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Cash-pay is now a real market in 2026, and the headline numbers are scattered: Wegovy tablets list a $149/month starter price, Zepbound vials list $299/month for the 2.5 mg starting dose, and a long tail of telehealth platforms publishes compounded semaglutide and tirzepatide pricing anywhere from sub-$150 first-month promos to $299/month standard

Other formulations may not qualify under the current CMS list

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