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When you should wait vs act now: the decision framework Wait if: Your insurance copay is under $200/month and you're comfortable with that cost You're within 3 months of meeting your deductible (after which your copay drops significantly) You're enrolled in a clinical trial for tirzepatide (free medication) You qualify for Eli Lilly's patient assistance program (income-based free medication) You're willing to delay treatment 3 to 5 years for biosimilar entry Act now with brand-name Zepbound if: Your insurance covers it with a copay under $150/month You strongly prefer FDA-approved medications You want pen convenience over vial-and-syringe You've tried compounded tirzepatide and experienced supply inconsistency Act now with LillyDirect vials if: You're self-pay and want brand-name medication Your insurance copay exceeds $549/month You're comfortable with self-injection You don't qualify for compounded tirzepatide (some states restrict access) Act now with compounded tirzepatide if: Your insurance doesn't cover Zepbound for weight loss Your copay exceeds $250/month You want the lowest current cost option You're comfortable with non-FDA-approved medication prepared by a licensed compounding pharmacy The cost-of-waiting calculation: Waiting 3 years (2026 to 2029) for potential biosimilar entry costs $11,760 to $38,160 in foregone treatment, depending on your current option
Lab work is not required to start or stay on treatment, but patients who want or need blood work can request it through the care team
NOTES None Acknowledgements Fig
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248,251,252 This mechanism is particularly evident in the use of GLP-1-based drugs, such as GLP-1RAs, in the treatment of T2DM
