Paying cash, you have two brand routes. LillyDirect self-pay single-dose vials are the cheapest: roughly $299/month for the 2.5 mg starting dose, then about $449/month for the 7.5 mg-and-up maintenance doses — but only if you buy each refill within 45 days of the previous fill. Miss that 45-day window and the maintenance price rises to about $699/month. The retail pharmacy list price without any program is near $1,086/month.
The Zepbound Savings Card does NOT help here — it requires commercial insurance that already covers the drug. Compounded tirzepatide through licensed telehealth is often lower (~from about $99/month all-in) but is not FDA-approved as a finished drug and quality varies by pharmacy, so weigh price against that trade-off with your prescriber.
Compare the all-in monthly cost — medication plus any visit or membership fee — not just the vial price. Prices are estimates as of July 2026 and change without notice; confirm current LillyDirect pricing at zepbound.lilly.com before you order.