Only if you finish the term, and between a third and a half do not. A claims cohort of 15,811 commercially insured US adults starting semaglutide for weight management put five-month discontinuation at 46% [2]. A prepay rung is a bet on completion. The seller pricing it knows the completion rate better than the buyer does. What a month costs before any term is applied is set out in what a GLP-1 actually costs per month.
How often a course stops
A retrospective analysis followed 1,374 adults dispensed an initial GLP-1 between January 2018 and June 2023 [1]. 436 of them, 31.7%, discontinued inside 180 days.
The documented reasons split three ways. An adverse drug reaction accounted for 26.8% of stops, a cost concern for 14.4%, and non-adherence for 11.2%. A weight indication rather than diabetes carried an adjusted odds ratio of 2.46 for discontinuation. The interval ran 1.17 to 5.17.
The larger cohort agreed on the order of magnitude. Five-month discontinuation ran 46%, and 48% among people who started after the supply shortage resolved. Most of that cohort also deviated from the recommended dose-escalation schedule inside those five months. Why people leave is collected in why people stop taking a GLP-1.
Tolerability is part of the arithmetic
A nationwide multicenter study covered 2,549 patients on semaglutide or tirzepatide [3]. At least one adverse event was recorded in 50.9% and 51.0% of the two groups, p = 0.524. Gastrointestinal events were the most frequent.
Discontinuation due to adverse events was similar between the two drugs. Pancreatic events were the exception and were more frequent with semaglutide, p = 0.006. Roughly half of buyers on either molecule meet something worth reporting. How long people last on each is tracked in how long people stay on a GLP-1.
What a term costs if it is not completed
What follows is arithmetic on published seller terms rather than a finding from any study. A twelve-month plan advertised at $99 a month against a $165 month-to-month rate saves $66 a month. That is $792 across a completed year.
Billed as a single up-front charge, the same plan asks $1,188 before the first fill arrives. A buyer who stops at month five has consumed five months of a twelve-month purchase. Whether the remaining seven are refunded is the question. Most sellers do not answer it on the page selling the term. HealthRX publishes both ends of that ladder, which makes the gap easy to see.
Where a site publishes no refund policy, the honest reading is that no policy has been established. It is not that money comes back. That is the case at He & She MD, whose annual plan bills a year at once.
Restarting is its own cost
Discontinuation is often not permanent. A restart usually means beginning the titration ladder again at a low dose. On a seller whose price holds flat across doses that changes nothing about the bill.
On a seller whose price rises with the dose it resets the buyer to the lowest rung. The average monthly cost over a year of stopping and restarting then sits somewhere the pricing page does not describe. Midi Health is the unusual case that prints every rung, so the walk back up can at least be priced. What a restart involves clinically is in how to restart a GLP-1 after stopping.
Whether stopping and restarting changes weight outcomes is a question these cohorts do not answer. They record who stopped and why. What happened to the people who came back is not in them. What returns in the meantime is measured in how much weight returns after stopping.
The practical reading
The published rates are not a reason to avoid a term. They are a reason to treat a term rate as conditional. Completion happens between half and two thirds of the time.
Find the refund policy before the term is bought rather than after. Two questions settle it: what is refunded on cancellation, and what the monthly rate reverts to. Whether the whole purchase is worth making is a separate calculation, set out in whether a GLP-1 is worth its price.