Ozempic vs. Mounjaro vs. Wegovy vs. Zepbound: Which Costs Less and Works Better?
Four brand names, two medicines. Ozempic and Wegovy are semaglutide; Mounjaro and Zepbound are tirzepatide. Which one you get comes down to three things: whether you have type 2 diabetes, how you'll pay, and how much weight loss you need. Here's the head-to-head data, the real 2026 prices and a decision tree to find your route.
Medically reviewed Medically reviewed by Christine Manzi, RPh — NPI 1275223448 · Last updated 2026-11-09
These are two medicines under four names: Ozempic and Wegovy are semaglutide, and Mounjaro and Zepbound are tirzepatide. Ozempic and Mounjaro are approved for type 2 diabetes; Wegovy and Zepbound for weight loss. Tirzepatide produces more weight loss: 20.2% vs. 13.7% in the one head-to-head trial. Without insurance, the Wegovy pill ($149–$299) and Wegovy pen ($199, then $349) cost least, Zepbound is $299–$449, and Mounjaro has no cash program. On Medicare, Wegovy and the Zepbound KwikPen are $50 a month for weight loss through the GLP-1 Bridge.
Two medicines, four brands
Ozempic and Wegovy
Why the same drug has two names: each brand is a separate FDA approval for a separate condition, at its own doses, with its own pens and insurance rules. The name on your prescription decides which coverage and savings programs apply. Tirzepatide works on two gut-hormone receptors (GIP and GLP-1); semaglutide works on one. That's the main reason tirzepatide produces more weight loss.
Side-by-side at a glance
| Ozempic | Mounjaro | Wegovy | Zepbound | |
|---|---|---|---|---|
| Medicine | Semaglutide | Tirzepatide | Semaglutide | Tirzepatide |
| Approved for | Type 2 diabetes | Type 2 diabetes | Weight loss, heart risk, MASH | Weight loss, sleep apnea |
| Weekly dose range | 0.25–2 mg | 2.5–15 mg | 0.25–2.4 mg (HD 7.2 mg) | 2.5–15 mg |
| Earliest top dose | Week 13 | Week 21 | Week 17 (2.4 mg) | Week 21 |
| Pill option | Yes | No | Yes | No |
| Cash price per month | $199 → $349–$499 | No program | $199 → $349 (HD $399) | $299–$449 |
| Commercial savings card | As little as $25 | As little as $25 | As little as $25 | As little as $25 |
| Medicare | Part D (diabetes) | Part D (diabetes) | $50 Bridge | $50 Bridge (KwikPen) |
| Pharmacy cost per month (NADAC) | ~$996 | ~$1,077 | ~$1,307 | ~$483–$676 (KwikPen) |
Weight loss: head-to-head results
In the only head-to-head trial, people on tirzepatide lost an average of 20.2% of their weight in 72 weeks, versus 13.7% on semaglutide.
Data: SURMOUNT-5 trial (New England Journal of Medicine, 2025)
Sources: Zepbound and Wegovy prescribing information (Wegovy pill: OASIS 4 trial). Bars scaled to 20.9%. Ozempic and Mounjaro aren't approved for weight loss; their diabetes trials show smaller losses (below), as people with type 2 diabetes lose less weight on any GLP-1.
- Tirzepatide leads at full dose. Zepbound 10–15 mg beat every semaglutide option in its trials, and won the direct comparison.
- Wegovy HD closes most of the gap. 7.2 mg reached 18.8%, for adults who tolerate 2.4 mg and need more.
- Lower doses still work. Zepbound 5 mg (15.0%) roughly matched Wegovy 2.4 mg (14.9%), at a lower self-pay price than Zepbound's higher doses.
- Stopping brings weight back. In Zepbound's withdrawal study, people switched to placebo regained 14% of their weight within a year. Plan for long-term cost.
Blood sugar: Mounjaro vs. Ozempic
Starting A1c 8.3%. 82–86% of people on Mounjaro reached an A1c under 7%, vs. 79% on semaglutide 1 mg. Ozempic's 2 mg dose wasn't part of this trial. Bars scaled to 11.2 kg.
Both lower A1c substantially; Mounjaro did more at every dose. Ozempic brings things Mounjaro doesn't: a kidney-disease approval for people with type 2 diabetes and chronic kidney disease, a pill form (Ozempic tablets, Rybelsus) and a cash-pay price. With good diabetes coverage, the decision is usually about tolerance, your kidneys and your plan's formulary.
Side effects compared
All four cause the same kind of side effects, mostly stomach-related and mostly in the weeks after each dose increase. The rates below come from different trials and populations, so compare within a row, not across rows:
| Medicine and dose | Trial population | Nausea | On placebo |
|---|---|---|---|
| Ozempic 1 mg | Type 2 diabetes | 20.3% | 6.1% |
| Mounjaro 15 mg | Type 2 diabetes | 18% | 4% |
| Zepbound 5–15 mg | Weight loss | 25–29% | 8% |
| Wegovy 2.4 mg | Weight loss | 44% | 16% |
All four
- Nausea, diarrhea, vomiting, constipation
- Less appetite, early fullness, burping
- Injection-site redness
- Hair thinning with rapid weight loss
All four labels
- Pancreatitis and gallbladder problems
- Low blood sugar with insulin or sulfonylureas
- Dehydration-related kidney injury
- Tell your team before surgery or sedation
All four labels
- Thyroid C-cell tumors in rodents; not for anyone with a personal or family history of medullary thyroid cancer or MEN 2
What each one costs
Sources: NovoCare, Lilly and Medicare GLP-1 Bridge terms; CMS NADAC survey of October 21, 2026. Not a quote from Arrow Pharmacy.
- Cheapest cash start: the Wegovy pill at $149 for the 1.5 mg month.
- Best value per pound lost: Zepbound. At $449 a month and 20.9% average loss, a year works out to about $258 per percentage point of body weight, versus $281 for the Wegovy pen. Full breakdown in our GLP-1 price guide.
- Insured? The $25 savings cards apply only with commercial coverage and are capped at $100–$150 a month. Details for all four are in our GLP-1 savings card guide.
- Arrow fills covered Zepbound with the $25 card but can't process Lilly's KwikPen self-pay card; for that route we'll point you to LillyDirect.
Which one fits your situation
Most weight loss
- Pick
- Zepbound 10–15 mg
- Why
- Won the head-to-head; 20.9% in its label trial
No needles
- Pick
- Wegovy pill (weight) or Ozempic tablets (diabetes)
- Why
- The only daily pill options among these four
Lowest cash start
- Pick
- Wegovy pill $149, or Wegovy pen $199
- Why
- Lowest published self-pay prices
Heart or kidney risk
- Pick
- Wegovy (no diabetes); Ozempic (diabetes and kidney disease)
- Why
- Approved for those outcomes
Connecticut note: HUSKY (Medicaid) stopped covering GLP-1s prescribed only for weight loss in mid-2025. It still covers them for type 2 diabetes, usually with prior authorization.
Switching between them
- Semaglutide ↔ tirzepatide: there's no official dose conversion. Your prescriber picks a starting point on the new drug's schedule, and you may get a new round of nausea as you step up.
- Wegovy pen ↔ pill: the only labeled switch. From the 2.4 mg pen, start the 25 mg pill one week after your last injection; from the 25 mg pill, start the 2.4 mg pen the day after your last tablet.
- Same molecule, different brand (Ozempic → Wegovy, Mounjaro → Zepbound): usually a coverage decision, done with a new prescription. Never use two GLP-1s together.
- Each strength is a new fill. Ask for the next one about a week ahead. Our dosing schedule calculator gives you the dates.
Call Arrow Pharmacy at (860) 522-9289. We'll check which of the four your insurance covers, what prior authorization it needs, and the cheapest way to pay, then have it ready when your prescriber sends it. Free delivery in the Hartford area.
Frequently asked questions
Is Wegovy the same as Ozempic?
Same medicine, different product. Both are semaglutide from Novo Nordisk. Ozempic is approved for type 2 diabetes (up to 2 mg weekly) and Wegovy for weight loss, heart-risk reduction and MASH liver disease (2.4 mg weekly, or 7.2 mg as Wegovy HD). They come in different pens, are covered under different insurance rules, and should never be used together.
Is Zepbound the same as Mounjaro?
Yes, both are tirzepatide from Eli Lilly at the same 2.5 to 15 mg doses. Mounjaro is approved for type 2 diabetes and Zepbound for weight loss and obstructive sleep apnea. Only Zepbound has Lilly's self-pay prices ($299 to $449 a month) and Medicare's $50 GLP-1 Bridge.
Is Zepbound the same as Ozempic?
No. Zepbound is tirzepatide, which acts on two gut-hormone receptors (GIP and GLP-1). Ozempic is semaglutide, which acts on one (GLP-1). They're made by different companies, approved for different conditions, and dosed differently, so switching between them isn't a milligram-for-milligram swap.
Which is better for weight loss, Zepbound or Wegovy?
In the one head-to-head trial, SURMOUNT-5, tirzepatide (Zepbound) produced 20.2% average weight loss over 72 weeks versus 13.7% for semaglutide (Wegovy). The Wegovy HD 7.2 mg dose narrows the gap: 18.8% in its own 72-week trial, versus 20.9% for Zepbound 15 mg in its label trial. Side effects, cost and coverage often decide it in practice.
Mounjaro vs. Ozempic: which lowers blood sugar more?
In the head-to-head SURPASS-2 trial (40 weeks, people with type 2 diabetes on metformin), every Mounjaro dose lowered A1c more than Ozempic's semaglutide 1 mg: by 2.0 to 2.3 points versus 1.9, with 7.6 to 11.2 kg of weight loss versus 5.7 kg. Ozempic has a pill version, a kidney-disease approval and a cash-pay price, which Mounjaro doesn't.
Which GLP-1 is cheapest without insurance?
By published cash price, the Wegovy pill starts lowest at $149 a month (1.5 mg) and is $299 at maintenance. The Wegovy pen is $199 for the first two months, then $349. Ozempic is $199, then $349 to $499. Zepbound is $299 to $449. Mounjaro has no cash-pay program. Per percentage point of weight lost, Zepbound works out among the best values despite the higher price.
Does Medicare cover Ozempic, Mounjaro, Wegovy or Zepbound?
For type 2 diabetes, Part D plans cover Ozempic and Mounjaro, and 2026 out-of-pocket drug costs are capped at $2,100. For weight loss, the Medicare GLP-1 Bridge (July 2026 through December 2027) offers Wegovy (pen or pill), the Zepbound KwikPen and Foundayo to eligible Part D members for $50 a month. Part D can also cover Wegovy for heart-risk reduction and Zepbound for sleep apnea.
Can I switch from Ozempic to Mounjaro, or from Wegovy to Zepbound?
Yes, with a new prescription, but there's no official dose conversion between semaglutide and tirzepatide. Your prescriber chooses where to start on the new drug's schedule, and you may get a fresh round of stomach side effects as you step up. The only labeled switch is within Wegovy: from the 2.4 mg pen to the 25 mg pill one week later, or from the pill to the pen the next day.
Which has the fewest side effects?
All four cause the same kind: nausea, diarrhea, vomiting and constipation, mostly when the dose goes up. Rates aren't directly comparable because the trials differed. In diabetes trials, nausea was 20% on Ozempic 1 mg and 18% on Mounjaro 15 mg; in weight-loss trials at higher doses, 44% on Wegovy 2.4 mg and 25 to 29% on Zepbound. All four carry the same boxed warning about thyroid C-cell tumors.
Can I get Ozempic or Mounjaro for weight loss?
They're approved for type 2 diabetes, and most insurers cover them only with that diagnosis. For weight loss without diabetes, the same medicines are sold as Wegovy (semaglutide) and Zepbound (tirzepatide), which are approved for it and have self-pay prices. Prescribing a diabetes brand for weight loss usually means paying without coverage.
Sources
- OZEMPIC (semaglutide) injection — FDA-approved prescribing information — U.S. National Library of Medicine (DailyMed) / Novo Nordisk
- WEGOVY (semaglutide) injection and tablets — FDA-approved prescribing information (revised June 2026) — U.S. National Library of Medicine (DailyMed) / Novo Nordisk
- MOUNJARO (tirzepatide) injection — FDA-approved prescribing information (revised August 2026) — U.S. National Library of Medicine (DailyMed) / Eli Lilly and Company
- ZEPBOUND (tirzepatide) injection — FDA-approved prescribing information (revised August 2026) — U.S. National Library of Medicine (DailyMed) / Eli Lilly and Company
- Tirzepatide bests semaglutide for weight loss in adults with obesity (SURMOUNT-5, NEJM 2025) — Healio Endocrinology
- Save on Wegovy (NovoCare self-pay pricing for the pen, Wegovy HD and the pill) — Novo Nordisk
- Save on Ozempic (savings card and self-pay pricing) — Novo Nordisk
- Zepbound coverage and savings (self-pay pricing and savings card terms) — Eli Lilly and Company
- Mounjaro Savings Card terms — Eli Lilly and Company
- Medicare GLP-1 Bridge: GLP-1 drugs for $50 a month (fact sheet) — Medicare.gov (CMS)
- Final CY 2026 Part D Redesign Program Instructions ($2,100 out-of-pocket threshold) — Centers for Medicare & Medicaid Services
- People call GLP-1s life-changing. CT says it can't afford them. — CT Mirror (March 2025)
- NADAC (National Average Drug Acquisition Cost) — Ozempic, Wegovy, Mounjaro and Zepbound pens, survey of October 21, 2026 — CMS