Two molecules, four brands
Tirzepatide is sold as Mounjaro (type 2 diabetes, approved 2022) and Zepbound (chronic weight management, approved November 2023; obstructive sleep apnea, December 2024). Semaglutide is sold as Ozempic (type 2 diabetes, 2017), Wegovy (weight management, June 2021; cardiovascular risk reduction, March 2024; a daily tablet since December 2025) and Rybelsus (an older daily tablet for diabetes). The pens within each pair are the same drug at overlapping doses; what differs is the indication on the label, which decides insurance coverage, and the price channel.
Effect
In SURMOUNT-5, the only head-to-head trial, tirzepatide produced 20.2% mean weight loss over 72 weeks against 13.7% for semaglutide 2.4 mg. SURMOUNT-1 (tirzepatide 15 mg) reported 20.9% at 72 weeks; STEP 1 (semaglutide 2.4 mg) 14.9% at 68 weeks; the Wegovy pill at 25 mg 13.6% at 64 weeks in OASIS 4. Semaglutide has the cardiovascular-outcomes trial (SELECT: 20% relative reduction in major adverse cardiovascular events) that earned Wegovy its second indication; tirzepatide's outcomes trial (SURPASS-CVOT) reported in 2025 in diabetes, and its obesity-outcomes data are pending. The tirzepatide and semaglutide references carry the trial detail and the cost-per-percent article the arithmetic.
Price without insurance, verified August 25, 2026
Zepbound vials through LillyDirect: $299 at 2.5 mg, $399 at 5 mg, $449 at 7.5 to 15 mg under the Self Pay Journey offer (refill-window conditions; $499 and $699 regular prices otherwise; terms stated through December 31, 2026). Wegovy pens through NovoCare: $199 for qualifying new-patient initial fills, then $349. Oral Wegovy: $149 at 1.5 mg and at 4 mg through August 31, 2026 (then $199), $299 at 9 and 25 mg. Mounjaro and Ozempic have no comparable weight-management cash channel; prescribed off-label for weight they are billed at pharmacy list prices, typically $1,000 to $1,100 a month before discounts. The price history page records each change.
Insurance
Diabetes indications (Mounjaro, Ozempic) are covered nearly everywhere. Weight-management indications (Zepbound, Wegovy) are covered by some employer plans with prior authorization and excluded by many; Medicare covers Wegovy for cardiovascular risk and Zepbound for sleep apnea, with an obesity pathway announced for 2026. The insurance hub has the rules and the savings-card terms.
Pen, vial, tablet
Zepbound comes as a single-dose autoinjector pen, a KwikPen, and single-dose vials (the vials are the cash channel). Wegovy comes as a single-dose pen and as a daily tablet that must be taken on an empty stomach with a small amount of water. Ozempic and Mounjaro come as multi-dose and single-dose pens respectively. None requires the syringe arithmetic that compounded vials do, which is the concrete safety advantage of the approved products.
How to get each online
Any licensed clinician can prescribe any of the four; telehealth programs that navigate insurance (Ro, Calibrate, Form Health, WeightWatchers Clinic, LifeMD, Hims and Hers, Noom's brand plan) do the prior-authorization work for a fee, and the Zepbound and Wegovy pages list them. A cash patient can use any prescriber and buy through LillyDirect or NovoCare.
Brand versus compounded
Compounded tirzepatide and semaglutide are the same molecules prepared by compounding pharmacies, not FDA-approved, and priced at $125 to $170 (tirzepatide) and $88 to $139 (semaglutide) a month at verified flat-rate providers. The gap against brand cash prices is roughly $280 to $310 a month at maintenance doses for tirzepatide and $210 to $260 for semaglutide; what it buys is FDA approval, a fixed-dose device and settled legal status. The brand-versus-compounded guide and the oral Wegovy article work through the trade.
Frequently asked questions
What is the difference between Zepbound and Mounjaro?
The same drug, tirzepatide, made by Eli Lilly: Mounjaro is approved for type 2 diabetes, Zepbound for chronic weight management and obstructive sleep apnea. The pens deliver the same doses; coverage and price differ by indication.
What is the difference between Wegovy and Ozempic?
The same drug, semaglutide, made by Novo Nordisk: Ozempic is approved for type 2 diabetes at 0.5 to 2 mg weekly, Wegovy for weight management and cardiovascular risk reduction at 2.4 mg weekly (and as a daily tablet since December 2025).
Is Zepbound or Wegovy better for weight loss?
Tirzepatide produced more weight loss in the only head-to-head trial: 20.2% versus 13.7% over 72 weeks in SURMOUNT-5. Semaglutide has the cardiovascular-outcomes evidence (SELECT) that tirzepatide's trial has not yet reported.
How much do Zepbound and Wegovy cost without insurance?
Zepbound vials through LillyDirect: $299 at 2.5 mg, $399 at 5 mg, $449 at 7.5 to 15 mg under Self Pay Journey conditions. Wegovy pens through NovoCare: $199 for qualifying initial fills, then $349; the Wegovy pill from $149 by dose. Verified August 25, 2026.