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Four questions, in order

1. What dose will I hold? Nobody knows at intake, but most patients settle at or near 2.4 mg. Price that, not the starter dose.

2. What does it cost all-in? Medication plus every recurring fee at that dose. Use the calculator.

3. Who compounds it? Ask for the pharmacy by name and check the state board register. If the programme will not say, that is the answer.

4. What happens if I stop? Read the cancellation terms before prepaying anything.

The single most expensive mistake

Choosing on the advertised price. That figure describes the four weeks you spend at the 0.25 mg starter dose — about 8% of a first year. Ten of your first twelve months are spent at or near maintenance. Across the market that mistake is worth thousands of dollars.

Independence

No programme pays for placement, position or the removal of a criticism. Rankings are computed from the published dataset rather than assigned. Where commercial links exist they are disclosed on the page carrying them and cannot affect an order that is generated from data.

Corrections

Substantive errors — a wrong price, a misstated term, a ranking moved by bad data — are logged with the date they were fixed. A site publishing prices in a fast-moving market that never records a correction is not being careful; it is not checking. Report anything you believe is wrong through contact.

The standard this site holds itself to

Publish what can be verified, label what cannot, and record what changed. Those three rules generate everything else: why 4 of 32 programmes carry a verified tag and the rest do not, why some rows are blank, and why corrections appear on the page where the error was rather than in a log nobody reads.

They also explain what is missing. There are no ratings out of ten, no star scores and no aggregate quality judgements, because we cannot measure service quality from outside and inventing a number for it would corrupt the figures that are real.

Why the dataset is published rather than described

Every table on this site is generated from one file: 32 programmes with all-in cost at five dose tiers, first-year totals, fee structure, commitment terms, care model, pharmacy disclosure, evidence status and source, each with a capture date.

That file is downloadable. Sort it by first-year cost and it should reproduce our cheapest ranking exactly. If it does not, that is a bug or a lie, and you can find it without our help. A comparison site that will not publish its own data is asking to be trusted rather than checked.

The commercial conflict, named

Comparison sites in health are funded by the companies they rank. That creates an obvious incentive to rank the highest-paying option first and describe the arrangement vaguely, and it is the reason readers are right to be sceptical of every site in this category.

The defences available are boring and checkable: compute rankings from a published dataset on a stated sort key, publish the dataset, log corrections publicly, and record negative facts about highly ranked programmes. None of that proves good faith. It makes bad faith detectable, which is the most any publisher can honestly offer.

What good looks like in this market

A programme that publishes its price at every dose tier, names the pharmacy that compounds the medicine, states its cancellation terms before you pay, and can decline to prescribe. Those four together are rarer than they should be, and they cost a programme nothing except the ability to advertise a number that is not the number.

The cheapest tracked route currently runs $145 a month all-in at a 2.4 mg maintenance dose, about $1,740 for a first year. That figure is what a well-informed buyer should be measuring every other offer against.

Where this sits against the dataset

The figures behind this page come from one file: 32 programmes, all-in cost at five dose tiers, terms, care model, pharmacy disclosure, evidence status and source, each with a capture date. All-in cost at a maintenance dose runs $145 to $324 across it.

Change the file and every table, ranking and calculator changes with it. There is no separate editorial layer to adjust, which is the structural reason a policy page here can describe a rule rather than an intention.

What it would take to prove us wrong

Download the dataset, sort it on the criterion named in any ranking title, and check whether our published order reproduces. Then open any provider link and compare our figure to theirs. Both checks take minutes and neither requires trusting us.

If they disagree, that is a bug or a lie and we would rather hear about it than have it found later by someone with less reason to be generous.

Putting start here in proportion

It is one input into a decision with three parts: what you pay at the dose you hold, who makes what you inject, and what happens if you stop. Weighting one to the exclusion of the others is how people end up on a cheap programme they abandon in month nine.

The frame: 20 programmes publish a capturable price, spanning $145 to $324 a month all-in at a 2.4 mg maintenance dose. 4 charge a mandatory recurring fee. 6 name the dispensing pharmacy before purchase.

What good looks like

A figure at a named dose, the pharmacy named, cancellation terms published before payment, and a plain statement that a compounded preparation is not FDA-approved. Four things, all cheap to publish, and a minority does all four.

The cheapest verified route sits at $145 a month, which establishes that disclosure and low price are not in tension.

What to ask before you pay

Five questions, all answerable in a short email, all before a medical history changes hands: the total at a maintenance dose including every fee; which pharmacy fills it; whether the prescriber is licensed in your state; the notice period to cancel and what is refundable; and which form of the active ingredient the pharmacy compounds from.

None requires clinical training to evaluate. The speed and specificity of the reply tells you how the operation is run, and it arrives before your money does.

The failure mode this section guards against

Choosing a programme on a number that describes a different situation than yours. An entry price when you will hold maintenance. A medication figure when a membership applies. A promotional rate when you will renew.

Each error is small alone and they compound in one direction, which is why the cheapest-looking option in most published comparisons is the one most likely to be mis-stated. Priced correctly the cheapest verified route sits at $145 a month all-in at a 2.4 mg maintenance dose.

Why we publish the working rather than a verdict

A single recommendation reads better and acts worse, because it hides the weighting. Two readers with different maintenance doses, different coverage and different tolerance for commitment should not receive the same answer.

So the tables carry the inputs and every ranking states its sort key. Disagree with our weighting and you can take the file and weight it yourself — which is what publishing it is for.

The number most people get wrong

The month-six figure. Almost everyone budgets from the first month, which on semaglutide describes four weeks at 0.25 mg — roughly 1 mg of active drug against the 9.6 mg a maintenance month delivers.

Ten of your first twelve months are spent at or near maintenance. A ranking sorted on the advertised month is sorting on about eight per cent of your year, and on a dose-scaled programme those are different numbers entirely.

Run the first-year calculator at the dose you expect to hold. It takes under a minute and it reorders the market for most people.

What a year of this actually looks like

Four weeks at 0.25 mg, four at 0.5 mg, four at 1 mg, four at 1.7 mg, then 2.4 mg for the remainder. Sixteen weeks of titration if nothing is repeated, and repeats are common rather than exceptional.

Budget two extra months at a lower tier and treat anything better as upside. Fix a weekly injection day, record dose and date, and diary the renewal date if an introductory rate applies — the reversion is where most complaints in this category begin.