Flat rate GLP-1 pricing means one price at every dose. The other common shape is a ladder. Each dose step costs more than the last.
Neither is cheaper on its own. The answer depends on two things. How fast the dose climbs, and where it stops.
The climb is set by the label
Both weekly drugs start low and step up every four weeks. The steps are the reason a ladder costs less at first.
For semaglutide, the Wegovy label sets a fixed table. The label states 0.25 mg for weeks 1 through 4[1]. Then 0.5 mg, 1 mg and 1.7 mg, four weeks each[1].
Maintenance starts at week 17[1]. For weight reduction in adults, the label states 1.7 mg or 2.4 mg, with 2.4 mg recommended[1].
The same label adds a step past 2.4 mg, up to 7.2 mg, for some adults[1]. The example below stops at 2.4 mg.
For tirzepatide, the Zepbound label states 2.5 mg once weekly for 4 weeks.[2] Then 5 mg[2].
After that, the label allows 2.5 mg increments, after at least 4 weeks on the current dose[2]. Its maintenance doses are 5 mg, 10 mg or 15 mg[2].
“At least” matters. The fastest path to 15 mg takes 20 weeks. Many people climb slower, and some stop lower.
What the roster shows
This site records each seller’s dose pricing as flat, rising or not stated. It is read from the seller’s own pages. The methodology page sets out how.
Of 463 sellers listing semaglutide or tirzepatide, 143 are recorded flat. 38 are recorded as rising with the dose.
The other 282 state nothing either way. Silence is not a flat price. It is also not a rising one.
A flat claim on a sales page can be contradicted at checkout. Where that has been found, the record is corrected to match the checkout.
Worked example: semaglutide on the Wegovy schedule
The prices below are examples, not any seller’s. Each fill is four weekly doses, so each label step is one charge.
| Weeks | Label dose | Ladder fill | Ladder total | Flat total |
|---|---|---|---|---|
| 1–4 | 0.25 mg | $179 | $179 | $249 |
| 5–8 | 0.5 mg | $179 | $358 | $498 |
| 9–12 | 1 mg | $229 | $587 | $747 |
| 13–16 | 1.7 mg | $279 | $866 | $996 |
| 17–20 | 2.4 mg | $329 | $1,195 | $1,245 |
Through week 20 the ladder is still ahead. It has cost $1,195. Flat has cost $1,245.
The lead ends in fill 6, weeks 21 to 24. From there, every maintenance fill costs $80 more on the ladder.
Converted to a calendar month, the maintenance fill is $356.42 on the ladder. Flat is $269.75.
Worked example: tirzepatide on the Zepbound schedule
This one uses the fastest climb the label allows. Again, every price is an example.
| Weeks | Label dose | Ladder fill | Ladder total | Flat total |
|---|---|---|---|---|
| 1–4 | 2.5 mg | $249 | $249 | $349 |
| 5–8 | 5 mg | $299 | $548 | $698 |
| 9–12 | 7.5 mg | $349 | $897 | $1,047 |
| 13–16 | 10 mg | $399 | $1,296 | $1,396 |
| 17–20 | 12.5 mg | $449 | $1,745 | $1,745 |
| 21–24 | 15 mg | $499 | $2,244 | $2,094 |
At week 20 the two totals are level: $1,745 on the ladder, $1,745 flat.
The ladder passes flat in fill 6, the first fill at 15 mg. Each 15 mg fill then costs $150 more.
A full year, four ways
The totals below cover 13 fills of four weekly doses. That is 52 weeks.
| Path | Flat, year | Ladder, year | Ladder minus flat |
|---|---|---|---|
| Semaglutide, to 2.4 mg | $3,237 | $3,827 | $590 |
| Semaglutide, held at 1.7 mg | $3,237 | $3,377 | $140 |
| Tirzepatide, to 15 mg | $4,537 | $5,737 | $1,200 |
| Tirzepatide, held at 5 mg | $4,537 | $3,837 | −$700 |
Climbing to the top dose, flat saves $590 on semaglutide and $1,200 on tirzepatide. That is at these example prices.
When flat is not cheaper
Flat pricing pays off once the ladder’s step price rises above it. A dose that stops at a cheaper step keeps the ladder ahead.
The Zepbound label lists 5 mg as a maintenance dose[2]. Held at 5 mg, the example ladder costs $700 less than flat over a year.
The label also says a prescriber may consider a lower maintenance dose if one is not tolerated[2]. That moves the answer toward the ladder too.
On semaglutide, holding at 1.7 mg still favors flat here, by $140. The 1.7 mg example fill is above the flat price.
Slower climbs help the ladder as well. The Wegovy label says escalation may be delayed 4 weeks when a dose is not tolerated[1].
Each delay adds one more fill at a low step. On a ladder that fill is cheap. On flat it costs full price.
Which dose a person reaches is a prescriber’s call. This page does not suggest one.
Months and steps do not line up
The label steps are four weeks. Many plans bill by calendar month. On a ladder, one monthly charge can straddle two doses.
That is worth asking about before the first charge. So is the cycle itself: a 28-day plan charges 13 times a year. See billed every 4 weeks vs monthly.
Where to compare
Plan length moves the price as well. That trap is covered in why one seller quotes four different prices.
For the market by molecule, read compounded semaglutide cost and compounded tirzepatide cost.
To total a month with every fee, use the all-in monthly calculator.