Almost no seller’s pricing page addresses what happens if you stop, and it is the fact that determines whether a monthly figure is a three-month cost or a permanent one. Two randomized trials have measured it directly, one for each molecule, and both point the same way — which is what turns a monthly price into a multi-year one.
Semaglutide: STEP 4
After 20 weeks of open-label semaglutide, 803 adults were randomized either to continue or to switch to placebo for a further 48 weeks. Those who continued lost a further 7.9%. Those switched to placebo regained 6.9%.[1] The two groups had been losing weight identically up to the randomization point.
Tirzepatide: SURMOUNT-4
The same design, longer lead-in. After 36 weeks of open-label tirzepatide, 670 adults were randomized to continue or withdraw for 52 weeks. Continuing produced a further 5.5% reduction. Withdrawing produced a 14.0% regain.[2]
What that means for a monthly price
If the effect depends on continuing, then the number that matters is not what a month costs but what a year costs, and then the year after. A seller at $99 a month is a $1,188 annual commitment. A seller at $299 is $3,588. Over three years the gap between those two is larger than most people’s stated reason for choosing one over the other.
It also changes which pricing structure to prefer. A flat rate across doses matters more the longer you stay on the drug, because you will spend most of that time at a maintenance dose rather than a starting one — see sellers that hold one price. And a twelve-month prepay tier stops being a gamble if the clinical expectation is indefinite treatment anyway.
What the trials do not say
Neither trial says regain is inevitable or complete. Both measured group means over a defined window, and in both the withdrawal groups remained below their original starting weight at the end. Neither studied compounded preparations, which is what most sellers here supply. Individual outcomes varied widely, and neither trial was designed to test whether any particular tapering or maintenance strategy changes the picture.
What they do establish is that stopping is not a neutral event, and that anyone budgeting for a course of treatment should budget for the possibility that it does not have an end date. That is a conversation to have with a prescriber before starting, not after — alongside tolerability, which decides more real outcomes than potency does. If the molecule choice is still open, the trial evidence is the place to start, and the price board is where a multi-year commitment gets costed.