The single most expensive thing about compounded tirzepatide is not the starting price. It is what happens to that price as your clinician moves you up the ladder.
Precision Telemed charges $199 for the first month and $249.99 a month after, covering every dose from the 2 mg starter to the maximum clinical 15 mg. Month-to-month, no subscription, no lock-in, no cancellation fees. A separate maintenance tier holds the lowest 2 mg dose at $179.99, and a three-month supply is $644.99.
The company is explicit about why: it states that most telehealth providers charge more as the dose increases, calls that a penalty for success, and prices against it. That is a fair description of how much of this market works.
Run the comparison against dose-based pricing
Coby Health publishes its whole dose ladder, which makes the arithmetic easy. At 2.5 mg Coby charges $239 against Precision Telemed's $249.99 — Coby is cheaper. At 12.5 mg Coby charges $439 against the same $249.99 — Precision Telemed is $189 a month cheaper for identical treatment.
Same dose, two pricing models: Coby Health against Precision Telemed
| Weekly dose | Coby Health | Precision Telemed | Difference |
|---|---|---|---|
| 2.5 mg | $239 | $249.99 | Coby cheaper by $11 |
| 5 mg | $299 | $249.99 | Precision cheaper by $49 |
| 7.5 mg | $329 | $249.99 | Precision cheaper by $79 |
| 10 mg | $379 | $249.99 | Precision cheaper by $129 |
| 12.5–15 mg | $439 | $249.99 | Precision cheaper by $189 |
Scroll the table sideways to see every column.
Since the titration schedule expects most people to climb past 5 mg, the flat model wins for almost anyone completing a standard course. The exception is someone who genuinely stays low — for whom Precision Telemed's own $179.99 maintenance tier is the better line anyway.
The disclosure nobody else matches
Its pharmacy is named: Rush Pharmacy, a 503A licensed compounding facility, with a stated commitment to licensed 503A pharmacies only and never research-grade suppliers. Vials ship cold-chain with an expiration date and refrigeration instructions.
Eleven clinicians are published individually with their training and NPI numbers — medical director Dr Joseph Palumbo, DO (NPI 1043478878), alongside internal medicine, emergency medicine, critical care, geriatric and family practice clinicians. No other provider we have reviewed publishes NPI numbers, which are verifiable in the national registry.
One structural caution: the $179.99 maintenance tier is capped at 2 mg, which is below any dose studied for weight loss. It is appropriate for holding weight, not for losing it — see our guide to GLP-1 microdosing.
Where a dose sits on the studied ladder
Move the slider to see whether a dose is one the weight-loss trials actually used. Doses below the studied range may still suit you — they simply have no trial result attached.
Standard titration step
Standard schedule: Weeks 1–4
The standard starting dose. Intended to build tolerance, not to produce weight loss.
In the trial programme behind Wegovy, adults reached a 2.4 mg weekly maintenance dose and lost an average of about 15% of body weight over 68 weeks.
Titration schedules are the standard ones for the approved products and are shown for orientation, not as a dosing instruction. Compounded products are not FDA-approved and your prescriber sets your schedule. Never change a dose on the basis of a web page.
What compounded tirzepatide actually is
Tirzepatide is the active ingredient in Mounjaro and Zepbound, both FDA-approved products from Eli Lilly. Unlike semaglutide, it acts on two receptors — GLP-1 and GIP — which is the basis for the larger average weight reductions seen in its trials. A compounded version is prepared by a pharmacy and is not FDA-approved or FDA-evaluated.
Compounded tirzepatide is consistently more expensive than compounded semaglutide, typically by $50 to $100 a month. That gap is real and reflects the raw material, so a provider pricing them identically is worth a question rather than a celebration.
Dosing usually starts at 2.5 mg weekly and escalates in 2.5 mg steps. As with semaglutide, dose-flat pricing is worth substantially more than a low starting price, because the starting dose is not the dose most people end up on.
Side effects mirror semaglutide's — predominantly gastrointestinal, worst after dose increases — though some patients report tirzepatide is better tolerated at equivalent efficacy. That is an individual matter and not something a telehealth intake form can predict for you.
Before you buy from anyone
- Get the total monthly cost in writing — medication plus any membership, not the headline figure.
- Ask whether the price changes as your dose increases. This is where most of the money is lost.
- Ask which pharmacy compounds it, and whether it is a 503A or 503B facility.
- Confirm what happens if you stop after one month, and whether there is an auto-rebill.
- Ask whether a refund is available if a provider declines to prescribe.
- Tell the prescriber every medication and supplement you take, including anything bought online.