A buyer choosing between these drugs compares what each takes off. This analysis prices the other side of that choice: what each gives back when you stop [1]. The ordering is the same, which means the drug that performs best also has the most to lose — the arithmetic underneath what six-month discontinuation does to a prepay.
Pooled across 17 studies, mean regain after stopping was 7.20%, with a confidence interval from 5.93 to 8.48. By drug it ran 4.83% for liraglutide 3.0 mg across four studies, 7.19% for semaglutide 2.4 mg across six, and 13.04% for tirzepatide across three. In the three randomized trials with a withdrawal phase, people who stopped gained 14.26 percentage points more than people who continued — a bigger swing than any month-to-month price difference on this desk’s headline versus billed price comparison.
One more thing this desk will say plainly: the analysis appears in Cureus, which does not carry the editorial weight of the journals most of the underlying trials were published in. That is not a reason to dismiss it — the authors rated 15 of their 17 included studies as high quality and used standard tools to do it — but it is a reason to treat the subgroup figures as an organized summary of existing evidence rather than a new finding.
For the buying decision the implication is direct. If you are comparing a tirzepatide price against a semaglutide price, you are also comparing roughly 13% of regain against roughly 7% should you stop — and the odds of stopping are not small, as the fill and discontinuation rates show. A cheaper monthly price on the stronger drug is not cheaper if the course ends early.
The authors conclude that the evidence supports treating these as long-term medications rather than courses. That is a clinical argument with a financial shape, and it is the one this desk keeps running into from the pricing side: an annual commitment priced against a drug you may need indefinitely looks different from one priced against a twelve-week result. The same mismatch appears in why falling prices and annual plans do not mix.