Sellers advertise an opening dose and go quiet about what comes after. A large claims study of tirzepatide in adults without type 2 diabetes says something useful about that silence: most people never get as far up the ladder as the marketing implies [1]. The figures below change which rung on a seller’s price list is worth reading first.
Three quarters were still under 10 mg
By the sixth prescription fill, 74.2% were taking less than 10 mg. The authors note escalation ran slower than in the clinical trials. The cohort held 20,998 adults (n = 20,998), mean age 47.4, 74.9% female, mean body mass index 36.9. Obesity-related complications were common: 66.0% had at least one and 44.4% had two or more.
That is the price point that matters. A rate quoted at 15 mg describes a tier most buyers do not reach inside six months. A rate at 2.5 or 5 mg describes where they actually are. Sellers who publish a flat figure across every dose are priced identically either way, and we count who does in what six months comes to.
Just over half were still on it
Persistence in the utilization cohort was 55.4%. Another 30.8% switched to a different anti-obesity medication or GLP-1, or restarted tirzepatide after stopping. Both figures are at six months, not twelve, and both belong to this cohort rather than to the twelve-month picture we cover in who stops within a year.
And it worked, at the doses they were on
Among those persistent for at least six months with weights recorded, mean weight reduction was 11.9%. Reductions of at least 5% were reached by 85.8%, and at least 10% by 61.5%. The authors call that consistent with the trials, which is notable given the slower escalation.
For a cash buyer the combination is the point: the useful result arrived at doses below the ones a price list tends to headline, and a bit over half were still buying at six months. A term that locks in twelve is priced against a pattern most people do not follow, which is the arithmetic in the term and prepay check.