What the trials show when people stop or stay on treatment
Three randomized trials tested what happens when people who have lost weight on an FDA-approved GLP-1 either continue or stop. All three studied brand-name medications, and all three were funded by the medications' manufacturers. None studied compounded medication: compounded medications are not FDA-approved and are not therapeutically equivalent to FDA-approved products, and these results do not describe them.
- STEP 4 (Wegovy; JAMA, 2021): 803 adults who reached Wegovy 2.4 mg during a 20-week run-in were randomized to keep taking it or switch to placebo for 48 weeks. Those who continued lost a further 7.9% of body weight; those switched to placebo gained 6.9%, a difference of 14.8 percentage points. Individual results vary.
- SURMOUNT-4 (Zepbound; JAMA, 2024): 670 adults who reached their maximum tolerated dose (10 mg or 15 mg) during a 36-week lead-in were randomized to continue or switch to placebo for 52 weeks. Those who continued lost a further 5.5%; those switched to placebo gained 14.0%. 89.5% of those who continued kept at least 80% of their earlier weight loss, compared with 16.6% of those on placebo. Individual results vary.
- SURMOUNT-MAINTAIN (Zepbound; The Lancet, 2026; funded by Eli Lilly): 378 US adults who reached their maximum tolerated dose (10 mg or 15 mg) over 60 weeks were randomized to stay on that dose, reduce to 5 mg, or switch to placebo for 52 weeks. From the start of the trial to week 112, average weight change was −21.9% for those who stayed on their dose, −16.6% for those reduced to 5 mg, and −9.9% for those on placebo. Rescue treatment for weight regain, allowed from week 84, was used by 8%, 25% and 67% of the three groups. The authors wrote that reducing to 5 mg "might provide a valuable alternative to discontinuation," while noting that individual treatment response might vary. Individual results vary.
The 5 mg result is for Zepbound; it says nothing about any dose of a compounded medication. For more on stopping, including the STEP 1 extension, see what happens when you stop a GLP-1.
What "maintenance dose" means on the Wegovy and Zepbound labels
On the FDA labels, the maintenance dose is the long-term weekly dose you reach after the starting and step-up doses. Both labels describe the medication as indicated "to reduce excess body weight and maintain weight reduction long term." The labels on DailyMed, checked September 24, 2026:
- Wegovy injection: starts at 0.25 mg once weekly and steps up every 4 weeks (0.5 mg, 1 mg, 1.7 mg) to a maintenance dose from week 17. For weight reduction in adults, the maintenance dose is "either 1.7 mg or 2.4 mg (recommended)." For patients who tolerate 2.4 mg for at least 4 weeks and need further weight reduction, the dose "may be increased to a maximum dosage of 7.2 mg."
- Wegovy tablets: 1.5 mg for the first 30 days, then 4 mg, then 9 mg, each for 30 days, then 25 mg as the maintenance dose.
- Zepbound: starts at 2.5 mg once weekly for 4 weeks, and "The 2.5 mg dosage is for treatment initiation and is not approved as a maintenance dosage." The dose can rise in 2.5 mg steps after at least 4 weeks on the current dose. "The recommended maintenance dosage is 5 mg, 10 mg, or 15 mg." If a patient does not tolerate a maintenance dose, the label says to "consider a lower maintenance dosage."
These are the doses on the labels of FDA-approved brand-name products. They do not apply to compounded semaglutide or compounded tirzepatide, which are not FDA-approved and are not therapeutically equivalent to FDA-approved products. Brand-name and compounded doses are not interchangeable, and there is no dose conversion between them; your provider determines the right dose based on your history. For compounded medication, the prescribing provider sets the dose.
Do you have to stay on a GLP-1 long term?
The Wegovy and Zepbound labels describe long-term use to maintain weight reduction, and in the brand-name trials above, which did not study compounded medication, people who stopped tended to regain weight while people who continued tended to keep it off. Individual results vary. That does not decide it for you: whether to continue, lower the dose or stop is a decision you make with your prescriber, based on your health, your goals, side effects and cost. If you are thinking about stopping, ask your prescriber what to watch for first.
What 12 months of treatment costs, by route
If insurance covers your medication, start with your plan's cost; if your coverage changed, our coverage guide covers appeals and other routes. If you have Medicare Part D and qualify for Medicare's GLP-1 Bridge, you pay a $50 copayment for a one-month supply of Wegovy, Foundayo or the Zepbound KwikPen through December 31, 2027 (CMS, checked September 24, 2026). That is likely to cost less than any cash-pay price in this table, including Cora's plans for compounded medication, which is not FDA-approved and is not therapeutically equivalent to FDA-approved products. The Bridge eligibility rules are in our coverage guide.
If you pay out of pocket, the table multiplies each published price out to 12 months. Brand-name prices are per LillyDirect, Lilly's Zepbound savings terms and NovoCare, checked September 24, 2026, and cover the medication only: you also need a prescription from your own prescriber. LillyDirect and NovoCare sell a month of injections as a 28-day fill, so a year is 13 fills. The totals assume today's prices hold for 12 months, which is not guaranteed: NovoCare says its pricing will be updated after December 31, 2026. Only maintenance doses are shown; starting doses are not.
The Cora rows are compounded medications, which are not FDA-approved and are not therapeutically equivalent to FDA-approved products. This table compares prices, not products.
| Option | Published price | 12 months at today's prices | Notes |
|---|---|---|---|
| LillyDirect: Zepbound vial, 5 mg | $399 per 28-day fill (four vials) | $5,187 (13 fills) | FDA-approved. No published end date. Needles and syringes sold separately. |
| LillyDirect: Zepbound vial, 7.5 mg to 15 mg | $449 per fill on the first fill and on refills within 45 days of your previous delivery; otherwise $499 (7.5 mg) or $699 (10 mg to 15 mg) | $5,837 if every refill is within 45 days; $9,087 at the $699 regular price (10 mg to 15 mg) | FDA-approved. No published end date. Needles and syringes sold separately. |
| LillyDirect: Zepbound KwikPen, 5 mg or 7.5 mg to 15 mg | $399 or $449 per fill (same 45-day rule) | Not calculated: the KwikPen self-pay program allows up to 11 fills a year and ends December 31, 2026 | FDA-approved. Pen needles sold separately. |
| NovoCare: Wegovy pen, 1.7 mg or 2.4 mg | $349 per fill (one box of four pens) | $4,537 (13 fills) | FDA-approved. Pricing to be updated after December 31, 2026. |
| NovoCare: Wegovy HD 7.2 mg | $399 per fill | $5,187 (13 fills) | FDA-approved. Pricing to be updated after December 31, 2026. |
| NovoCare: Wegovy pill, 25 mg | $299 per 30 tablets | About $3,638 (365 days) | FDA-approved. Pricing to be updated after December 31, 2026. |
| Cora Health Essential Plan (compounded semaglutide) | $99/month on the annual plan ($1,188 billed every 12 months); $120/month on the 6-month plan ($720 every 6 months); $145/month quarterly ($435 every 3 months); $175 month-to-month | $1,188 (annual); $1,440 (6-month); $1,740 (quarterly); $2,100 (month-to-month) | Compounded by a US-licensed 503A pharmacy: not FDA-approved and not therapeutically equivalent to FDA-approved products. Includes the provider consultation, medication, shipping and ongoing monitoring; the price does not change with your dose. Renews automatically until you cancel. Prices may change. |
| Cora Health Premium Plan (compounded tirzepatide) | $135/month on the annual plan ($1,620 billed every 12 months); $175/month on the 6-month plan ($1,050 every 6 months); $199/month quarterly ($597 every 3 months); $225 month-to-month | $1,620 (annual); $2,100 (6-month); $2,388 (quarterly); $2,700 (month-to-month) | Compounded by a US-licensed 503A pharmacy: not FDA-approved and not therapeutically equivalent to FDA-approved products. Includes the provider consultation, medication, shipping and ongoing monitoring; the price does not change with your dose. Renews automatically until you cancel. Prices may change. |
Looking past 12 months
Cora's plans renew automatically until you cancel, so at today's prices, 24 months on the annual plan comes to $2,376 for compounded semaglutide and $3,240 for compounded tirzepatide. Prices may change. Compounded medications are not FDA-approved and are not therapeutically equivalent to FDA-approved products.
We don't show 24-month totals for brand-name self-pay: NovoCare has not published its pricing for after December 31, 2026, and Lilly's KwikPen self-pay program ends that day. Novo Nordisk has announced that it will lower the list price of Wegovy (the 2.4 mg injection and 25 mg tablets) to $675 on January 1, 2027, and says the change does not affect its self-pay prices (Novo Nordisk, February 24, 2026). A list price is not what a self-paying patient pays.
Where Cora fits
If you are weighing compounded medication, Cora connects patients with licensed providers at Wasef Health, PC, who may prescribe compounded semaglutide or compounded tirzepatide when it is appropriate; a US-licensed 503A compounding pharmacy prepares and dispenses the medication. Cora does not prescribe or compound medication. Compounded medications are not FDA-approved. They are prepared by state-licensed pharmacies based on a valid prescription from a licensed provider. Compounded medications are not therapeutically equivalent to FDA-approved products. Brand-name and compounded doses are not interchangeable, and there is no dose conversion between them; your provider determines the right dose based on your history. Plans start at $99/month for compounded semaglutide and $135/month for compounded tirzepatide on the annual plan ($1,188 and $1,620 billed every 12 months), and renew automatically until you cancel. Prices may change. Each price includes the provider consultation, the medication, pharmacy fulfillment, shipping and ongoing provider monitoring, with no separate membership fee, and it does not change with your dose, so it stays the same if your provider changes your dose. Cora does not bill insurance; HSA and FSA cards are accepted. Every tier is on the plans page.
FAQ: maintenance dose and long-term cost
What is the maintenance dose of Zepbound? The Zepbound label's recommended maintenance dose is 5 mg, 10 mg or 15 mg once weekly; 2.5 mg is a starting dose and is not approved for maintenance. Your prescriber chooses the dose. This is the label for the FDA-approved brand-name product.
What is the maintenance dose of Wegovy? For weight reduction in adults, the Wegovy injection label's maintenance dose is 1.7 mg or 2.4 mg once weekly, with 2.4 mg recommended; it may be increased to a maximum of 7.2 mg for patients who tolerate 2.4 mg for at least 4 weeks and need further weight reduction. The Wegovy tablet maintenance dose is 25 mg. Your prescriber chooses the dose.
Is there a maintenance dose for compounded semaglutide or compounded tirzepatide? Not on an FDA label: compounded medications are not FDA-approved and are not therapeutically equivalent to FDA-approved products. Brand-name and compounded doses are not interchangeable, and there is no dose conversion between them; your provider determines the right dose based on your history.
Does Cora charge more for a higher dose? No. Cora's price does not change with your dose. Every tier and its billed total is on the plans page.
Sources
Brand prices, labels and program terms last verified September 24, 2026. They change; confirm with the source before you decide. This article is general information, not medical advice. Wegovy® and Zepbound® are registered trademarks of their respective owners; NovoCare, LillyDirect, KwikPen and Foundayo are trademarks of their respective owners. Cora Health is not affiliated with Novo Nordisk or Eli Lilly.
- STEP 4: Rubino D, et al. JAMA. 2021;325(14):1414-1425. pubmed.ncbi.nlm.nih.gov/33755728
- SURMOUNT-4: Aronne LJ, et al. JAMA. 2024;331(1):38-48. pubmed.ncbi.nlm.nih.gov/38078870
- SURMOUNT-MAINTAIN: Horn DB, et al. The Lancet. 2026;407(10545):2305-2318, published online May 12, 2026. Funded by Eli Lilly. pubmed.ncbi.nlm.nih.gov/42119587
- DailyMed: Wegovy (injection and tablets) prescribing information, effective June 18, 2026 (checked September 24, 2026). dailymed.nlm.nih.gov
- DailyMed: Zepbound prescribing information, effective August 28, 2026 (checked September 24, 2026). dailymed.nlm.nih.gov
- Eli Lilly: LillyDirect Zepbound self-pay pricing (checked September 24, 2026). lilly.com
- Eli Lilly: Zepbound Savings Card and KwikPen self-pay program terms (checked September 24, 2026). zepbound.lilly.com
- Novo Nordisk: NovoCare Pharmacy Wegovy pricing and Wegovy savings offer (checked September 24, 2026). novocare.com
- Novo Nordisk: announcement of the January 1, 2027 list price reduction (February 24, 2026). prnewswire.com
- CMS: Medicare GLP-1 Bridge (checked September 24, 2026). cms.gov
Cora Health Content Team
Written by the Cora Health content team. This article covers business, pricing, or comparison information and was not medically reviewed; for clinical guidance, see articles labeled "Medically Reviewed."
Related reading
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new medication or treatment. Cora Health does not prescribe medication; licensed providers at Wasef Health, PC review every patient assessment and prescribe only when clinically appropriate.
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