Zepbound lists at roughly $1,000 to $1,300 monthly, with self-pay vials often $349 to $499

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Am J Physiol Endocrinol Metab 294(5):E846E852 Chedid V, Vijayvargiya P, Carlson P, Van Malderen K, Acosta A, Zinsmeister A et al (2018) Allelic variant in the glucagon-like peptide 1 receptor gene associated with greater effect of liraglutide and exenatide on gastric emptying: a pilot pharmacogenetics study
Higher doses correlate with increased GI side effects (nausea, flushing)
Others may be hesitant about self-injecting altogether