Compounded tirzepatide programs in all 50 states, scored

Each program here makes the same promise in its own words: it serves all 50 states. That promise is the only filter. The Care & cost score, the starting-dose price and the order are carried over from the full compounded tirzepatide lineup.

Two kinds of reader get the most from this page. One lives in a state where fewer programs operate. The other expects to change address during treatment, whether that's a move, a second home or a long work posting, and wants a program that can follow.

Compounded tirzepatide is made by a pharmacy without FDA approval, and it does not receive FDA premarket review of safety, effectiveness or quality. Our scoring method explains how each program's points were set.

An all-state promise has two halves. A clinician licensed where you are writes the prescription, and a pharmacy has to fill it and ship it to your address. The second half is the one programs say less about.

Most states license pharmacies that ship in from elsewhere, so the pharmacy filling your vial should hold a license or permit for your state. You can look a named pharmacy up with your state board of pharmacy. That's one reason the Pharmacy chip carries real weight here: a program that names its pharmacy lets you check.

A program can also use more than one pharmacy and route orders by state. Then the pharmacy on your label may not be the one named on its homepage. Ask which pharmacy will fill yours, for your address.

A compounded vial's storage rules come from the pharmacy's own label, and when that label says to keep it refrigerated, delivery time to your state matters, especially in summer or to a rural address. Ask how the program ships and what happens if a package arrives warm.

• Covered: starting care from any state. The program says it can see a patient in each of the 50 states.
• Not covered: the same pharmacy everywhere. The promise doesn't say which pharmacy fills orders for your state.
• Not covered: the same price everywhere. A seasonal or intro price can be limited to some states. The price here is the program's standing month-to-month price.
• Not covered: every address. Washington, DC, Puerto Rico and military addresses sit outside a 50-state list. Ask if one applies to you.
• Left off this page. Programs listing 49 states or fewer, and programs that publish no state list, appear on the full tirzepatide lineup instead. They may still serve you.

Starting-dose prices here run $149 to $324 a month, with required fees folded in. At the middle price, $239, a year at the starting dose costs about $2,868 by our math. The two ends of the range are about $2,100 a year apart. These are annualized comparisons at unchanged starting prices, not the actual payments due in the first 365 days; dose changes, introductory offers and separate tests can change the budget.

Tirzepatide's dose usually steps up in the first months, so the starting price is where the bill begins, not where it settles. Plans that keep one price at every dose hold their price as you move up; plans priced by dose don't.

Across every program we track, 23 offer compounded tirzepatide at $85–$399 a month. On tirzepatide's band, each ten dollars off the monthly price is worth about 1.3 price points.

Ask whether shipping, cold packing included, is inside the plan price for your state or billed on top. The guide to where to get compounded tirzepatide covers the other places it's sold.

1. Which pharmacy will fill my prescription at my address, and is it licensed in my state?
2. How long does shipping to my state take, and is the vial packed cold?
3. Is the price I see the same in my state, including any sale?
4. If I move to another state mid-plan, do refills keep coming without a new consult fee?
5. Can I pause shipments while I travel, or send a refill to a different address?