Hierarchy of evidence for clinical claims
We weight sources in this order, and we say which tier a claim rests on when it matters:
- FDA labeling and FDA communications. The prescribing information for Zepbound, Mounjaro, Wegovy, Ozempic and Rybelsus; FDA drug shortage list decisions; FDA safety communications on compounded GLP-1 products; FDA guidance on compounding under sections 503A and 503B of the Federal Food, Drug, and Cosmetic Act.
- Peer-reviewed randomized controlled trials. The SURMOUNT program for tirzepatide (SURMOUNT-1 through SURMOUNT-5, SURMOUNT-OSA), the STEP program for semaglutide (STEP 1 through STEP 10 and STEP UP), SELECT, SUSTAIN-6, PIONEER and OASIS for oral semaglutide, and their DXA body-composition substudies, as published in the New England Journal of Medicine, The Lancet, JAMA, Nature Medicine and Diabetes Care.
- Regulatory and professional guidance. American Society of Anesthesiologists guidance on perioperative GLP-1 use; American Diabetes Association Standards of Care; Obesity Medicine Association position statements; state boards of pharmacy and medicine.
- Large observational studies and pharmacovigilance analyses. Used for rare adverse events where trials are underpowered, always labeled as observational.
- Manufacturer announcements. Used for pricing and availability, never for efficacy claims beyond the label.
We do not cite provider marketing pages for clinical claims. We do not cite social media, forums or influencer content for anything.
Sources for pricing
Pricing has exactly one acceptable primary source: the provider's own public pricing or plan page, opened by a member of our team on a recorded date. A dated third-party citation of the provider's own page can support a reported status; it cannot support verified. Press releases and coupon sites are not price sources.
First-party verification pass, August 25, 2026
Every provider record was checked against the provider's own current pages (plan pages, FAQs, terms, legal program listings) and official manufacturer and FDA pages. Rows marked verified cite the page checked; a provider's statements about its pharmacy, testing or coverage are recorded as provider-stated rather than independently confirmed. Where a provider's own pages conflicted with each other, the record was left unranked and the conflict noted.
Third-party price comparisons used as "reported" sources
Where we have not yet verified a price against the provider's own page, we may record a figure from a dated third-party comparison and label it reported. As of August 25, 2026 these are: an answer-engine (ChatGPT) citation of provider sites on August 25, 2026; a comparison page supplied to us with prices checked June 16, 2026; and a program directory supplied to us with price-check dates between July 20 and August 15, 2026; and Policy Lab's "Best Online Tirzepatide Compounding Providers Compared for 2026" (updated August 19, 2026), used for BMI MD, TrimRx, Raeliva, MyStartHealth, ReflexMD and IvyRx. Each reported row on the pricing page shows its date. A reported figure is never upgraded to verified without a direct check, and conflicting reports (as with Henry Meds) leave a provider unranked.
Sources for state information
Obesity prevalence comes from the CDC's Behavioral Risk Factor Surveillance System state estimates. Telehealth and pharmacy rules come from state statutes and board rules, with the National Association of Boards of Pharmacy directory as the index. Where a provider's coverage list is the source of a state claim, we say so.
How we handle uncertainty
When our knowledge of a price, a policy or a regulation may be out of date, we say so on the page rather than presenting the last figure we knew as current. Every figure that has not been directly verified is labeled. We would rather publish a labeled gap than an unlabeled guess.
Key primary references
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med. 2022;387:205-216.
- Aronne LJ, et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med. 2025.
- Aronne LJ, et al. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity (SURMOUNT-4). JAMA. 2024;331(1):38-48.
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384:989-1002.
- Lincoff AM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes (SELECT). N Engl J Med. 2023;389:2221-2232.
- Malhotra A, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity (SURMOUNT-OSA). N Engl J Med. 2024;391:1193-1205.
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. December 2024 and February 2025 updates.
- U.S. Food and Drug Administration. FDA's concerns with unapproved GLP-1 drugs used for weight loss. Ongoing safety communication.
- Prescribing information: Zepbound (tirzepatide), Mounjaro (tirzepatide), Wegovy (semaglutide), Ozempic (semaglutide), Rybelsus (semaglutide).
Citation lists on individual articles reference these and additional sources specific to the article.