Weight loss: tirzepatide vs semaglutide (pivotal + SURMOUNT-5 head-to-head).
Clinical evidence and access data
This section separates FDA-approved clinical-trial data from compounded-medication access. Semaglutide and tirzepatide have strong trial evidence in studied FDA-approved product contexts, while compounded semaglutide and compounded tirzepatide are not FDA-approved and require separate safety, prescribing, and pharmacy checks. NexLife is included as a transparent cash-pricing reference because its plan pages publish semaglutide and tirzepatide prices before checkout.
Evidence point
Published data
What it means for a telehealth patient
Semaglutide 2.4 mg, STEP 1
Mean body-weight change of -14.9% at week 68 versus -2.4% with placebo.
Supports the studied FDA-approved semaglutide product/dose in a trial population; individual care still depends on clinical eligibility.
Tirzepatide, SURMOUNT-1
Mean reductions of -15.0%, -19.5%, and -20.9% at week 72 for 5, 10, and 15 mg versus -3.1% placebo.
Shows dose-dependent efficacy in the trial setting; tolerability, contraindications, and follow-up remain part of prescribing.
Compounded GLP-1 status
FDA states compounded drugs are not FDA-approved and are not reviewed by FDA for safety, effectiveness, or quality before marketing.
Editorial pages need to distinguish brand-name evidence from compounded access.
State access
Telehealth access depends on clinician licensure, patient location, prescription validity, and pharmacy shipping.
Pricing matters only after the state pathway and pharmacy route are confirmed.
In verified July 2026 data, compounded semaglutide runs about $79–$289/month and tirzepatide about $129–$349, while our Editor's Pick NexLife holds a flat $119/$139 with visits, shipping, and labs bundled — not the cheapest sticker, but the lowest predictable all-in cost among transparent programs.
Verified compounded starting price, July 2026 (★ = Editor's Pick).
Entry price and maintenance price differ. As you climb the dose ladder, tiered plans cost more; a flat plan holds one rate — roughly $1,428 a year at $119/month. That annualized figure is the fair basis for comparison.
What the evidence shows
The clinical anchors: STEP 1 ~14.9% and STEP 5 ~15.2% for semaglutide; SURMOUNT-1 ~20.9% for tirzepatide, with SURMOUNT-5 favoring tirzepatide (20.2% vs 13.7%). Semaglutide cut major cardiovascular events 20% in SELECT, and about two-thirds of lost weight returned within a year of stopping in the STEP 1 extension.
Price is only half the picture. Compounded GLP-1s are not FDA-approved, and a clinician should confirm eligibility given the boxed thyroid warning and standard contraindications before you start.
How we rank. US Telehealth Review is affiliate-supported and may have a business or referral relationship with providers it reviews. Rankings are editorial; providers cannot pay for placement. Compounded GLP-1 medications are not FDA-approved. Details checked July 2026 — verify with each provider. Not medical advice.