Tools
Titration-year calculator
Year one is not year two. A titration year includes months at doses below the one you settle at, so on a dose-tiered program the first year genuinely costs less than every year after it. This works out both, for every program.
Why the two years differ
On a flat-rate program they do not: one price at every dose means twelve identical months, and year one equals year two exactly. On a dose-tiered program the ramp is cheaper than the settled rate, which makes a first-year quote look better than the cost you will actually carry.
That is why this site quotes every headline figure at the maintenance dose — it describes the year you keep having, not the one you have once. Where a program has published no price at a step, the row says how many steps were substituted.
The structural point
A flat program's worst case is that you overpay slightly at low doses. A tiered program's worst case is an open-ended increase you did not price at signup. See flat versus dose-tiered pricing.
Questions
How much does the first year of a GLP-1 cost?
It depends on how fast you titrate and where you settle. On a flat-rate program the first year equals every other year. On a dose-tiered program the first year is cheaper than the steady state, because you spend months at doses below your settling point.
How long does titration take?
Roughly four weeks at each dose is typical, which is about twenty weeks to reach the top of the tirzepatide ladder and sixteen for semaglutide. The calculator lets you change the interval.
Why is year two more expensive than year one?
Only on dose-tiered programs, and because year one contains cheaper months at lower doses. Budget on the steady-state figure, not the first-year one.