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Also, the 2026 bulk list proposal focuses on 503B outsourcing facilities and whether they can use bulk tirzepatide substance

Tiered Model: Month 1-2 (2.5-5 mg): Pay: $299/month Looks like great deal Month 6-12+ (12.5-15 mg): Pay: $499/month Total cost often higher than flat-rate Less predictable Why Providers Choose Flat-Rate: Patient preference for simplicity Easier to administer Better retention (no price shock) Fair overall pricing Competitive advantage Cost Comparison Example: 18-Month Treatment Flat-Rate ($349/month): Months 1-18: $349/month Total: $6,282 Tiered Pricing Example: Months 1-2 (2.5-5 mg): $299/month = $598 Months 3-6 (7.5-10 mg): $399/month = $1,596 Months 7-18 (12.5-15 mg): $499/month = $5,988 Total: $8,182 Flat-rate saves $1,900 over tiered in this example

Step-Up Dosing To Minimize Side Effects The recommended Wegovy dosing schedule uses a step-up approach to improve tolerance

Avoid providers that just ship medication with no medical oversight

Steward's worst side effect has been constipation, which happened each time she upped her dose, as well as mild bouts of nausea