 15 mg, so the titration conversation carries no commercial weight.
The programs that price the ladder in silence
10 of the 27 rankable tirzepatide programs do not publish a price at every dose. For those, the true cost of the climb is unknowable from public information — you find out when the invoice arrives. Our dose encyclopedia has a page for each of the six doses showing exactly who publishes what.
What to establish before enrolling
Three questions, in writing: what does 15 mg cost on this program, what does the dose I am starting at cost, and does either change if I stay a year. A program that answers all three plainly is being straight with you regardless of the number. A program that will only quote a starting price has told you something too.
Questions
How long does tirzepatide titration take?
At least twenty weeks to reach 15 mg per week, with roughly four weeks at each of 2.5, 5, 7.5, 10 and 12.5 mg first. The 2.5 mg starting dose is explicitly not a treatment dose.
Does tirzepatide cost more at 15 mg than at 2.5 mg?
On 11 of the 27 rankable programs in this database, yes. On the other 16 the price is flat at every dose.
What is the biggest price jump across a tirzepatide dose ladder?
Ro (Ro Body), at $150 a month between its lowest and highest published rungs — $1,800 across a year.