Annualized tirzepatide cost: the flat-rate vs dose-tiered math

The mistake the sticker price invites

Tirzepatide is titrated: 2.5 mg weekly to start, stepping up in 2.5 mg increments at intervals of at least 4 weeks as tolerated, commonly settling at 7.5–15 mg for maintenance. Dose-tiered pricing attaches a higher price to each step. So the number in the ad — the 2.5 mg intro price — describes your cheapest month, and often only that month.

The math, month by month

The illustrative dose-tiered curve uses advertised ranges from our dataset: ~$279 for months 1–2, ~$399 for months 3–6 as titration passes 5–7.5 mg, ~$499 for months 7–12 at higher doses. Your curve depends on how fast you titrate and where you stop — but the shape is the point. The flat line is $186 × 12 = $2,232 regardless.

Three questions that expose the trajectory

Before enrolling anywhere, ask: (1) "What will I pay per month at 10 mg?" — not at the starting dose. (2) "Does the price change at refill even without a dose change?" (3) "If I prepay, what happens if I stop at month four?" A provider that answers all three in writing is telling you it prices honestly; a provider that redirects you to the intro price is telling you something too.

Dosing is a clinical decision made with a licensed prescriber; this article is cost math, not medical advice. Figures checked July 2026 and may change.