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The financial comparison (12-month cost): The decision tree: Choose insurance route if: Your plan has a copay (not coinsurance) under $100/month You've already completed step therapy for another reason You have time to wait 8-12 weeks for appeals Your deductible is already met for the year Choose compounded semaglutide if: Your plan requires step therapy you haven't started Your coinsurance would be over $300/month You need to start treatment within 2 weeks You've been denied once and don't want to appeal You're on a high-deductible plan and haven't met your deductible The break-even analysis: If your insurance approval takes 10 weeks and you start compounded semaglutide immediately, you get 10 weeks of treatment (2.5 months) for $742 to $867

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